Secrets to success with Dr Miami
Jana Denzel talks to social media star Dr Miami about his journey into plastic surgery, how he thinks the industry will change post-COVID and what job he would do if he was not a surgeon.
Dr Michael Salzhauer, better known as the social media star Dr. Miami, believes “plastic makes perfect.” Dr. Miami is not only one of the best plastic surgeons in the world, but is also one of the most followed – with millions of fans getting a daily peek inside his operating room. Today, we speak to him about the link between aesthetics from plastic surgery to dentistry, how changing someone’s appearance effects their self-esteem and his advice to younger dentists.
Dr Miami! Where did it all start? What drove you to go into plastic surgery?
Dr Miami: My girlfriend, who became my wife 25 years ago, got into a car accident. She got a cut through her lower lip. They took her to the hospital, some intern sewed it up, and it left a scar that she didn’t like. So she wanted to get it fixed.
I went to go to a plastic surgeon. At the time, in the late 80s and early 90s, a plastic surgeon to me was somebody who made old rich people look weird. But I took her into Manhattan, and we went into a plastic surgeon’s office. I saw an album of before and after pictures in his waiting room and it was the first time that I really saw what plastic surgery was.
Before digital imaging, plastic surgery was not talked about often in public or in polite company. You really never saw before and after pictures. So when I looked through the album, it looked like magic. It looked like Harry Potter wizardry. It didn’t look like the same person. Where did the nose go? How did the breast get like that? How is that the same person? Where did the tummy go?
So, when she came out of her consultation, I asked: ‘Dude, what is this? Tell me.’ And he said: ‘This is plastic surgery.’
So the next summer, I started medical school. The first thing I did was go right to the plastic surgery department and said: ‘Tell me how I can be like you’. Since then, it’s been 28 years where I’ve done nothing but think, focus on and dream about plastic surgery.
Now, in the beginning it wasn’t cosmetic surgery. It was just reconstructive surgery. But as I got towards the end of my plastic surgery residency, my chairman said: ‘Hey, you should do a fellowship.’ I said: ‘Okay, but I’m not leaving Miami because I got my kids and my house.’
But there happened to be an aesthetic surgery fellowship in Miami. I did that for a year and I fell in love with cosmetic surgery. That’s my story. I’ve been doing nothing but that out of my practice.
Favourite transformation and why?
Dr Miami: I don’t remember all of them, but I will say this. I remember early on in my practice, maybe my fourth or fifth year in, there was a young girl who came in. She was maybe 18 or 19 years old. She had kind of a big nose and a weak chin, but other than that, she was just beautiful. Her eyes were beautiful, her body was beautiful and she had gorgeous skin – perfect.
I did a nose job and a chin implant on her. I carried that before and after picture around in my wallet for about five years afterwards – I would just show anybody who would look. This was way before smartphones, before you could whip out your phone and show pictures.
I carried an actual thumbnail picture of this before and after because I remember her coming into the office as a very shy, low self-esteem, awkward late teenager. Seeing her a year or two later just blossoming really reminded me: ‘This is why you do what you do.’ So that would be one of my favourite transformations.
How much do you feel that changing someone’s appearance has an impact on their work as well as their self esteem?
Dr Miami: If I meet the right patient at the right time of their life, I can have a huge impact.
Take that girl, for example. She became almost a different person. She went from being shy and reticent to talking to strangers. Just imagine the difference in terms of what kind of job she applies for. I’m sure in the past she wouldn’t want to do anything that had to do with the public or meeting strangers. But afterwards, a few years later, she’s like a different person. From who she marries to how happy she is, those things are priceless.
On the other hand, if it’s somebody who’s just doing plastic surgery on a whim, I try to weed out those people with body dysmorphia. That’s certainly not helpful. It’s the same thing with older women, too.
I remember I had a patient not too long ago. She came to me again, maybe a year or two after she had surgery from me. She said: ‘I just want you to know, not too long after the surgery, I was in a grocery store and I went down an aisle and I turned the corner and I just started to cry.’
I asked her why and she said: ‘A guy looked at me in a way that a man hasn’t looked at me in 20 years.’ In other words, she had been so down on herself and her appearance. The thought that she could attract a look of desire from a stranger in a supermarket had escaped her. When she got that look she just broke down.
She was just so happy, and she just wanted to say thank you. Those are the kinds of moments and things that you get when patients open up about how it changes them.
So that’s definitely something that crosses over when we talk about cosmetic or aesthetic dentistry as well. It’s all in the whole field of aesthetics.
Dr Miami: Let me tell you, when patients come in and they tell me: ‘I only have $10,000 to spend on making myself look better and feel better’. I would say to put it on your smile first. I tell that to patients in a subtle and polite way.
In my mind, the hierarchy of aesthetics starts with the smile.
If you don’t have the smile, what’s the point of having large breasts or a nice body if you can’t talk and you know, you’re embarrassed to open your mouth? That’s just my opinion. In my mind, I think the smile comes first and then everything else. This includes weight loss, fitness, breast augmentation or a tummy tuck. Everything else comes after.
And I think that most Americans would agree. I don’t know what it’s like overseas. But in America, I think most people would agree to fix your smile first and then everything else.
There has always been some controversy towards cosmetic dentistry. It’s often deemed dangerous and unnecessary. What are your views?
Dr Miami: Cosmetic dentistry is no different than any other cosmetic surgery. I’m making an incision. I’m doing surgery. I’m cutting up your body to make it better. If it’s to make it better, why wouldn’t you do it?
