It’s about 6 p.m. on a weeknight in Dr. Miami’s Bal Harbour office. He’s preparing for his last surgery of the day, what he calls a “full mommy makeover”—a breast augmentation, tummy tuck and Brazilian butt lift. Inside the operating room a team comprised of an anesthesiologist, a surgical assistant and recovery nurse are preparing the patient, who flew in just for the procedure. As Dr. Miami enters the room to begin, two more staff members join him—his assistant and his social media manager—wearing surgical masks and hair caps and toting iPhones, ready to document the surgery for Snapchat. At this point, Fetty Wap’s “Trap Queen” would usually be blaring from the speakers in the room, but not tonight—Dr. Miami’s an Orthodox Jew, and we’re in the middle of the “Three Weeks,” a time of mourning. A photographer seated next to a computer, where an assistant is answering emails, blurts out, “What’s that smell?” There’s definitely something in the air, a cross between the spinning drill of a dentist, barbecuing meat, and plastic that’s just been lit on fire. “It’s burning flesh! You’ve never barbecued chicken before?” Dr. Miami says, his smile hidden by his mask. The recovery nurse adds, “You get used to it.” 

Maybe not the smell, but fans of Dr. Miami, whose real name is Dr. Michael Salzhauer, have gotten used to the blood and guts he shares daily on Snapchat. “It's a risky thing,” he says of the decision to broadcast real-time Snapchats of his patients’ surgeries. “We’re the first to ever have a dialogue with our audience this way, as far as I know…we definitely touched a nerve.”