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Keeping Up With Dr. Miami

The plastic surgeon stars in his own Snapchat universe of butt lifts and trap music

Disclaimer: Dr. Miami’s Snapchat isn’t for the squeamish. Neither are some of the procedural images below. Proceed with caution.

GIF via the Dr. Miami Snapchat.

“Good morning everyone, my name is Michael. They call me Dr. Miami. I’m a plastic surgeon, and I make people feel better about their bodies. Watch me as I Snapchat my way through Thursday!”

Dr. Miami, a.k.a. 43-year-old Michael Salzhauer, recites this monologue every morning on Snapchat for the hundreds of thousands of viewers who tune into his daily story — generally graphic play-by-plays of the plastic surgeries he performs, including boob jobs, liposuction and butt lifts. Thanks to his mix of surgical realism, an operating-room soundtrack filled with hip-hop and a dynamic supporting cast of funny and relatable nurses and assistants, the show is equal parts medical documentary, comedy and infomercial. Blood gets purified to the beat of Miami club bangers while Salzhauer makes shameless requests of his audience, like asking his fans to help him secure a new pair of Yeezy sneakers before they drop. When he’s not at work, he’s the perfect family man, an Orthodox Jewish dad explaining the meaning of a Yiddish phrase or showing up at the Miami Heat’s Jewish Heritage Night with all five kids in tow. In the operating room, waists are snatched, asses are plumped and tummies are tucked while Salzhauer’s staff discuss the previous night’s parties or the time they found an ex on Ashley Madison.

The overall effect is funny, gruesome and educational. It’s pure marketing genius, showcasing the transformational potential of plastic surgery, where the endings are always happy and where people feel better about their bodies. Patients see him perform his trademarked Brazilian Butt Lift (BBL) — $7,945 — on Snapchat; then they come into the office to get it done themselves. His fans include reality TV stars like Kailyn Lowry from “Teen Mom 2.” “She was a fan of the Snapchat and Instagram and she reached out to me,” Salzhauer says. As Salzhauer reshaped Lowry’s figure, he and his staff contemplated the marketing potential of the phrase “Super BBL Sunday.”

Teen Mom 2’s Kailyn Lowry before and after her Dr. Miami BBL. Photos via @kaillowry, @drmiamiland on Instagram.

Often, patients will wait months for a few minutes of Salzhauer’s time. As Salzhauer’s Snapchat following has grown (he has more than 500,000 viewers a day), so too has his waiting list (now about 18 months long). In all, he performs about 20 surgeries a week, or nearly 1,000 a year.

On a Thursday this fall, I spent a full day in Dr. Miami-land, peering behind the scenes of a Snapchat story that’s become its own reality TV show. Though I usually skipped to the next clip as his goriest scenes passed through my Snapchat feed, in his lush Bal Harbour office I had no choice but to pivot between watching the show play out in front of my face and tuning into the Snapchat broadcast from my phone.

“Ta, ta, ta, ta, ta,” Dr. Miami sings with a slight R&B edge — as if The Weeknd were in love but skeptical.

He Snapchats himself doing the “Ta walk” every morning as he wanders the halls of his practice searching for Ta, or Tatiana Pinzon, the practice’s feisty pre-operative surgical coordinator and important co-star on Snapchat. She’s rivaled in screen time only by Brittany Benson and Ashley Belance, Dr. Miami’s social media assistants who are responsible for much of the Snapping. Benson was an HR coordinator for the Miami Dolphins before starting with Dr. Miami last March. Belance, still a student at Florida International University, discovered the job opening on Dr. Miami’s Instagram, of which she was already a huge fan.

Tatiana Pinzon breaks down everyday for Salzhauer and their audience. Photo by Jared Ryder.

“We have a BBL, a BBL and rhinoplasty, a labiaplasty, some lipo, some skin excision,” Pinzon announces. Pinzon is an avatar of the Dr. Miami body, having passed under the doctor’s knife during her career as a pre-operative coordinator at the practice. “So we’re cutting a whole bunch of stuff.”

I met a few patients scheduled for some “cutting” minutes earlier in the waiting room, a space that’s not usually on camera since prospective clients haven’t had a chance to sign a waiver yet. But the opportunity for a cameo (complete with less-than-flattering “before” shots) is often what drives new clients to pack Dr. Miami’s waiting room the moment it opens. Many of them like to creative-direct their own shoot — requesting, for example, that certain music be played while they lie unconscious in the OR. “Seeing the number of surgeries he does every day and watching him listen to music and talk while doing them has earned him a good reputation,” says Natalie, an Asian-American woman in her late 20s who came to the office directly after getting off a plane from Vegas. She hopes to consult with Dr. Miami about a BBL, which he calls “the fastest-trending plastic surgery of all time.”

