Leaders in Medical Education

Dr. Michael Salzhauer, Snapchat Plastic Surgeon

Thasin Jaigirdar
Jul 22, 2015

Dr. Michael Salzhauer is a cosmetic and plastic surgeon based out of Florida. He received his Medical Degree from Washington University in St. Louis. He is known for leveraging social media to educate and give people a first-hand view of plastic surgery. You can follow his operations on Snapchat and Instagram @therealdrmiami. He has also made many appearances on channels such as CBS, NBC, and Fox News to discuss plastic surgery. We are excited to be featuring him on our series today!

How did you become interested in medicine? What drew you towards plastic and in particular, aesthetics?
I always wanted to be a doctor since I was a little kid. My dad bought me a cheap stethoscope when I was four years old and let me listen to his heart every night. He didn’t graduate from high school and it was a dream of his to see me go to medical school. I also used to watch the TV show MASH, a show about surgeons in the Korean War. It was a very jokey comedy with some fun people acting as the surgeons. So, overall, my initial exposure to medicine really consisted of my pediatrician, my stethoscope, and MASH.

In high school, I began to look for combined BA/MD programs, and I found one at Brooklyn College which I was accepted into. The program guaranteed me a medical school spot without having to take the MCAT or apply. During my first year there, I volunteered at The hospital for Joint Diseases in Manhattan and followed around a Neurosurgeon. However, I realized that neurosurgeons are not the fun people that I thought they would be based on MASH. However, it was still very very interesting to me.

Shortly after beginning the BA/MD program, the school changed the rules and asked to take the MCAT and fill out a med school application as a “formality.”  I was a bit annoyed and worried by that and decided to actually study for the MCAT just in case the school didn’t add additional requirements. I ended up doing really well on the exam and decided to apply to Washington University in St. Louis after my second year of college and miraculously got accepted. I decided to enter at the time, forgoing my Bachelor’s degree. I ended up attending medical school at the young age of 20.

I wouldn’t necessarily recommend this same path to everyone. I had been thinking about medicine since I was four. It didn’t even occur to me that there were other jobs out there and I didn’t have a plan B. So I was quite driven and it worked out OK for me.

I was drawn to plastics after something that had happened to my wife. When we were dating still back in college, she got into a car accident and got a really nasty cut on her chin. She was taken into the ER and some intern sewed her up with what I jokingly called  “2-O rope”,  leaving a noticeable scar with stitch marks. The scar really bothered her, and 6 months later she began to look for a plastic surgeon to fix it. We opened the yellow pages and found one and went to visit him. He was a very nice guy and I thought the work he was doing was pretty cool as he explained it. He was actually the first ever plastic surgeon I met.

When I got to medical school the following summer, I was still unsure about neurosurgery. I eventually ran into some plastic surgeons at medical school and they were super nice, creative and laid back guys who took me under their wing.

The first operations I saw in plastics were reconstruction related and not aesthetics related. They consisted of complicated trauma injuries and cancer reconstructions. That is what first drew me to the specialty.  I didn’t actually get involved with aesthetics until well into my general surgery and plastics training.

Although aesthetics may look the same thing every day, it is actually very challenging and a lot of thought and creativity go into it. I think it’s the most challenging form of surgery because when you are a general surgeon or a trauma surgeon, the patient is in dire straits and will die unless you do something. No matter what you do, at least you tried and they had no choice. But, with aesthetic surgery, these are perfectly healthy people, and you need a high level of confidence and skills to for instance take a model’s face or a young healthy girl and say that you can make them look and feel better about their bodies. I don’t ride motorcycles or sky-dive, but you do need a certain level of courage. There is always risk with surgery, so in that respect it adds a bit of thrill to my life.

Also, plastic surgery can easily be judged by everybody in the general public. You can tell if someone did a good job with a procedure. On the other hand, you can be the worst gallbladder surgeon in the world but nobody can really tell how you did from the outside because it’s all internal.

