RX11_John Paul Tutela, MD, Founder, Tutela Plastic Surgery: Audio automatically transcribed by Sonix

RX11_John Paul Tutela, MD, Founder, Tutela Plastic Surgery: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Narrator:
ForbesBooks presents: Entrepreneur RX, with Dr. John Shufeldt. Helping health care professionals own their future.

John Shufeldt:
Hello and welcome to another edition of Entrepreneur RX, my name is John Shufeldt, and I'm thrilled today to have the guest of John Paul Tutela. Doctor Tutela is a board-certified plastic surgeon, he has offices in New York and New Jersey, he's been featured in places like the Daily Mail and Reader's Digest, and it became the kind of the go-to plastic surgeon in the country after one of the cast members of Jersey Shore had a mommy makeover from him. John, I mean, how often do you have to say that. John, welcome to the show!

John Paul Tutela:
Thank you. Thank you so much for having me. Great to be here.

John Shufeldt:
So before we talk about how you literally became elevated to this, to this stature, give us a little bit about your background. You know, I read about you and this is really interesting, you have three generations of physicians that you're, in your family, is that correct?

John Paul Tutela:
Yes. Yeah, it is. So I grew up in northeastern New Jersey. My grandfather was the first one to go into medicine. And coming up, no, actually just maybe two or three years ago would have been 80 years of the Tutela family delivering medicine in New Jersey. And he was a general practitioner, and back then, general practitioners also operated. They would do appendectomies and forceps deliveries, so he also performed surgery as well. His son, my father, Rocco Tutela, was a plastic surgeon and was kind of my inspiration to kind of go into the field. I think I wanted to be a plastic surgeon before I even knew what it was. I just wanted it to do whatever dad did. In my generation, actually, my two, I have two brothers and they're both surgeons as well, so the three of us went into medicine and all of us performe surgery, one of them does eye surgery, the other one is general surgeon, and I'm a plastic surgeon.

John Paul Tutela:
That is, I mean, that has to be, you have to be one of the few families in the U.S. who have three generations, really all surgeons. Where did your grandfather go to medical school? I have such an interest in this.

John Paul Tutela:
Sure, he went to medical school at Loyola. And then my father went to medical school in Bologna, Italy, and I went to medical school in New Jersey Medical School in Newark.

John Shufeldt:
I mean, your dad and plastic surgery now, so I've been in medicine for, I don't know, I left, graduate, left and graduate of medical school in 86.

John Paul Tutela:
Yeah.

John Shufeldt:
He must have been one of the pioneers of plastic surgery, your father.

John Paul Tutela:
You know, he was, he was definitely, you know, early on in the field. But they were definitely a generation or two of the pioneers of the field that really kind of brought it as a forefront, as its own specialty. But certainly, you know, he did a lot of things that were very early on in the field with cosmetic surgery and a lot of reconstruction as well.

John Shufeldt:
That is interesting. Now you, it looks like you did, was it five-plus-two when you were doing it? Five years a general, two years of plastics?

John Paul Tutela:
Yeah, actually three years of plastic surgery. My year, that I graduated or started that training, was actually the first year they mandated all plastic surgery residency be changed to three years of a dedicated plastic surgery, so it was five and three.

John Shufeldt:
Wow. And now, as I have some, you know, I have some mentees have done another straight plastic surgery residencies, right, are they six years plus?

John Paul Tutela:
Yes.

John Shufeldt:
But it's basically a year general and five years, interestingly, that will save you a few years, huh?

John Paul Tutela:
Yeah. Yeah, yeah, that certainly would have gotten you out in the workforce a little sooner. The combined programs are all, I think, six years now, and there's kind of a mix of how many years are dedicated to plastic surgery. It has to be at least three. Some of them try and get a hold of their residents earlier and earlier, so they're doing more and more just plastic surgery.

John Shufeldt:
Interesting. You know, it's funny, I was telling Joe, the moderator of all this, I never even considered plastic surgery in medical school, and I don't even know why, because it to be such a cool field. But it never even crossed my radar, probably because I didn't know anybody who did it and certainly didn't have a father who did, so it's really interesting that you have that very early introduction to such a, you know, to what became your life's, you know, your lifelong career.

John Paul Tutela:
Yeah, sure. You know, I'm so grateful to have the influence that I did. And it's interesting too, my father having, you know, three sons that went into medicine never really pushed it on us at all. You know, I always just said, whatever you want to do, just make sure that you work hard at it, that you put in the time and effort. I think it kind of just rubbed off a little bit more by example that we kind of wanted to be doing what he did.