“If he were to fuck up on Snapchat, it would be bad.”

“If he were to fuck up on Snapchat” — with so many people watching — “it would be bad,” she reasons.

Brittany Benson responding to questions about pricing and recovery on Snapchat. GIF via the author.

Usually, one or two surgeries serve as the day’s highlights, but fate has brought me here for what I imagine is the first labiaplasty to be broadcast live on Snapchat. A labiaplasty is a feat of cosmetic gynecology that removes “excess” skin and “rejuvenates” the vulva.

Dr. Miami, however, seems more excited about the formal announcement of his latest extracurricular venture: Surg Recordz, a digital music publishing business that links independent hip-hop artists with larger labels. He gathers his staff in the waiting room to deliver the news, even though most of them have already seen his snap from last night, when he announced the label from the middle of the OR.

“Here’s the point, Surg Recordz is a real thing,” Dr. Miami says. Three hundred unsigned artists have already submitted mixtapes, just 12 hours after he posted the snap. The energy in the room is beyond hyped.

Dr. Miami in his “Booty Doc” video from 2012. GIF via Youtube.

“My rapper name is HNDRD,” he tells them, leaning into the hip-hop mogul character he’s creating for himself.

Some of his employees shout out their own rapper names. “Big Tasty” and “Miss Mango” are standouts.

“We’re going to start shooting our pilot soon,” he continues. Like other social media stars, he dreams of landing a reality TV deal. “We have to have something going on that will be interesting, and I think the record label thing is funny and interesting.”

After all this media talk, the meeting comes to a suddenly spiritual end when the room begins to chant the company mantra in unison: “It takes courage to change. We help our patients through their journey by providing the best plastic surgery experience…”

The timer runs out on the Snapchat video Benson is recording, so she pauses the mantra here before cueing the group back up to finish the “pledge of beauty allegiance.”

The beauty warriors gather in the Bal Harbour Plastic Surgery Associates conference room. Photo by Jared Ryder.

“The best plastic surgery experience possible,” she leads, as she presses record on a new clip.

“The best plastic surgery experience in the safest environment,” they follow. “Our mission is to encourage the beauty and self-confidence our patients desire.”

They end with a cheer.

“All of the funny stuff I do on Snapchat is just to make my wife, Eva, laugh. She’s my main audience.”

“All of the funny stuff I do on Snapchat is just to make my wife, Eva, laugh,” he tells me later. “She’s my main audience.” She’s also the person who inspired him to pursue a career in plastic surgery. When they were college students living in Brooklyn, Eva was in a car accident that left her with a scar on her lip and chin. He consulted the Yellow Pages and called up the plastic surgeon with the biggest ad.

“We went to the guy’s office on the Upper East Side, and I started checking out the before-and-after pictures he had on the walls,” Dr. Miami remembers. “I was like, ‘What kind of surgery is this again?’ I only vaguely knew what plastic surgery was. He said, ‘Why don’t you hang out and see what I do?’”

Ashley Benance Snapchats a procedure. Photo by Jared Ryder.

Salzhauer eventually decided to specialize in plastic surgery at Washington University School of Medicine in St. Louis. Afterward, he and Eva moved to Miami so he could train in plastic surgery techniques at the Mount Sinai Medical Center and the University of Miami. And while Salzhauer excelled at surgery, he was just as adept at marketing, launching a quick succession of projects to bring attention to his work.

In 2008, he began calling himself Dr. Miami, after releasing plastic surgery simulation software called “Salzhauer’s Surgeon in a Box.” Two years later, he created the “Heidi Yourself” app, which allowed users to see what they would look like with any of the 10 cosmetic surgeries Heidi Montag underwent in one day. For a brief period between 2012 and 2013, he went by “Dr. Schnoz,” starring in a short parody film about rhinoplasty as well as a recreation of LMFAO’s 2011 hit “Party Rock Anthem” called “Booty Doc.” (“Every day he’s suctioning,” not shufflin’.) In 2014, he directed and starred in another short film called “My Beautiful Zombie” where he played a Rambo-lookalike plastic surgeon who operates on the undead. (It was selected for the Miami Short Film Festival.)

More Dr. Miami’s “Booty Doc.” GIF viaYoutube.

Currently, he’s working on a proposed boutique named BootyQ — a retail extension of the Dr. Miami lifestyle brand, featuring “bootylicious clothes” and “aesthetic treatments” like Botox. Essentially, it’s Dr. Miami’s very own DASH. Salzhauer has already tapped Rocky Santiago, a controversial former cast member of “Bad Girls Club,” to be the manager. So far, though, BootyQ’s opening has been held up by complaints from the Bal Harbour village council. In protest, Salzhauer dressed up like a king to speak to what he calls the “Town Council of Darkness.” But the matter persists; he’s still waiting for the council’s approval to offer procedures like laser treatments in a retail space, and including the word “booty” in a business name has proven controversial in such a wealthy enclave. The council will weigh in on BootyQ again later this month. No doubt Salzhauer will snap the outcome, just another plot twist in his daily story.

