Dr. Stephen J. Ronan

Top Doc Interviews Presents Dr. Stephen J. Ronan

Dr. Ronan was born at the Presidio in San Francisco. He was raised in Petaluma where he attended St. Vincent Grammar and High School. He graduated St. Vincent H.S. with more than 20 awards and scholarships. He participated in sports year round (football, basketball, baseball and tennis) throughout these years and was chosen for multiple All-Star teams, MVP awards, etc.

Dr. Ronan majored in Physiology at the University of California, Davis. Next, Dr. Ronan graduated from the Medical College of Virginia in Richmond, Virginia. Dr. Ronan continued his training (residency and fellowship) in general and then plastic surgery at the Medical College of Virginia. During his residency and fellowship, Dr. Ronan was chosen as the Chief Surgical House Officer at Columbia Hospitals (Chippenham, Johnston-Willis and John Randolph) for multiple years.

Dr. Ronan is Board Certified by the American Board of Plastic Surgery. He received the prestigious S. Dawson Theogaraj in 2000 for excellence in plastic surgery scholarship. He is a life member of the Heritage Society of the Medical College of Virginia, Virginia Commonwealth University. He is also a life member of the Maliniac Circle (Plastic Surgery Educational Foundation).

We recently caught up with him for a brief interview:

1. Can you start by telling us your name and provide me with your credentials.

Stephen J Ronan MD FACS

2. How long have you been practicing?

Since 2001. I was involved with another practice, but in less than a year I went out on my own and started Blackhawk Plastic Surgery and later the Blackhawk Surgery Center.

3. Do you have any affiliations with any of your local hospitals or does your office have a surgical suite?

I have both a surgery center accredited by AAAASF and Medicare, and then I have hospital affiliations with Valley Care Hospital and San Joaquin General Hospital.

4. What made you want to become a Plastic Surgeon as opposed to being another Surgeon?

Well, I actually thought I was going to do orthopedics from the time I was little. In medical school, I had done my research in orthopedics, and I also thought plastic surgery was pretty cool, but the training was so long and brutal that I was steering towards orthopedics, which has a shorter and easier residency. During medical school, the ortho rotation was fourth year, but they allowed you to do plastic surgery third year. I heard they taught you how to sew in plastics, so I thought I’d do a month for fun and go learn how to sew, and then go impress them in orthopedics fourth year with my stellar sewing ability! By the end of that month in plastic surgery, I knew what I was going to do for my career. The plastic surgery department was very good to me; they let me do a lot very quickly, and I ended up staying with them for 10 years for my training.

5. Would you consider yourself plastic, reconstructive or a cosmetic surgeon?

I am a plastic surgeon that does aesthetic surgery. I would say I do 95%+ aesthetic surgery. The reconstructive things I do are functional nose surgery, skin cancer reconstruction, breast reduction or occasional trauma. I don’t take any ER call. The emergency things I do are just patients of mine or friends that call me. But almost everything in my practice is aesthetic.

6. What are your most common surgery cases that you see in your practice?

Most common is breast: augmentation, augmentation with lift or revisions. Then it would be followed by tummy tuck, face lift and nose or rhinoplasty. Those are the most common things. I do a huge amount of revision surgery – either breast surgery that hasn’t gone well, body procedures, facial, nose. Doing so many revisional surgeries has really helped me get better at primary surgery because after seeing common themes of mistakes or judgment issues, it’s helped learn and avoid the pitfalls. I’ve learned some rules I should follow to avoid revisions. Revisional surgery can be a lot more challenging and in some ways more fun.

7. What is the most common question you get from potential patients about their surgical procedures?

Very common is questions regarding anxiety. They’re just nervous about it. Certainly, everybody asks me how long off of work. And then there’s just very specific questions depending on the procedure. But really, a lot of questions have to do with anxiety. If someone’s coming in for a revision, things didn’t go so well before, and so now, they’re really nervous about redoing it because they don’t want things to go poorly a second or fourth time.

7-A. So say if a breast augmentation revision comes in, how do you essentially quell their concern with them being nervous about it?

There’s some things I can do, and there’s some things I can’t. So if I can kind of convey to the why they are where they are. Maybe they made a decision to cut a muscle, and then the consequences of that. So if I can, in a more engineering fashion, get them to see exactly what happened and why it happened, they have less fear. You have to do this in a non-judgmental way. If I can get them to see all that, they typically gain a lot of confidence in the repair I propose. The stories from the patients are often the same. A lot of times you could blindfold me, have the patient can come in and start telling me their concerns, and I could tell you where things went wrong and what procedure we’re going to need to do to correct it. I can usually ask a few questions and pinpoint what the problem is without even seeing them. The same kind of problems tend to recur, and they fit into categories. So I think as patients figure out that I can drill down and very quickly explain exactly why, that usually gives them a lot of confidence in the corrective or revisional surgery.

8. What separates you or truly makes you stand out in regards to Plastic/Cosmetic Surgery from your competitors?

Certainly volume, we do a high volume. We have the premier facility in the area. It’s really pretty spectacular; it’s 6500 square feet and I’m the only surgeon, so it’s a pretty nice place. My revision rate is very low. We’re extremely efficient time wise in the OR, which is good for patients. A lot of guys book tummy tucks for three to four hours; we usually do them in 60 minutes. I have the same crew every single time, so it makes everything just more efficient.

