With Snapchat now the de rigueur mode of communication as more and more people, sports teams, cities, media outlets, you-name-it become ghosts in the machine, it was only a matter of time before businesses started utilizing the technology to show off their products.
Products including augmented breasts, freshly plumped booties and newly tucked tummies.
What else to expect from the app that has us vomiting rainbows?
Plastic surgeons have started demonstrating their skills via Snapchat, and their stories on any given day can include graphic play-by-plays of boob jobs, Brazilian butt lifts (the famed BBL—know it, love it) and labiaplasties, no blurring or smiley faces over nipples—or anything else—required.
WARNING: GRAPHIC IMAGES BELOW
While Snapchat so far is largely like every other social media format in that most users are only offering up highlights or carefully curated lowlights of their lives for sharing, it doesn't get any more real than watching a woman's bare behind being sliced open and reshaped using fat from her stomach.
No matter how much Extreme Makeover, Dr. 90210 or Botched you've seen—this is a whole new ballgame. (My eternal thanks to Dr. Otto Placik (@bodysculptor) of Chicago for inserting a "warning: nudity, graphic video next" slide into his story before the close-up view of the labiaplasty—before and after. I appreciated the buffer.)
"It's like having your own reality show in your pocket, but better because you have no censors or network to answer to. You just do whatever you feel is entertaining or funny—and educational," says Dr. Michael Salzhauer—aka Dr. Miami (@therealdrmiami), the plastic surgeon who posted his first Snapchat story in February 2015 and this past April just lost out on the 2016 Shorty Award for Snapchatter of the Year.
The honor went to DJ Khaled.
"Did I know Snapchat was going to blow up? I had no idea," the 44-year-old father of five tells E! News, explaining that it was his then-15-year-old daughter who showed him how to use the app after his Instagram account, which had about 90,000 followers, was abruptly deleted "for violating community standards." (He's back on now, with 411,000 followers, and he hosts a Facebook talk show, Naked Tea, in addition to snapping daily during business hours.)
"I was like, 'Isn't that for sexting?'" he recalled thinking about Snapchat. "I didn't even know it had a story feature."
His first story got about 2,000 views, which he didn't think much of at the time when compared with his Instagram likes, but then the next day he got 4,000, and within a few weeks his posts were getting 50,000 views a day. "It just kept growing," he says, and now he's averaging 1.5 million daily views.
The number of individual people following on a daily basis is lower, around 800,000, but if that many turning up to watch full-on surgery still sounds shockingly high, just think about the deep-seated fascination that society has historically had with makeovers—be they extreme or a contouring trick that takes five minutes.
Combine that with the current allure of Snapchat, which has started logging more than 10 billion video views a day.
And you've got yourself a phenomenon.
While the weirdness factor of such graphic operations being right there for the viewing in between updates from Jessica Alba and your favorite NBA team is high, the videos are also strangely engrossing, like the NSFW love child of cooking shows and NOVA.
And such as has been the case with YouTube, Periscope and other video-centric social media, Snapchat popularity is there for the seizing by those who've figured out how to make the most of the medium—and Dr. Miami, author of the children's book My Beautiful Mommy, turned out to be a natural.
Like the actual surgery itself, Dr. Miami has the Snapchatting down to a science. He introduces himself at the start of each day, he gets a rundown of what procedures are on the schedule, there's some banter with his staff at Bal Harbor Plastic Surgery Associates and, before he closes up shop, he puts on some blingy shades and does "shout-outs" in response to some of the hundreds of messages he gets each day.
He has two social media assistants, Brittany Benson and Ashley Belance, who handle his accounts and shoot the Snapchat videos in the operating room.
"It's fun as a doctor…It's entertaining and interesting for students," Dr. Miami told me. "The human body is inherently fascinating…Most people never get to see it, and the detail we're showing now, really it's cool. It's enough to make you want to commit to 20 years of schooling."
And even when not recruiting tomorrow's surgeons to the fold, his account is certainly demystifying a process that, sure, we've heard so much about, but who's ever going to watch her own liposuction, let alone someone else's?
Dr. Miami pointed out that, despite the boom in reality makeover shows, most people really have no idea of what occurs in the operating room.
"With the Snapchat you see real people, you see real surgery. You see real results," he says. "You see that it's not perfect, but it's better [than what you might imagine]. It's painful, but it's tolerable—[the human body] in all its beautiful detail."
And now there's a way to get that message across in a more digestible package for all—provided you don't lose your lunch in the process.
