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Dr. Robert Schwarcz is among a growing number of plastic surgeons feeling the pressure to compete on social media. His New York practice is thriving despite his small Instagram following, but he knows that in order to grow his followers (and his business), he needs patients willing to share their before and after photos—something New Yorkers don’t seem too eager to do.

“I used to practice in Los Angeles, and I remember many patients being very generous in letting me use their before and after photos,” says Schwarcz. “We New Yorkers are very private people, and it makes it difficult to get permission.”

Plastic surgery in the mainstream

Cosmetic surgery isn’t the taboo topic it once was, and it also isn’t as expensive as one might imagine. According to the American Society of Plastic Surgeons, the average breast augmentation surgery costs about $3,700. Thanks to Beyoncé and Nicki Minaj, plump butts are in style, and the average buttock augmentation surgery will set you back about $4,500. Apps and filters re-instated facelifts on the list of the most requested cosmetic procedures in 2016, and they cost about $7,000.

Elective surgeries like these are not typically covered by insurance, so it may seem a bit pricey to pay that much out of pocket for a procedure. But many Americans are just a large gift or work bonus away from the breasts, butt, and face they’ve always wanted.

A Chinese doctor performs facial injection on a woman at a plastic cosmetic surgery hospital in Guangzhou city

With such relatively reasonable price tags, everyone from celebrities to the average joe has access to cosmetic procedures, and with that access has come increased visibility. “Plastic surgeon” is among an increasing number of “social media famous” career choices (right up there with model and “influencer”), where posting results and growing a following can lead to some pretty big business—as well as notoriety.

Miami-based plastic surgeon Michael “Dr. Miami” Salzhauer is a shining example of this, and he claims that he’s the first in the field to post his procedures on social media. Salzhauer livestreams surgeries on Snapchat and has amassed over 600,000 followers on Instagram by posting everything from before and after photos to videos of him rapping in the operating room. His followers seem to love it and television producers took note, giving him his own reality television series on WEtv.
Andrew “Dr. Curves” Jimerson is another example of social media success. The Atlanta-based plastic surgeon has over 200,000 followers on Instagram, which include, like Dr. Miami, everyday people and celebrities alike. Jimerson says that the significance of extending his social media reach is not lost on him. In fact, it’s at the heart of his business. When followers see people like them getting procedures that they’d never heard of, they want to know more.

“I think that my practice has been built on results, and my marketing has been built on social media,” Jimerson says. “So we use social media heavily to inform our patients. Some of our patients have been following us for for years. I think it’s brought a lot of people to plastic surgery … who would not normally have it because they get to see it and they start building trust with our practice and also have confidence in what we’re doing.”

https://www.instagram.com/p/BYGLj5-DmLV/?taken-by=drcurves

Dr. Miami and Dr. Curves are the success stories here. They were able to build a significant social media base and maintain practices without sacrificing their reputations. Their businesses have grown exponentially with their followings, but they may be the exception rather than the rule. Some plastic surgeons, those who aren’t “social media famous,” struggle to strike a balance.

Caricature or the real deal?

Dr. Robert Schwarcz’s Instagram feed isn’t too different from those of Dr. Miami and Dr. Curves. Of course, he’s still “Dr. Schwarcz” to his patients, as he hasn’t taken on a glamorous moniker. But his feed, scattered with photos of him in the operating room as well as some of him having leisure time with his family, is on par with the big names. The problem, Schwarcz says, is striking the delicate balance between promoting the practice, appealing to those who want to see the human side of him, and not damaging his professional reputation.

“Sometimes I worry that I’ll be taken too lightly,” says Schwarcz. “I don’t want to cheapen my brand.”

That worry is reflected in the privacy settings on his page. While many of his counterparts have public pages, people hoping to follow Dr. Schwarcz have to request to follow him. It may seem like an insignificant difference, but pages with public profiles are able to attract more followers through the use of location tags and well-placed hashtags.

That doesn’t mean that Schwarcz isn’t rightfully concerned. Dr. Miami has been the focus of both praise and criticism. New York plastic surgeon Dr. Daniel Maman told Racked that social media scenarios that focus on the doctor rather than the patient can have dire consequences.

“A lot of these guys who have big Snapchat accounts, they spend half the time cracking jokes and dressing up and chatting with viewers, and I think that’s a distraction and certainly not the standard of care when it comes to surgery,” Maman said.

https://www.instagram.com/p/BVa0EYindXk/?taken-by=therealdrmiami

While rapping and cracking jokes does wonders to humanize the doctors behind the surgeries, for the wrong surgeons in the wrong environment, it can prove deadly. A study just last month found that many Instagram accounts using cosmetic surgery hashtags aren’t run by board-certified plastic surgeons at all. In fact, only 17.8 percent of the professionals using the hashtags were actually eligible for membership in the American Society for Aesthetic Plastic Surgery (ASAPS).

That doesn’t necessarily mean people using these hashtags are not capable of giving stellar results. Eligibility for the ASAPS simply means someone is trained and certified in plastic surgery specifically. But the fact is, when you find a surgeon on social media, you never really know what you’re getting.

“I think [social media has] made a huge difference, both positive and negative,” Andrew Jimerson (“Dr. Curves”) tells Culture Trip. “It can have a negative effect because sometimes it gives people who are not authorities on the topic a voice. You know, sometimes those people can seem like authorities when they’re actually not.”

Location, location, location

Despite his hesitancy to get into the social media game, Schwarcz’s biggest obstacle to joining the ranks of Instagram’s plastic surgeon elite may come down to where he’s located. New Yorkers are notoriously lowkey. We don’t make a fuss about celebrities, nor do we want everyone knowing whether the nose we have today is the same one we had in middle school. Living in a building and greeting neighbors with a pleasant “hello” is a practice left to New York City newbies, one that wanes once you’re properly in the city for a few months.

So posting before and after photos of New Yorkers on social media for the world to see? It may be a bit tricky.

As his name suggests, “Dr. Curves” specializes in body enhancements from the neck down. His market in Atlanta, where big butts are both plentiful and desired, is perfect for his clientele. Similarly, Dr. Miami is in a beach city where the physical beauty standard and demand for tighter glutes and perkier breasts is as high as the tide in a surfer’s fantasies. Both surgeons also cater to millennial patients who tend to be more open about things like plastic surgery than generations before them.

Still, Schwarcz knows followers are currency, and while finding patients willing to bare their before and afters in New York City may be challenging it’s not impossible. He’s committed to staying the course.

“I’m on Instagram and Facebook,” Schwarcz says. “The benefits are that people get to see a different side of me and there are no geographic limitations. I think it’s very cool when someone contacts me with questions halfway across the world. We can all agree on beauty.”

“At the end of the day, I’m helping people. That’s what matters.”

About the author

Nadia leads Culture Trip's U.S. editorial team. She's a law-educated journalist covering culture, sexual health, health care policy, and marijuana legislation. Her work has been featured in a number of publications including Medical Daily and Newsweek.

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