Your teeth are not going to fix themselves on their own. You are not going to magically wake up tomorrow and have nice teeth.
Yes, however, some may say that if your teeth are functioning normal and fine, why would you want to go through unnecessary trauma purely for cosmetic purposes? The same with someone’s body. If it’s working and functioning fine, why would you want to put them through that unnecessary trauma just for purely cosmetic purposes?
Dr Miami: I don’t know. Why don’t you live in a cave, why bother building a house? Why put on clothes when you’re born naked? I don’t know. I mean those are just normal things. Part of the human condition is that we try to master nature. We try to master our environment so that we have a better, more fulfilling life. I think that’s just a normal extension of it.
Let me tell you this. In the United States, if you have an 11-year-old kid walking around with teeth sticking out in all directions and you don’t put braces on that kid, it’s almost like child abuse. Other parents will look at you like: ‘Why aren’t you taking your son to the dentist?’ Or think that you must not be able to afford braces.
In other words, why would you let your kid walk around with teeth going out in all directions when you can fix it? Same thing with an adult. You obviously have your hierarchy of needs. You need to have your shelter, safety, and food first. But once you have your basics and you have extra money that you’ve earned, why wouldn’t you invest in yourself or your kids or your loved one?
You’re not only a plastic surgeon, but you’re an entrepreneur. You have your own music track, you’re a social media icon, and you’ve been on TV. If you weren’t a plastic surgeon and had to choose just one career, what would it be?
Dr Miami: Oh, I don’t know. A shepherd maybe in New Zealand somewhere, that sounds like a good gig. No, I don’t know. I probably would be a psychiatrist. I think what I do is like psychiatry with a knife. In other words, what I deal with is self-esteem, the same as you.
Ultimately, we are in the happiness business. You see, I might do surgery and the patient looks fantastic. Everybody thinks they’re fantastic, but the patient doesn’t like it and patient doesn’t feel better about themselves. We failed.
So yeah, it’s psychology, it’s therapy with a knife. If I couldn’t operate, I probably would do some kind of therapy, or find other ways to make people feel better.
If you could give one piece of advice from when you were first starting off in your career, what would it be?
Dr Miami: I would say try to figure out as quickly as you can what kinds of procedures you like to do the most and what kind of patients you like to operate or do those procedures on. Once you’ve shot the arrow, paint the target around it. Then market only to those people and those procedures you want to do.
I think too many doctors, dentists, and surgeons try to do everything when they open their practice. Obviously, in the beginning, it might take you some time to figure out exactly what you enjoy doing and the kind of people you like to operate on. But once you find that sweet spot, just keep hitting that sweet spot. Don’t advertise or market yourself to the whole world.
There’s enough of the kinds of people you want to operate on out there that will fill your days.
What would you say are the three main skills you need to have as an entrepreneur?
Dr Miami: First of all, the main skill you need to have as a baseline is the skill that you’re marketing. The best marketing campaign in the world is going to fail if the product that you’re marketing is not good. Sometimes people put the cart before the horse.
Say you’ve just come out of your training, you’ve done a grand total of six veneers. I don’t know what the number is, but let’s say I did six breast augmentations. Don’t market yourself as the world’s greatest breast augmentation surgeon because you only did six or even a hundred.
Work on your skills. If that means working with somebody else or if it means working next to somebody so you get the experience, you’re good. That’s the first thing: master your skill. The second skill is obviously marketing, and the third would be how to deal with patients and clients.
If you’ve got those three things, the skills and the marketing to get patients in the door. And you know how to relate to patients and clients, and to do a good job for them and connect with them, you’re golden. And that goes for any field.
If you were to have dinner with anyone in the world, dead or alive, who would it be and why?
Dr Miami: For me, it would be my late dad. I would wake my dad up and tell him to come have dinner with me. I miss him and he is funny.
My dad was an immigrant here, so he had that really great sense of humour that only outsiders have. I think he gave that to me – I’ve felt like a little bit of an outsider my whole life. I just would love to spend 24 hours with my dad.
What is your greatest accomplishment to date and what do you feel most grateful for?
Dr Miami: I’m most grateful for my wife and kids. That’s the number one and two. After that, everything’s a distant third. But I guess it would be the practice. It would be just being able to help people and really influence their lives and change what they do with a smile. It has a huge impact on people for years and years. It’s not a small thing.
I started doing this one thing when I opened my practice. I read it a marketing book. We put a little diary on the checkout counter in the office, so that after surgery patients could write little notes. Handwritten thank you notes. I filled up maybe 15 or 16 of these books. Thousands of those handwritten thank you notes. That’s what I’m most proud of.
I jokingly tell my office manager that at my funeral I want them to bring out all those books and read every single one. I’m not sure how long it would take.
Here in the UK, dentistry is never going to be the same again after COVID-19. How is the world of plastic surgery going to change post-COVID?
We jokingly said we’re going to have a drive-through Botox – but we were only half joking. I don’t know. For plastic surgery, it’s not so bad, because the patient load is fairly low. I don’t do more than three or four surgeries a day. So I don’t usually have more than three or four follow ups a day. I’ve been doing a lot of my consultations virtually for years anyway.
So my practice is not going to change that much other than we better be careful with scheduling so people don’t have to be in the same place at same time. And obviously we’ll need to have all the PPE and do all the disinfecting, and all the COVID testing and screening.