"What's good about the Snapchat is, it's not in real time, per se," Dr. Miami says. "We broadcast in real time but you don't have to be bored to tears" watching an entire surgery, which generally takes hours, from prep to post-op.
"I'm operating for nine to 12 hours a day, it's not that entertaining," he added. "But being able to show the interesting parts of the surgery and being able to chitchat for 15, 20 minutes, that's reasonable."
But in between the banter and the shtick, his account is not for the squeamish—admittedly I'll watch Dr. Miami chat with his staff and then flip through most of the surgeries as fast as my thumb will make them go away—nor are the accounts of the plastic surgeons following in his footsteps.
Damn it, though, if those before-and-after pics aren't something to see!
"The primary purpose of this Snapchat account is for education," Dr. Matthew Schulman (@nycplasticsurg) opened one of his stories last week, explaining for the uninitiated that what we were about to see would be footage of a real three-to-four-hour surgery in time-lapsed form. "The content's going to be graphic," he continued, "so if you see something that's a little too graphic for you—and there will be for a lot of you—just tap the screen."
Schulman, who started using Snapchat a little over a year ago, said that his videos get over 1 million views a day. And, he made sure to point out, he was getting the numbers without the bells and whistles.
"This is for educational purposes, to spread information about plastic surgery," he emphasized. "If you're here looking for dancing monkeys and circus acts, you're in the wrong account. But you will see a Justin Bieber doll!"
You better Belieb you will. Then it was time to get down to the bloody business of breast-augmenting.
"Any surgeries that I do I will broadcast," Schulman told Fox News in April. "I traditionally do breast and body surgeries. We also broadcast non-surgical procedures like Botox fillers, facials and chemical peels."
He added, "I'd say about 80 to 85 percent of the people who come in for a consultation are active followers on Snapchat."
"Initially I was a little reluctant because I didn't know how people would react to seeing the graphic images of the operating room," Dr. Sej Patel (@mydrsej) told Racked last month. "But when I started doing it I realized it was really powerful because it made everyone see that what was going on was real. That solidified what I was doing in a lot of people's minds and it did really help out our business."
Dr. Christopher Balgobin (aka Dr. BBL, @drbwebmd) of Minneapolis would likely agree. He was schooled in the art of the Snapchat by Dr. Miami's team (a training course can run up to $15,000, according to Buzzfeed), though "franchisee," as he's often referred to, may be a bit of a misnomer since he doesn't license the Dr. Miami name. The docs and their staffs do, however, reference each other on social media (they're like the Cash Money of plastic surgery) and Dr. BBL announced on Snapchat last week that his consult appointments are fast filling up for the year.
Dr. Dallas (Dr. Robert Najera, @realdrdallas) of Texas and Dr. 6ix (Dr. Martin Jugenberg, @realdrsix) of Toronto are also among the graduates of the Dr. Miami school of Snapchat, mixing a party vibe in with the plastic surgery and joining forces with the Sunshine State-based MD to expand their brands.
But what would-be-patient/fan wouldn't want to go straight to the source? Hence Dr. Miami being completely booked for the next two-plus years.
"I got really lucky, there was a cancellation," adult entertainment performer Kaci Kash, 26, told E! News a week after undergoing a BBL, the results of which she was happy to show off on Snapchat—which is what drew her to Dr. Miami's office in the first place.
And go check out @TheRealDrMiami snapchat to see my 1 week post op booty ?— Kaci Kash (@Kaci_Kash) June 10, 2016
"How much fun he made surgery [look], how enthused and happy he is on Snapchat. He's just a happy person in general… and then his results are what made me want to go and see him," she said. And she praised not just the doc but his whole staff too, calling the office "very professional."
"From the moment you walk in the door till the moment you leave, you just feel good about going there," Kash said.
Another recent patient who, like Kash, agreed not just to be snapped but also identified, was Love & Hip-Hop: Atlanta's Jessica Dime, who had her breasts redone and was included in a Snapchat story last Wednesday.
"I got you a present, Ashley—celebrity skin!" Dr. Miami teased one of his Snapchat managers, wielding an actual piece of epidermis.
Rest assured, all of the patients whose surgeries are featured on Dr. Miami's (or any of the other doctors mentioned in this story's) Snapchat have consented to sharing their experiences in one way or another. Most of the patients I saw on a variety of accounts went unidentified and the only parts of them shown were the ones being operated on. Some consent to just still photos rather than video.
And across the board, if patients don't want to be snapped, they don't get snapped.
Yet a patient agreeing to be on Snapchat doesn't change the minds of those who think bringing a camera into the operating room is sacrilegious, consent be damned.
