Perkins, now in his 80s, grew up in Evansville, Illinois, receiving his medical degree from Indiana University and pursuing a surgical residency at Stanford University School of Medicine. When choosing to specialize as a young physician in the 1960s, Perkins initially considered an ears, nose and throat specialty, but the nose and throat bits didn't particularly interest him — he didn't want to have to remove people's tonsils regularly.
He was more fascinated by ears, especially after observing an operation in which a microscope was used to remove a tiny bone in the ear. At that time, he said, microsurgery wasn't really being done elsewhere.
After completing a residency program at Stanford, he spent a year traveling the country studying the work of various ear surgeons. He began building his own ears-only practice by traveling back and forth between Palo Alto, where he lived, and Los Angeles to do operations.
He would go on to help found the California Ear Institute at Stanford, specializing in ear surgery, working with doctors in training and developing new surgical procedures and techniques.
He also launched Project Hear, an ear tissue bank, and developed a process for transplanting ear drums.
In his research to find a way to make synthetic ear drums, he began working with collagen, and then learned it could also be used for injection into the skin to smooth wrinkles. The products he created, Zyderm and Zyplast, were born, and are now two of the leading collagen products used today. The discovery led him to found Collagen Corporation.
"There are a lot more wrinkles in the world than there are perforated eardrums," he said. "(It) became a cash cow."
When it comes to making money, Perkins said that when he started as a practicing physician, it was more frowned upon in the medical community to make money from one's research and development projects than it is today.
"I never got into these things to make money," he said. He knew making a profit was possible, he said, but the driving force behind his inventions was a desire to solve problems that physicians face and give them effective tools to help their patients. He wanted to have a bigger impact, faster, than he could by treating patients one at a time.
He pointed to Jonas Salk, who discovered and developed the polio vaccine. Not everyone can have as widespread an impact as Salk did, he said, but developing tools to help doctors more effectively treat their patients helps multiply his impact.
The joint challenges of solving a medical problem and building a business have driven Perkins down a career of serial medical device entrepreneurship.
In a 2006 article in the "Medical Futures" magazine, he offered the following advice: "I tend to think of an entrepreneur like a sheep dog," he said. "They gather their flock, they herd them and keep them together and drive them through a gate at the same time. An entrepreneur herds resources, starting with an unfulfilled clinical need, and then puts other things around it."
A few of his other companies:
• In 1982, he founded Laserscope, Inc., which develops and manufactures medical lasers.
• In 1984, he founded ReSound Corporation, a hearing aid company that is considered a market leader in the hearing aid industry, he said. It was purchased by Great Nordic to become GN Resound.
• In 1995, he founded Novacept, a company that makes a device that stops excess menstrual bleeding for women. That company was acquired by Cytyc in 2004 for $325 million.
• He also reports launching Sound ID, SurgRx, Dfine, Pulmonx and Cohesion.
And, he can boast of at least one other Silicon Valley accomplishment: Perkins has an item named after him on the menu at Buck's of Woodside, The Dr. Perkins Boca Burger Breakfast Special.
Most recently, he's been building a new business, EarLens, around an eponymous hearing aid he invented.
"Think of it like a contact lens for your eye, but it resides on your eardrum," he said.
As of October 2017, the EarLens blog reported that Perkins holds 18 issued patents, with 37 pending.
Recently, at a nondescript research and development building in eastern Menlo Park, Perkins allowed this reporter to sit in on a procedure to install an EarLens hearing device. He currently serves as the EarLens' founder and chief medical officer.
Using a microscope and precise, small tools, an ear, nose and throat physician first moistened the eardrum with some oil, and then placed the tiny device into the patient's ear. She then flashed a penlight into the ear to test whether it was working. The patient said she could hear music coming from the light. Next, the patient would have her hearing device calibrated to adjust to her particular hearing sensitivities.
Traditional hearing aids, including one variety he helped patent decades ago, aren't great at picking up the frequencies at which a lot of speech and noise occur, he said. Most other hearing aids use a "very mini speaker" that, because of their size, can't amplify the high frequencies, he explained.
One problem with other hearing aids, he said, is that 80 to 90 percent of the sounds we rely on to make language intelligible — consonants like t, g, sh, s, and f — are particularly hard to hear with hearing-damaged ears because they occur at higher frequencies.
EarLens, he said, "more than doubles" the frequency range of other hearing aids.
A processor outside the ear converts incoming sound into electrical current, which goes down a wire in a small tube into a tip in the ear, which contains a laser diode. That diode transmits a form of invisible light that goes into the ear canal, where a tiny solar cell detects the light, which then generates a current and vibrates the ear drum.
The lens stays in place because of its custom shape, and because of surface tension, the device remains on the eardrum membrane, aided by oil drops that users apply a couple of times a week to keep the surface moist.
The reason the sound-to-light-to-sound method works, he said, is that very little energy is required to trigger what he called the "threshold of hearing." Moving the eardrum a single micron creates the sound equivalent of standing next to a jet engine, he said.
The EarLens hearing aids, which can also operate as wireless headphones, are available to purchase and costs vary, according to EarLens spokesperson John White. Perkins said they cost about $12,000 a pair.
"The market for this is huge worldwide," he said, noting that as people age, many develop hearing problems: About 20 percent of people in their 50s, 40 percent of people in their 60s, and 60 percent of people in their 70s report hearing problems. Currently, EarLens has clearance from the Food and Drug Administration for adults but not yet for children, so the devices are available only to people ages 18 and up.
One of the challenges of building up the company is figuring out how to train people to fit and install them the aids. They are customized to fit ear shape, which requires an initial appointment and a follow-up. "That's why they fit so well," he said.
The plan is to train physicians across the U.S. to insert the devices at the Menlo Park clinic.
"A doctor has to put (the device) in," he said. "It's not Harry's Hearing Aid Hut."
As of February, the company had about 170 employees.
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