Salzhauer first stumbled across Snapchat about a year ago, after he woke up one morning to find his Instagram account, with its 90,000 followers, deleted; he had (yet again) violated Instagram’s “community guidelines.” Back then, he didn’t even know what Snapchat was, but after his 15-year-old daughter Aleah told him it was her favorite social platform and one of his employees suggested he snap the actual surgeries he performed, Salzhauer began his latest marketing experiment.

Photo by Jared Ryder.

“He wants to be famous,” says Maddie Salazar, one of his receptionists. “That’s like, his thing. I’ve only worked here 10 months, but the other girls will tell you — it’s always been his thing. He’s like Walt Disney, a visionary in plastic surgery.”

“We’re bringing the Dr. Miami BBL worldwide,” Salzhauer announces on Snapchat. I’m watching the latest updates to the day’s story at a nearby Cuban restaurant, shoveling down plantains before the blood begins to spew. He’s readying for a procedure with Chris Balgobin, a Minneapolis-based surgeon who runs the first of many planned Dr. Miami franchises. Today, Balgobin has come to observe the boss in person. Balgobin throws a quick peace sign and then the two men fist-bump. “He’s a surgeon; he knows what he’s doing,” Salzhauer explains. “But I’m going to show him my techniques.”

GIF via the Dr. Miami Snapchat.

Over my phone, I watch Balgobin move a narrow, mechanically powered liposuction vacuum in and out of a patient. His motion resembles a pool player about to take a shot. After he sucks up clusters of viscous yellow fat cells, they are relocated to a plastic container, where they’re purified and then re-injected into the patient’s behind. I cringe less as time passes, anticipating my odyssey into the operating room. But before I can join Salzhauer, he must reconstruct a vulva. While I haven’t been invited in to see the procedure happen in real time, I can still watch like a normal fan from the convenience of my phone.

Salzhauer pulls his patient’s extra skin back to show us her clitoris.

“This picture may look confusing, especially for those of you who have never seen an actual vagina,” he says, before launching into a detailed explanation of female anatomy.

Clamping his patient’s vagina with tongs, Salzhauer points at the urethra, letting us know that’s where urine comes from. “Of course the anus is below, separate from all of this,” he continues. Next, he explains where period blood comes from, while Fetty Wap moans in the background. “We’re teasing this apart here,” Salzhauer says, referring to his patient’s inner and outer labia.

He takes a small pair of scissors and meticulously clips the patient’s unwanted vaginal skin folds away. This vaginal resurfacing is totally cosmetic.

“Remy boys go fuckingggg hard baby,” Fetty sings, as an assistant holds the newly snipped labia majora in place while Salzhauer begins to sew each side of the lips back together.

Patients aren’t featured on Salzhauer’s Snapchat without consent, but signed waivers do little to keep skeptics from wondering what kind of doctor would expose his patients in such an uncensored way.

GIF via the Dr. Miami Snapchat.

Of course, patients aren’t featured on Salzhauer’s Snapchat without consent, but signed waivers do little to keep skeptics from wondering what kind of doctor would expose his patients in such an uncensored way. On the Dr. Miami Snapchat, there are no jump cuts to the final results like there are on Dr. 90210 or Botched. Instead, metal cookie cutters are shown removing nipples from breasts before augmentation. Rows of buckets glisten with gelatinous red fat. And in a state where texting and driving is against the law, Salzhauer is Snapchatting while suturing.

In a state where texting and driving is against the law, Salzhauer is Snapchatting while suturing.

“There are some old-school doctors who are like, ‘I would never deem to stoop to that type of communication with my patients,’” Salzhauer says of his critics, whom he calls “haters.”

“It’s the same way old money looks down at new money. But it’s just money.”

Now, I’m standing a foot or so behind Salzhauer as he repeatedly inserts and a suction tube into the side of a woman’s stomach. It’s almost as loud as a lawnmower, and Salzhauer jerks it around in a way that might look dangerous if I weren’t used to seeing him do it on Snapchat. Next to me is Crazy Mike, another Snapchat celeb who has stopped in Miami as part of his 100-day Snapchat tour. After legions of his own followers suggested he meet Salzhauer, Crazy Mike stopped by the Dr. Miami office — with his pink-and-blue dog Shazam in tow — to see what contributed to Salzhauer’s own fame.

GIF via the Dr. Miami Snapchat.