"I actually find it offensive," Dr. Z. Paul Lorenc, a board-certified plastic surgeon in New York who's been practicing for more than 20 years, told E! News. "I think it compromises the integrity of what we do in the operating room. I think it compromises the sanctity of the operating room. It doesn't give the subject of the photograph the chance to say yes or no."
He gets that people are consenting, but he still thinks that, once someone is under anesthesia and no longer able to see what's going on in the O.R., then the consent becomes moot.
"You have to have the right to change your mind," he insists.
Dr. Lorenc is on social media, including Instagram, but he draws the line at intraoperative filming and photographs.
"I always teach residents that once you cross a certain line, at least in our profession, you can't go back," he continued. "Because once you pull the trigger on something like that you cannot go back and you will always be perceived as someone who really...you really are disrespecting the patient. I'm pretty old-fashioned when it comes to that."
Dr. Lorenc has had cameras in his office before, as footage from non-invasive procedures has been shown in seconds-long snippets when he's provided expert commentary to shows such as Today over the years, but he sees "so many possible disasters" when it comes to letting Snapchat into the operating room.
"I'm the first person to embrace new technology, whether inside the O.R. or outside the O.R., but it has to be done with the understanding of its repercussions. It has to be done with the understanding of how it has an effect on your relationship with your patients," he told me. "When you think about it, a patient comes into my office, they don't know me [and after a couple of consultations] they put their life in my hands. To me that still amazes me after 20 years of doing this…The last thing that I would want to do is break that trust. And I think exposing patients in a very vulnerable position, in a very vulnerable situation, breaks that trust."
Meanwhile, you can guess how much sleep Dr. Miami is losing over those who don't approve of what he's doing.
"They're entitled to their opinion but I really don't care what my critics say," he told E! News. "Look, I'm 44 years old, I've got five kids, I'm board-certified, nobody's ever sued me for malpractice... I've got 10,000 patients. I know who I am, I know what I do. My patients are happy."
It's not just plastic surgeons who are using Snapchat, either, as other doctors are finding it a useful way to send live updates to family members during surgeries, diagnose a patient from afar or otherwise educate—and sometimes entertain—the masses as well. In fact, health care marketing on Snapchat is quickly becoming its own field.
"I think that Snapchatting surgery, like Instagramming before it, can be a very useful way to share information with prospective patients, Dr. John Zannis, a board-certified plastic surgeon based in New Bern, N.C., tells E! News. "I have not done this before, although I have recorded surgeries and shared them on YouTube. The digital landscape is constantly changing, and at a rapid pace. Doctors must keep up with modern trends if they want to be competitive in the marketplace of cosmic surgery.
"Not only are these types of digital endeavors excellent marketing tools, but they can truly be helpful for patients considering surgery. The most important thing is that patient privacy is respected. Recording or sharing any part of a procedure must be explicitly approved by the patient and the types of social media sharing also discussed."
For sure, any time that the subject of medical care and Snapchat is broached among officials, you can bet that the primary consideration is indeed HIPAA laws and patient privacy. And those whose job it is to maintain the integrity of the profession are keeping an eye on the trend.
"Regarding the use of social media or any broadcast during surgery, there are many variables—such as safety and content appropriateness—for each patient, doctor and facility to consider," Adam Ross, a spokesperson for the American Society of Plastic Surgeons, tells E! News.
"In all cases, privacy laws and patient consent must be honored. Ultimately, any surgery broadcast is at the discretion and agreement of all participating parties."
So provided that Snapchat itself doesn't start cracking down on content—and so long as patients are consenting—surgery-on-Snapchat isn't going away anytime soon.
Moreover, the median age of plastic surgery patients is trending downward, in part thanks to increased media exposure and how many young celebrities are cheerily admitting to having tried it ("it" being anything from breast implants to a nose job to Botox).
Factor in our continued embrace of social media and the ever-blurring line between what's traditionally been private versus what's increasingly become public, and what we've got here is just one more thing we couldn't have imagined two years ago becoming the norm. Something most of us couldn't fathom being interested in seeing (like your second cousin's political views on Facebook) has now been packaged into bite-size bits for whoever wants to take a look.
And just as YouTube and Instagram have created new crops of celebrities, the same is happening on Snapchat.
"It blows my wife's mind now," Dr. Miami says. "People want to take pictures with me, she says, 'Don't you know he's like the least cool person on earth? I married him because he was geeky.'"
But the nerdy doctor has found his niche.
"We don't even really take appointments anymore," he told me. "We have walk-ins. If they want to put a deposit down for 2018, God bless 'em."