Snapchat Surgeons – Where do you stand?

We discuss the trend in live broadcasted cosmetic procedures – is it social media with a purpose or the final frontier of privacy?

With the ubiquitous rise of social media and the increasingly expanding aesthetic medical environment, platforms such as Snapchat have become super-charged marketing tools.

With this constantly evolving market, there is now a growing number of plastic and cosmetic surgeons who have built a strong following by filming themselves performing cosmetic procedures.

While surgery used to be a very private encounter between the doctor and the patient, nowadays patients can consent to having their surgery broadcasted live on Snapchat and seen by thousands upon thousands of followers. If you’re privy to this new trend, you know there is no censorship involved.

An increasing number of doctors are now using the popular social media app as an educational and marketing tool, essentially allowing viewers and followers a ‘behind the scenes’ look at cosmetic procedures – from Brazilian butts lifts to breast augmentations and tummy tucks.

Although the videos are hugely popular – watched by millions – they do raise ethical, moral and even safety concerns. Have we crossed over to the final frontier of privacy? Is it educational, or has it turned cosmetic surgery into a form of entertainment?

Where it all started

Snapchat first found fame by allowing users to share video clips and photos for ten seconds or less before they disappear, and in 2013 the “story feature” was introduced.

Dermatologist Dr Sandra Lee, known as Dr Pimple Popper, began displaying her extractions on Instagram two years ago. She has over 1.9 million followers on Instagram and over 1.7 million YouTube subscribers. The Californian dermatologist gets many questions from followers interested in careers in medicine, finding her work fascinating.
Miami plastic surgeon Dr Michael Salzhauer, who goes by the name Dr Miami, is at the forefront of the recent Snapchat movement and is credited as being the first to use Snapchat in real time during his surgeries.
Originally experimenting with the platform Instagram, Dr Michael Salzhauer found the app too restricting after his account was abruptly deleted “for violating community standards”. After joining Snapchat, his following has grown at an astonishing rate and he now has an average of 1.5 million views per snap.

Tomorrow’s marketing tool today In an interview with Vice (US) in April this year, Dr Salzhauer said, “I don’t think I would’ve had the social media success or influence if I wasn’t at this stage of my career.

In other words, it’s taken 19 years in practice and training and 10,000 patients to get to the level of skill and consistency with results and expertise to where I can show off a little bit on social media. This wouldn’t work for me if I was just opening up my practice. It just wouldn’t.”

“Of course it’s had an effect on the business. I was pretty busy anyway, but now I’m crazy busy. I’m booked until the end of next May. Every single day. It’s like, a thousand people, paid and signed up for surgery for the foreseeable future,” says Dr Salzhauer.

New York plastic surgeon Dr Matthew Schulman has been another early adopter of the social technology. In an article with the New York Post, he said, “I was looking for a platform to show surgeries in a way that was realistic and not sensationalised or glamorised as is commonly done for television.”

Both Dr Salzhauer and Dr Schulman claim that about 75-90% of their patients agree to have their surgeries shown on Snapchat, and that most of their clientele discover them through the app.

While a majority of patients typically request that their names and any identifiable markings on their bodies are covered up, there is a population that are seeking internet fame. For those who request it, Dr Salzhauer will often plug their Snapchat names (ie, write them out) before the procedure for good viral measure.

There is no doubt this trend has inflicted a lot of debate, with critics believing live- streaming surgery is inappropriate and pushes ethical boundaries about what is acceptable in the practice of safe surgery. Even when patients give written consent, they may be signing up for more than they bargained for.

“A doctor-patient relationship should be a sacred one and patient safety should be the No. 1 priority,’’ says Dr Dan Mills, president of the American Society for Aesthetic Plastic Surgery. “If I happen to be live-streaming a surgery and something goes wrong, am I going to be thinking more about the patient or am I going to be thinking about the live- streaming? That’s why we don’t let family members or friends into the [operating room]. If you let everyone in, that is going to compromise your judgment. You are also adding things to the operating room not ideal for optimum sterility.”

“Our ethics committees are working on this as we speak,” Dr Mills adds. “There is no question that some physicians using Snapchat are being unprofessional and lack integrity based on their behaviour.”

While the biggest qualm critics have with this new trend is that doctors may be distracted during surgery, Snapchat surgeons say that it isn’t any different from teaching medical students and talking them through the steps.

Could this new trend just be a case of ‘keeping up with the times’? A recent study in the Journal of Medical Internet Research found millennial surgeons have a ‘relaxed stance’ when it comes to social media use in the context of professional medical practice, which could hint a grey area in current ethical standards.

Dr S. Manjula Jegasothy, a dermatologist who founded the Miami Skin Institute in Florida, first heard about Dr Salzhauer’s Snapchats from her own patients, she told Vanity Fair (US) earlier this year. “They said, ‘Can you believe this Dr Snapchat?’” she says.

So Dr Jegasothy started watching, and although she thinks Salzhauer’s snaps are a little flippant at times, she doesn’t see anything wrong with filming these surgeries. “It’s important to respect the boundaries of taste; that might be the one issue in terms of what he does,” she says. “But if you try to be tasteful and not gross out or offend people, then it’s going to show what you’re really like and what your staff is like. We shouldn’t have anything to hide. I don’t think secrecy is good. If you’re doing a good job, you shouldn’t have to be secretive.”

Society’s obsession with content

Viewers of these medical clips fall into three groups – those interested in pursuing careers in medicine, those wanting to learn about surgeries they may undergo, and those simply mesmerised by what they see.

Dr Schulman told his viewers in one of his Snapchat stories, “The primary purpose of this Snapchat account is for education… The content’s going to be graphic, 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.”

Social media platforms such as Snapchat have made all these previously unusual and unobservable situations, such as plastic surgery, easily available to everyone. It has become something of a cultural addiction.
The length of Snapchat videos (usually a few seconds) makes them appealing to viewers and provides an incentive to consume copious amounts of content at a very fast rate.

We are increasingly becoming accustomed to consuming the lives of others for entertainment, whether it is of educational value or not. The high level of interactivity that social apps such as Snapchat offer, keeps viewers interested and hungry for more.

Whether you are for or against surgery Snapchatting, at this point the trend is only growing and very much changing the face of plastic surgery. For surgeons, it ultimately represents a platform to show surgeries in a way that is realistic, essentially opening the theatre doors and letting viewers into the world of plastic surgery with no constraints.

While Snapchat continues to grow, and more aesthetic surgeons gravitate towards the trend, both globally and now in Australia, it becomes increasingly important to proceed with caution.

It’s important to question what impact Snapchatting these surgeries may have on the industry and society as a whole. AMP

dr-miami“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, aka plastic surgeon Michael Salzhauer, recites this monologue every morning on Snapchat for the hundreds of thousands of viewers who tune into his daily story.