Crazy Mike’s guess is that Salzhauer’s Snapchat fans find him inspiring. Earlier, he explained to me how he tries to hit the same note for his own followers by reciting monologues sourced on YouTube with the keyword “motivational speeches.” I stared at his “Play Crazy” tattoo as we waited together outside the OR; then I watched him literally play crazy as he demonstrated how to eat fire. Salzhauer filmed the whole thing, volunteering Benson to try it herself. It’s nearing 9 p.m. and I’m overwhelmed by Crazy Mike and his energy. But Benson and Salzhauer seem to feed off it, loving the content they’re getting for Snacpchat, and soon, Crazy Mike and I are both invited into the operating room.

Once there, Crazy Mike grows quiet. Over the course of the surgery, he offers just three words: “This is intense.”

Salzhauer aims to keep the operating room from being a scary place and to build trust with potential patients who start off as viewers.

Personally, I’m surprised by how normal everything feels. Salzhauer aims to keep the operating room from being a scary place and to build trust with potential patients who start off as viewers. It’s a grand reinvention — transforming something that’s usually associated with fear, paralysis and the ominous beeping of machines into a place filled with laughter, gossip and music.

Photo by Jared Ryder

Again, Salzhauer’s approach isn’t without its critics, who suggest that the emphasis on fun and entertainment may detract from Salzhauer’s performance as a doctor. (A cold, sterile operating room is typically regarded as a good thing.) Dr. Miami, of course, sees his bedside manner and his ability to wield a scalpel as two different things. “You go into a state when you’re doing this,” he says. “A lot of cosmetic surgery is right-brained. So when I’m doing liposuction or putting in someone’s breast implants, my right brain is working hard while my left brain is taking a nap or talking to you.”

I ask him about the stigma still attached to cosmetic enhancements.

“Plastic surgery is nothing to be ashamed of. It’s part of scientific progress. It’s one of the greatest inventions of the 21st century, right up there with the computer. Through all recorded history before us, you were stuck with the body you were born with,” he tells me, the surgery nearly over.

In Dr. Miami-land, no one is stuck with anything.

As the leaders of Dr. Miami’s social team, Benson and Belance respond to almost all of the thousands of picture, video and text messages that @TheRealDrMiami receives every day. They exclude only trolls from their constant correspondence with viewers.

Sample tenets in the “Salzhauer Squad Goals Guide” include “Thou shalt not be basic.”

Cradling Dr. Miami’s Squad Goals Guide.

They also run point on Salzhauer’s efforts to connect with his fan base in a more meaningful way. Having been ushered into a successful plastic surgery career by another plastic surgeon, Salzhauer is passionate about paying forward that mentorship. So he began the Dr. Miami Squads, which are sort of like fan clubs that enable people to act as ambassadors of Bal Harbour Plastic Surgery in their own communities. Thus far, Salzhauer has squads throughout the United States and in Saudi Arabia, Pakistan and Uruguay. Each one gets branded T-shirts, a “Salzhauer Squad Goals Guide” booklet (Sample tenets: “Thou shalt not be basic”) and, until recently, a silicone breast implant. (They temporarily ran out, so Salzhauer sends a plastic balloon, for now.) “The goal is to inspire young people into pursuing careers in healthcare, and specifically plastic surgery,” he explains.

Salzhauer calls the squad leaders “Trap Kings” and “Trap Queens,” because trap is part of the current Dr. Miami brand. This is fairly unexpected terminology from a middle-aged, fairly traditional Orthodox Jew, whose wife delivers him Kosher meals nightly to his office. “Trapping” comes from the idea of a “trap house,” a work-live space used to manufacture and package drugs. But to trap is to hustle, and according to Salzhauer, “Successful people are always selling.”

Under the advisement of staffers like Pinzon, Benson and Belance, Salzhauer has decided that the best way to disseminate messages to a new crop of consumers is to become a hip-hop-tinged lifestyle brand with a popping social media presence.

GIF via “M.I.A” by the Uno Boyz.

And with the advent of Surg Recordz, that mission is growing. Since my time in Miami, Salzhauer has produced a video for “M.I.A.,” an ode to Miami women by an Orlando rap duo called the Uno Boyz. It’s no surprise that the video opens on a close-up of Salzhauer’s face, as seen through a cell phone screen.

“Brittany, I love these Uno Boyz!” he says in the video. “I think with a little direction from Surg Recordz, they could be something. Fly them down to Miami and make the video. Give them the keys to my mansion….” At 33 seconds in, the song begins; it’s a smooth anthem about having a couple of “bad bitches out in M.I.A.” Benson and Belance are among the Salzhauer staffers who appear by poolside in the video.

“This is what we do day in and day out,” Salzhauer told me in the OR — referring to his practice’s multifaceted media production as much as to the plastic surgery. And the Dr. Miami hustle continues. Today, on Snapchat. Tomorrow, who knows?