John Shufeldt:
That's actually, you know, usually it's exactly right. Usually when you push you, when you push kids into it, it's the last thing they end up wanting to do. But if you say, hey, it's here if you want it, and they're like, yeah, of course I want it, that's really cool. All right so I got to ask you this, and you probably get asked this millions of times, so in 2016, somehow Snooki came to you. Tell us about, that had to be a hysterical story. How did that happen?

John Paul Tutela:
You know, she just reached out to me, we had a mutual friend that had had surgery from me before, she had a little bit more surgery, it was a breast and tummy. She had a wonderful experience. And when she found out that Nicole or Snooki was looking to have surgery for a mommy makeover and, you know, some cosmetic breast surgery, she pointed in my direction. They both came to the office, you know, and it just, you know, kind of took off naturally from there.

John Shufeldt:
Now and you also did. I always use to laugh, I used to do this to my son, I lift up my shirt and say, look, you know, look on the situation. You also did surgery on Mike Sorrentino as well. Or maybe not surgery, did something on him.

John Paul Tutela:
Yeah, yeah. So, you know, he was referred also then now from Nicole after she had a great experience. And Mike's fiancée at the time or a girlfriend at the time, and then they got engaged, wanted to have some breast augmentation. So she came to me, that's when I met Mike and I started doing some injectable, you know, just botox and kind of skincare stuff for Mike as well. And they're great. They're wonderful to have in the office. So sweet and kind and insightful in so many different ways. They're really just a great group.

John Shufeldt:
That's, you know, it's interesting because, you know, I've heard from my plastic surgery friends, and you'll have to give me your own experience with this, but the key, one of the keys of plastic surgery is knowing who not to operate on. Is that still ring true?

John Paul Tutela:
Sure. Absolutely. You know, I think it's a challenge, you know, because sometimes the red flags are not necessarily, you know, shouting at you. But one of my mentors always said, listen to your staff because a lot of times people's personalities are very different when they're in front of the doctor compared to when they're kind of interacting with your staff. So absolutely, when you get those red flags, you know, you've got to find a way to kind of gently back out of, back out of a situation.

John Shufeldt:
You know, it's funny. For about 10 years, I owned a kind of a cosmetic sort of practice where we did, we had nurses and did injections and all the laser stuff, and then, I do some of it myself, but very little. But because this always rang in the back of my head like, A, do you really want to be doing this? And B, do you really have this sixth sense of knowing who not to do things on in the few times, oh my god, I should have listened to my gut. It must be harder to get out of it once you kind of once you get into. In other words, once you have the interaction with the person and you sit down with them, and then all of a sudden the red flags go off, what red flags do you look at? Because I think this has to be an art.

John Paul Tutela:
To be truly honest, I've been very lucky in my practice with my patients. Probably where it's actually come up the most is with injections. They have very, very high expectations of what their issue is. A lot of times they're hyper-focusing on something and making something such a huge deal that they're upset about something on their face, something that some other surgeon did, which is always another red flag when they're very upset at somebody else and when they're kind of blowing it out of proportion, it's kind of when you start to take a step or two back and realize, wow, this thing, which is a millimeter off, they're making it seem like their life is ruined over it. Then you start to realize, wow, how can I ever make this person happy? Maybe you'll try to just do as little as possible so you're not committing too much. And then, you know, if they come back and they want more, the phrase that I've used in the past is, I don't know that I can make you happy, you know, and it's just as simple as that.

John Shufeldt:
Yeah, so it's I think the problems are deeper than your skin is my favorite.

John Paul Tutela:
Yeah.

John Shufeldt:
It's one of my favorite, I can only go skin deep, but I think yours are probably deeper. You know, it's really, one thing about plastic surgery, I think that's so interesting, I was speaking to a dermatologist who is very well-regarded, Lily Talakoub, and she mentioned this and it struck me, is that you guys have to be very entrepreneurial because I think the vast majority of people coming out of plastic surgery is probably either going to practice or open their own practice, where did you learn this? Because then I've spent some time on your website. I've spent some time researching you. You're clearly entrepreneurial. How did you learn that?

