Alumna Janet Neigel, an oculofacial plastic surgeon, divides her practice between treating facial injury and disease and elective cosmetic procedures
Rutgers graduate Janet Neigel has a unique, hybrid medical practice. She is an oculofacial plastic surgeon, a certified ophthalmologist who specializes in plastic surgery of the eyes and face. After years of practicing solely reconstructive medicine, Dr. Neigel now divides her time between treating facial injury and disease and elective cosmetic procedures. One day, you might find her in her surgical suite repairing a facial fracture of a car crash victim or removing a tumor from an eye socket. On another, she might be performing a upper eyelid blepharoplasy or a mid-face lift or rejuvenating a patient’s skin with injectable fillers or spa treatments. Rutgers Today spoke with Dr. Neigel about her practice, how she got there and the business of cosmetic surgery today.
Rutgers Today: Did you always want to be a doctor?
Dr. Neigel: I would never have predicted I’d end up doing what I do today; but looking back, I can see where it might have come from. My mother worked as a medical receptionist – my Dad was a carpet salesman –and I visited her a lot at the office. I grew up in Maplewood, the oldest of four girls. and it was my job to take care of my sisters after school. I was a Girl Scout and into getting badges. I loved taking things apart and fixing them.
Rutgers Today: Were you pre-med at Rutgers?
Dr. Neigel: I graduated with honors in biology from Douglass College in 1976 and had thought about medical school, but at least initially, I didn’t want to make the sacrifice to get there. I had to work my way through college as a waitress, and being pre-med would have meant doing 24/7 in the library. Then, shortly after graduation one of my school study partners said, “What do you think about applying to med school in the Philippines together?” ‘Why not?’ I thought. My grades and MCATS were okay, but not great, and it turned out that my friend got in and I didn’t. That’s when I decided to go for a master’s in medical photography at the Rochester Institute of Technology. And then, the week before I was to begin, I received a call from Manila offering me a spot at the school. The decision to go – becoming one of three American women out of a class of 250 students, the majority of them Filipinos – determined my career. I stayed for two very interesting years and then transferred to UMDNJ in Newark.
Rutgers Today: What is oculofacial plastic surgery and what made you decide to specialize in it?
Dr. Neigel: Oculofacial plastic surgery is reconstructive surgery that involves the areas surrounding the face and eyes. Surgeons with this specialty treat diseases and problems involving the eyelids; the lacrimal (tear) system; the socket; and the orbit (the region surrounding the eyeball). During medical school I found myself attracted to three specialties – dermatology, plastic surgery, and otolaryngology – and it all came together when I did a post- fellowship year in orbit and oculofacial plastics at the University of British Columbia. There, I trained with a cranio-facial team operating on patients with congenital facial or skull defects and victims of sports injuries, car accidents, fights, or other trauma.
Rutgers Today: What makes you well suited to this specialty?
Dr. Neigel: I’m not squeamish and I stay calm under pressure. When I opened my first practice in New Jersey in 1986, I worked out of United Hospital in Newark, where I treated gun shot wounds and facial fractures and had to remove my share of eyes. I also take pride in my craft and get a great deal of satisfaction helping my patients look and feel better.
Rutgers Today: Are there any traumatic care cases that stay with you, patients who affected you emotionally?
Dr. Neigel: One young woman found me on the internet and came from India to be my patient. She had a great deal of facial hair and hyper pigmentation. The first time I met her in the office, she sat with her head down, barely able to make eye contact. After a few treatments, her appearance improved dramatically, along with her confidence. The last I heard from her, she’d gotten married and had a baby. Another girl, 7 years old, arrived from South America with an orbital tumor in her sinuses. You could see it bulging. Working with a pediatric neurosurgeon, I had to remove her eye and eye socket to get to the tumor, but she didn’t lose the eye. She has scarring and the eye doesn’t function 100 percent, but she’s now an oncology nurse at St. Barnabas Hospital in Livingston. Not long ago I attended her wedding.
Rutgers Today: What made you turn your expertise to elective cosmetology?
Dr. Neigel: I saw my first wrinkle. It’s actually true but only part of the reason. I was influenced by one of my medical school professors involved in early trials of Botox. I believed it to be the miracle drug of the ‘90s – and not just for wrinkles. Botox was first approved for strabismus (crossed eyes) and blepharospasm, a benign, neurological disorder involving contractions of the muscles around the eyes. They’ve been discovering new uses for Botox ever since, for conditions as varied as vocal cord dysfunction and diabetic neuropathy.
Rutgers Today: How many patients do you see a week and for what types of procedures?
Dr. Neigel: I see about 60 to 70 patients each week at my main surgical suite in West Orange and in offices in Jersey City and Morristown. Half of my patients’ cases are reconstructive, and the other half cosmetic. The average age of my cosmetic patients is between 35 and 55 and 75 percent of them are women. I do about two dozen different types of procedures, a lot of laser skin resurfacing, injectable dermal fillers, mini-facelifts, and liposuction. But by far the most popular treatment is botulinum toxin A, better known as Botox. Botox and its twin sister, Dysport, are less expensive than surgical solutions. People can’t afford the expense of more complicated procedures or the down time. The average cosmetic patient makes less than $100,000 a year. He or she is middle class, with a full-time job and kids at home.
Rutgers Today: Has the economy affected business?
Dr. Neigel: Anyone who tells you the recession hasn’t hurt cosmetic surgery is lying. A recent study found most of the big-ticket items, like liposuction and tummy tucks, had declined dramatically, but the less expensive, shorter-term treatments, like lip plumping and Botox, are holding relatively steady. People are coming in for these treatments not just for vanity, but because they are concerned about the future. They are going through a divorce, looking for employment, or are worried about job stability. They tell me that they don’t want to look tired and haggard. I am very sensitive to the state of mind of my patients and explain that while a procedure can help them look more youthful and attractive, it will not take them back to where they were 20 years ago. I tell them, “Think five years.”
Rutgers Today: What’s the greatest next thing on the horizon?
Dr. Neigel: Sculptra, sometimes called “the liquid facelift,” has been gaining popularity since it was approved last July. It’s a synthetic injectable that allows me to restore volume to the sunken parts of the face, achieving facial balance and restoring a youthful look in a way that is much more subtle and longer lasting than what has been possible with other traditional fillers.
Rutgers Today: What do you do for fun?
Dr. Neigel: I have three kids ages 8 to 12 and they keep me pretty busy. I love to travel and have made it Hong Kong, Bali, Japan, Korea and Thailand in recent years. True relaxation for me is reading. I like biographies and the occasional trashy beach novel.