I have seen that you have been running your own practice for nearly 13 years now. What does it takes to run a successful practice?
It’s just as hard as everything else that came before it.  The 7 years of residency/fellowship, the 4 years of medical school. You need almost as much experience, effort, study, and research to make a practice successful. All of the traits that got you to that point will serve you during the building of your business. You have to be disciplined, able to motivate people, and you have to learn it from scratch. I never took any business, marketing, or accounting courses. But I’ve read a lot of business books since I finished my training. It always helps to have good people around you and hire good people.

Looking back, I would have thought a little bit more about the actual logistics and practical aspects of starting a practice. Coming out of residency after 11 years of medical training I had zero business experience and therefore did not take a paycheck home for 9 months.

What compelled you to leverage social media (Twitter, Snapchat, etc) to share medical information?
Like most medical practices these days, I had a lame Facebook site and a boring Instagram page. I always wanted to reach out to a larger audience to explain what plastic surgery is and how it changes lives. However, I could never get the message across adequately.

One day a patient came in and as very blunt with me, telling me how my Instagram page sucked and that it was boring. She mentioned that I had all of these great before and after pictures and how she would rather see those pictures and pictures of what actually happens in the Operating Room. This led to a light bulb going off, and I started trying it. I took a picture from my gallery and put it on my Instagram. I viewed it not only a way to show what plastics can accomplish but also express my personality and the personality of those at my office. I also was able to not only educate people on the basics but also dive into plastic surgery at a more detailed level. We got to about 90k followers on Instagram, and one morning it was deleted when I woke up.

That morning my 15 year-old daughter suggested we try Snapchat as an alternative to Instagram. So, on the first day we Snapchatted, we had about 2000 people watching. When I showed my daughter, her eyes nearly popped out of her head. That was the most views she had ever seen on Snapchat. The next day, it was 4000, and then 10000, and eventually it broke 100,000 a day watching. It’s honestly like having your own little reality show in your pocket where I get to entertain and educate viewers about plastic surgery.

It got to the point where we had so many inquiries and messages that I had to hire staff to handle it. Right now there are about 270,000 viewers on Snapchat who view my 15-30 minutes of daily footage. It turns out that a large percentage of people who view my Snapchat Stories are in the field (ie: Doctors, Medical School Students, Undergraduates etc), and the other large percentage are just students who might be taking general biology or people just interested in plastic surgery.

What role do you think social media could serve in improving medical education in the US? How about overall healthcare?
I think that social media can serve a great function. I personally would watch other surgeons do their surgeries too. If I was a medical student or resident I would be excited to watch those videos as well. Really in any education, you are limited to who happens to be teaching at your school or near you. With internet now, you could easily go watch a professor’s course at Harvard on Economics. We don’t have that yet in Medical Education that I know of. You can’t just zoom into the operating rooms of the greatest surgeons in the world to learn from them-- but imagine if you could.

I think with overall healthcare, we can see improvements as well. Through social media we can help more people better understand how surgery actually works. It makes things less scary for them by revealing the mystery behind the curtain. It allows patients make a better informed decision about what they want to do with their bodies. The patients do need to receive correct information in order to accomplish this.

When you see into an operating room, and watch how the operation happens, it is a much better explanation than words on a piece of paper or a surgical animation video.  Patients tend to have some image in their mind of what happens based on what they read on the internet or from less-than-credible sources. If they see the operation, it enhance the inform consent process because you don’t have to explain it if they see what’s happening.

Do you have any final thoughts you would like to share?

I never for one second regretted going into medicine. I do think that students need to understand that it’s a very long road and you have to imagine yourself 15 years from now. Don’t just think about the short-term. You have to try to have as much balance as you can for now and realize that there is a light at the end of the tunnel. You can be happy in medicine and you don’t have to have your personality squashed because you can find creative outlets to keep that part of your life. Also, be happy. Life is short.