John Paul Tutela:
You're absolutely right. A lot of plastic surgeons end up on their own. That's something in medicine that is not really talked about for other practitioners, which I think is a shame, you know, private practice and solo practice in every field used to be what everybody did. You know, the reality is in all of this training, and I was just talking about it with some people in the operating room yesterday, throughout all of this training, you know, four years of medical school, I did five years of general surgery, another year in a basic science lab, three years in plastic surgery, not one moment of all of those years and hours of training were dedicated to teach a doctor how to run a practice. Not even the first thing, you're not even taught how to bill for a procedure. It's almost ridiculous that through all that, all that training, you're not even taught like, how do you recoup any money for doing those operations or any sort of billable procedure or just seeing a patient, you know? And I really think it's a shame. And so I always, I guess I had a sense, just again, I had my father, he had his practice, he was a solo practitioner, my plans were to join him and just, you know, I guess, take over his practice. That did not come true, he passed away when I was still in general surgery training, but I knew that I wanted to set up like that. I wanted to have my own office, not really have anybody else to answer to. But in the same way, you know, obviously you're answering to your patients, you know, be able to build a practice and an experience for my patients that I had complete control over. And I felt just like the more control I had, the more I can kind of build that patient experience from the moment they call in to post-procedure, check-ins, and stuff like that. And so I just always knew very much that's what I wanted to do, and I really just started small. I was actually using my brother's office for about a year or two, where I would just kind of see patients in his office a couple of times a week and then go operate, and I didn't have a place on my own at all. And then even once I did build out my own office, we kept everything small. Some people want to build something big and magnificent. Now you have this big overhead, and that's one of those things that they don't teach you at all any sort of business acumen in training. But, you know, try to just keep everything kind of lean and mean, small place, small overhead, even staff wise, kind of kept things minimal and let things grow as the practice grew. And I think that's probably one of the most important things that people could glean, from at least my experience is keeping small, just get what you need and as you grow, then you can start building bigger things and doing bigger things and, you know, go from there.

John Shufeldt:
I think you hit it on the head. I think a lot of people do get out and borrow to the hilt and try to build a huge office, huge practice, open a surgery center as part of their office and all of a sudden they're underwater. And then COVID strikes and all of a sudden, everything... Everything shuts down. How did COVID affect your practice? I know in emergency medicine and you guys had a much worse than we did. Our ED volume went about 30 percent. How does it affect plastics practice and the hot spot of the country?

John Paul Tutela:
Yeah, sure. It stopped it, like a light switch, basically for about 10 weeks. You know, all elective surgery was essentially banned. So I couldn't do any of my cosmetic surgery and even the breast cancer reconstruction. Most of that also came to a stop, too, because a lot of the reconstructive part of it was able to be kind of delayed a little bit. So for 10 weeks straight, everything was off. So that was, yeah, that was scary. It really was, you know, I never thought in my lifetime I would be, you know, out of work. You know, I could, you know, I thought, you know, in the beginning, you know, it's going to take a little while to get things moving and, you know, things will be slow. But once you know you're five or six years in and things are kind of humming along, to get turned out like a light switch was startling. And then there was the question, you know, once we're allowed to get back to it, you know, what are, what are patients and people's appetite for cosmetic procedures going to be? You know, maybe people, you know, don't care about it anymore. Luckily, they did. And actually, people, I would say cosmetic procedures across the board have probably increased my practice at least 50 percent from pre-COVID, which is a pretty big bump.

John Shufeldt:
It's interesting you said that, you know, I thought emergency medicine was recession-proof and I'd always use you guys as the other side of, I said unlike plastic surgery, I think emergency medicine is recession proof, but it wasn't COVID proof, and we had friends across the country being laid off in emergency departments because of patients just stopped coming in and had the exact same perspective you did, now that they've realized they don't really need emergency medicine as much as they thought they did, when they come back and they have come back, and it sounds even more interesting that they came back in droves to plastic surgery. I wonder why that is.

John Paul Tutela:
I think a lot of it has to do, you know, I guess a couple, a couple of different factors. One, I think some people had some money that they weren't spending. Now, all of a sudden, for a year, most people weren't going out to dinner and no vacations and this and that. So they had some money around, you know, especially if they were in a job that they were able to keep. And, you know, Zoom meetings has definitely been a factor that a lot of my patients have, you know, at least verbalized to me. You know that now all of a sudden, they've been spending hours and hours a week staring at themselves on a computer screen, you know, probably in bad lighting, and they're like staring at different parts of their face that they're realizing they don't really like to look at. So that definitely has driven the injectable part of the practice, for sure.

John Shufeldt:
You know what, I never. That's classic. I never would have thought of that. You know, I get on zoom, ... A human Shar-Pei. So I'm like, okay, interesting, I'm not it, I'm not young anymore. I'm going to probably have to fly out and see you. I mean, if Snooki can do it, I can do it. So changing, changing tax here a little bit. So one of the things that I had in, you know, my very ridiculous cosmetic little business but we had a cool sculpting machine, which I thought was totally amazing. What do you see coming down the pike in kind of the med-tech thing that's going to materially change your practice?

John Paul Tutela:
Sure. I think the two biggest things right now that people are really trying to get their minds wrapped around as far as devices go, things that are looking a little bit more and more promising, and obviously, as time goes by, these things just get better, is skin tightening, non-surgical skin tightening, right now, a lot of it is radio frequency, RF devices, and I think they do an OK job that is just going to get better. And then there's two products out right now that are trying to aim at muscle building, one of them that I'm familiar with is called the Emsculpt. I don't I don't have the machine, but I had it in the office for a little while, to kind of trial, and it's pretty neat. And again, I think that's going to also kind of just get better and better, but basically sends pulses to your muscles, have them twitch, and after a half hour session, it mimics doing three thousand sit-ups or something like that.