9. What if any trends do you see in the next few years for aesthetic Surgery?

With regards to faces, I’ve never been a fan of the traditional face lift which most people do. The reason why is they are essentially trying to just tighten things up – make a long incision, lift up skin, and then cut out a lot of skin – and it’s not what the problem is. The problem isn’t that their face is loose; it’s that it has become empty. So I do short-scar face lifts where it’s about a third the length of a traditional face lift scar, and the surgeries are completely natural looking. I had someone come in last week who didn’t see her mom for about four months after the surgery and then saw her on the east coast. And her mom is commenting to her about how great she looks, but even her mom doesn’t know she had surgery! Then she went back for a high school reunion and nobody knew. She felt great, looked great. So the trend is going to be moving toward short-scar techniques and using fat as a filler in the face in conjunction with everything else.

Noses aren’t radically changing; they’re pretty solid now. The key is to do an open or structure rhinoplasty versus the old school closed or reduction rhinoplasty. Noses are one of the more difficult procedures which is why some plastic surgeons don’t even do them.

With breasts, we’re seeing significant shift back into silicon. We’re probably 90% silicone now. I typically do augments through the armpit, even with silicone. So they don’t have to have a scar on their breast. That’s always a huge plus.

Lasers keep getting better. We do Pearl Fusions. We have done more of them than anywhere in the country. We have never had a significant problem with them. Zero hypopigmentation.

10. What advice would you give your prospective patients that will read this interview prior to considering Plastic/Cosmetic surgery?

They certainly need to do their homework and get the right credentials. This means a surgeon certified by the American Board of Plastic Surgery. They want to make sure that it’s a place that does a lot of whatever procedure it is that they want. There’s plastic surgeons that do hand surgery and microsurgery. I would not go to them for a facelift or a breast augmentation or revision. But if you slash your finger, and you need it replanted or nerve surgery, then you want to go to someone who does those with some regularity. That’s kind of important because there’s a number of hospital-based guys that kind of dabble in aesthetic surgery, and so it’s important to explain to people that you want to go where they do a lot of what you want.

I think you want to go to a great surgery center as opposed to going to a hospital where infection rates are higher. The other thing about it is the sort of TLC you get at a surgery center like ours is not even in the same league as what you get at a hospital. It’s a personal level of care as opposed to having 20 different people come by and grab your chart, look at it and ask you a question. My shortest term employee is six years.

11. What have you been noticing in marketing trends (how practices are marketed) for Plastic Surgeons over the last few years?

If we go back to when I started my practice, it’s been quite a bit of changes. So back in 2001, people had websites, but they really didn’t know how to use them very well. They were very rudimentary back then. I kind of got out front, I think, on websites when I was just starting out, which was very helpful. And then back then, we saw the birth of the directory sites – so one supersite on plastic surgery or just breast augment or just whatever, and they would try to generate leads and surgeons could buy real estate on that site. So those started growing, and way back then, they were very effective early on. I would try to buy the real estate in my area for all of the sites, and I might even pay extra to be exclusive. That was very, very helpful. But the directory sites have really lost value in general – a lot.

And now it’s all about internet marketing, which is very complicated. It’s tough to do on your own anymore. I used to manage all of that stuff. Back when I just started my practice, I did everything. I left a two-man practice that was relatively busy. In about 5 years, I did 50% more than the best year those two guys had ever done combined. At that point we tried many different types of marketing but the website and directories were most effective. And then I built my surgery center and my whole office complex. So by 2005, I was under the one big complex, which is where I’ve been ever since.

12. What would you say has been the most effective marketing for your practice so far?

Certainly word of mouth, but if you take out those types of things, it’s going to be internet advertising.

13. Most surgeons have stated the Internet is the future of their practice in terms of marketing… Why do you think so many Plastic/Cosmetic surgeons are betting their practice on the internet?

I used to do one of the glossy magazines – nice, glossy, regional magazines. Almost everybody was in it at $3,000 a month or so. And I kind of sat back and thought, “everybody’s in it. What’s making yourself different? And it’s expensive.”And now, $3,000 a month might touch a million people online, and you can push it to people who are interested in what you’re selling. It’s not just a blanket of people anymore; you can pick gender and age and what they’re searching for. It’s way more specific.

14. If you could give the other Plastic/Cosmetic surgeons that will be reading this article one piece of marketing advice that would help them get more patients and build a thriving practice…. what would that be?

I can tell you what I did, and you can do the exact same thing. So I started off, I essentially had nothing. I left this other practice – and quickly. I went into work and saw some things, and I knew I was not going to go back to that office. So I took a box and packed my desk up, and I printed off some sheets for my post-opps over the next few weeks and walked out, knowing I wasn’t coming back.

I ended up working out of my car for a week, week and a half, going and seeing patients all over, and then found an office. It was a real estate office, and I made it into my office. I took all the furniture out of my house and put it into this office. And everything I made, I put into marketing – all those directory sites and built my site – and kind of got the ball rolling. My marketing budget has gone down over time, not up. So that’s essentially what I did. If I was doing it today, I would do largely internet

marketing and just put every penny you can into it until you get enough of a base that it feeds itself.

Thank you for your time today Dr. Ronan. I know the Audience of “I Love Plastic Surgery” is going to love this and that it’s really going to help patients make a better decision regarding the choice of their surgeon and assist other surgeons in helping them market their practice.

If you would like to know more about Dr. Stephan J. Ronan and Blackhawk Plastic Surgery please visit http://blackhawkplasticsurgery.com/ or contact him at (925) 736-5757 for a free consultation.