John Shufeldt:
And I've actually seen that. I think on an infomercial, you put on your abdomen it just like your, looks like your abdomen to a small seizure.

John Paul Tutela:
Yeah.

John Shufeldt:
And then you get off like which is like a thousand sit-ups, which, you know, 50 sit-ups have already built me.

John Paul Tutela:
Yes.

John Shufeldt:
It's interesting, I'll have to look at that. Anything else coming down? Any surgical techniques that you see as the juicier will be, really revolutionary and how to approach certain areas?

John Paul Tutela:
You know, I think surgery is something that changes slowly. I don't think that there's anything, you know, that's so groundbreaking that is like a totally brand new way to do everything. I think a lot of what I do, especially with breast work, you know, a lot of what I do is breast lifts, breast lift with implants and a breast lift with implants is something that was traditionally really done in two surgeries. And where I trained with surgeon Bradley Calobrace, you know, we'd do it in one surgery. And he did probably more of these cases than maybe anybody in the world. So that's something that I really kind of took off with because I kind of really dedicated my time to learn how he did it and learn how to do it well, so that... But that's nothing new anymore. But that's something that I think was a big thing that happened maybe 10 or 15 years ago. But a lot of people still, I think, struggle with getting that right. And you know, there's other things that are always trying to be pushed like meshes and things like that to hold the implant in place. I use them, you know, only as needed. Some people use it for every single surgery, and we'll see how the long-term data is on that. But I think surgical procedures are things that are kind of slow to change just because a lot of the techniques are there. It's just a matter of being able to master them.

John Shufeldt:
One of the things I notice about you, John, is that you've really leveraged your social media. How did you do? And this would be the advice part of the show, how, because other people will listen to this and say, you know, I want to do what this guy did. How do you leverage or how did you leverage your social media? Because I mean, you get over a million views on Instagram. How did you pull that off?

John Paul Tutela:
First things first is to have results that people are going to like to look at. As a surgeon, you really have to be able to hone your craft and have good results and make sure that they're reproducible, because that's that's everything. So once you're able to do that, then a platform like Instagram is really perfect because it's very visual. People kind of just scroll on, they're mindlessly come across your page and really, you know, it's something that once they quote unquote follow you, it's a form of advertising that follows them every day, you know, pops up on their screen and they're happy to look, that's why they follow you. I would say the biggest boost I got initially was actually when I or after I operated on Nicole or Snooki, she had mentioned to me that she was going to do a YouTube thing on her channel and give me a shout-out on Instagram. And I thought to myself, oh dang, I really got to tighten up my Instagram. You know, she's got 10 million followers. This could really help. And it did. It gave me a boost right away. And, you know, I think it got people talking and looking and then it had somewhere, you know, I had some place for people to look me up. So I did dedicate some time kind of hiring somebody who, just helped make the page look clean and look nice and get the appropriate hashtags. So, you know, I think spending a little bit of money on advertising, both social media advertising, getting your page to look nice and you know, other forms of advertising is important at first. You know, traditionally doctors would never advertise, it was looked down upon if somebody had an ad out in the paper for their practice, everything had to be word of mouth and that takes 15 years. You know, for enough people to hear about you, to get a, to get a practice moving. So, but you know, luckily in our day and age today, it's not really so frowned upon. But so, you know, just trying to get out there and get your name and your practice in front of as many eyes as possible. You know, the social media thing, too, is something where it's important to kind of show your personality a little bit, even though I'm not on the screen a lot, I don't really kind of get in front of the camera myself, people are able to see my day-to-day life, the things that are important to me. You know, I cook a lot, I garden, I like music, so they get, they get a sense of who you are and they like to follow, follow along. It's almost like their own personal reality TV channel into your life and if people are interested, so, you know, I show it to them, and I think it gets people excited to kind of follow along.

John Shufeldt:
That's really, that's actually great advice, and I think you'll see a lot more people starting to do that now when they hear it from someone like you. John, this has been really, this has been awesome. Where can people find out more about you?

John Paul Tutela:
So, you know, I think the best place to find me is on Instagram. My Instagram handle is @TutelaPS for plastic surgery. My website TutelaPlasticSurgery.com is another good place, but you know, I'm pretty easy to find and you know, I'd be happy to talk to anybody about anything. It's been wonderful to talk to you, and I thank you so much for having me on the show.

Narrator:
Thanks for listening to Entrepreneur RX with Dr. John Shufeldt. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. This has been a presentation of ForbesBooks.

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