The Impact of Social Media on Plastic Surgery with Dr. David Hidalgo
Posted posted on August 19, 2025
On This Week's Episode:
In a world where likes can influence looks, social media is rewriting the rules of plastic surgery. Renowned surgeon Dr. David Hidalgo joins Give Good Face with Dr. Anthony Rossi to dissect the intersection of aesthetic trends, artistry, and patient safety. From the allure (and limits) of deep plane facelifts and SMAS facelifts to the evolving role of fat grafting, this conversation reveals how modern surgery balances creativity, precision, and realistic expectations.
Guest Bio:
Dr. Hidalgo began his practice at Memorial Sloan-Kettering Cancer Center (MSK) as a reconstructive microsurgeon. He reconstructed the most challenging facial, breast and body defects, often requiring complex microsurgical tissue transplantation techniques. He developed an innovative procedure for jaw reconstruction in cancer patients while there. This involved transferring the fibula bone from the leg to the face after shaping it into an exact replica of the jaw segment removed. The bone circulation was restored in the neck with microsurgical techniques. This seminal work was reported in five key publications that brought Dr. Hidalgo international acclaim. His method of jaw reconstruction became, and has remained, the standard of care around the world. He started a fellowship training program at Memorial and became the Chief of the Plastic and Reconstructive Service there. He served in that capacity for eight years before leaving to begin a private practice in aesthetic surgery in 2001.
Today, Dr. Hidalgo sees patients and operates within his Park Avenue facility that is affiliated with Weill-Cornell Medical College (New York-Presbyterian Hospital). He holds the academic title of Clinical Professor of Surgery at that institution. He is an invited expert at international, national, and regional meetings where he lectures on facial and body contouring surgery. He is a member of the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, the American Association of Plastic Surgeons, and the American College of Surgeons, as well as many regional societies.
Episode Transcript:
DR. HIDALGO: You're not really familiar with all the technique and the anatomy. You can get into some danger, and unfortunately people have died from that. The margin for error is millimetre. So if you have the free flap we were just talking about, you got to put blood vessels together under the microscope, there's no room for failure.
DR. ROSSI: Tell me your transition. I think a lot of med students and young doctors, you know, also want to know about that. You can see things that are not right. They're good, but to make them great, you've got to do a little bit more.
DR. ROSSI: Hi, everyone. Welcome back to Give Good Face, the podcast where we talk about all things aesthetic, beauty, medicine. And today, I'm super fortunate and honored to have Dr. David Hidalgo here of New York City. He's a world famous plastic surgeon. He was the chair of plastic surgery at Memorial Sloan Kettering, where I work. His name is still talked about in so many arenas, not only for his amazing surgical skills, but also his skills as an artist. So, Dr. Hidalgo, thank you so much for being here.
DR. HIDALGO: Anthony, a pleasure to be here.
DR. ROSSI: I'm super excited because, you know, I work at Memorial and everyone talks about how amazing you are. The scrub techs, the nurses — they all say how great of a surgeon you are and how great it was to watch you operate. And now you've been in practice for over a decade, right?
DR. HIDALGO: Over 20 years. Twenty years in private practice on Park Avenue.
DR. ROSSI: You've seen your focus shift. At Memorial it was a lot of reconstruction for cancer.
DR. HIDALGO: Yes.
DR. ROSSI: And now you're more in the aesthetic space.
DR. HIDALGO: Yes.
DR. ROSSI: But the two blend.
DR. HIDALGO: They do. Memorial was more hardcore surgery. You did the first fibula free flap mandible reconstruction.
DR. ROSSI: Wow.
DR. HIDALGO: So I was like six months out of my fellowship. And it was daunting — you're at the most famous cancer institution in the world. But the tools we had at that time weren't very good. What I did was adapt a trauma technique to cancer reconstruction. There was an opportunity to do that with a supportive institution, and we took the leap. It moved the field forward and transformed thousands of lives worldwide. It was a big leap.
DR. ROSSI: I mean, the free flap is amazing. And to pioneer that takes so much guts.
DR. HIDALGO: Well, just for the audience: a free flap means taking tissue — bone, muscle, skin — from one part of the body, detaching it entirely, and reattaching its blood vessels under a microscope. Sutures as fine as human hair. You restore circulation, then shape it. It was a giant advance. We learned how to mine different parts of the body for different tissues.
DR. HIDALGO: The institution was very supportive. My colleagues were, too, because the tools we had weren't cutting it. We were welcomed with open arms.
DR. ROSSI: And that innovation — we don't always see that in medicine. You were at Memorial for how long?
DR. HIDALDO: About 14 years.
DR. ROSSI: And then tell me your transition, because med students want to know.
DR. HIDALGO: Doing something for the first time takes courage. You're like a soldier — maybe not a great analogy — but you want to go to war and learn how to do things. Memorial was like that for me. Foundational.
Plastic surgery is a continuum. Reconstruction and aesthetics are the same principles — shape and form. Morphing from reconstruction to cosmetic surgery wasn't a big leap for me. But you can't close one door and the next day do cosmetics. I transitioned over years.
Plastic surgery careers are long. You won’t get tired of things, but you can explore new directions. You can shift your practice to what interests you at that moment.
DR. ROSSI: That's great advice. And function follows form — or vice versa.
DR. HIDALGO: Yes. In reconstruction and aesthetics, the margin for error is millimeter.
With free flaps, a millimeter makes a huge difference. With a 16-year-old with a nasal bump, the concept is simple, but it has to be perfect because it must last 70–80 years. It’s as demanding as a free flap. The consequences are different but just as important. The principles are the same.
DR. ROSSI: People always say you're meticulous. And every millimeter counts.
DR. HIDALGO: It does. You have to be unforgiving in the pursuit of perfection. And sometimes you pay a price with the clock. You schedule a surgery for three hours, and you're five hours in — still not right. But you know you can get it right. So you keep going. You blow up your OR schedule and your family schedule. But the goal is paramount. It's about doing right by the patient.
DR. ROSSI: Patient first — especially now with the boom in plastic surgery. How do you feel about the mindset around it?
DR. HIDALGO: It's always been popular — but underground. People wouldn’t talk about it but would quietly share referrals. Vogue articles would flood your office.
Today it's omnipresent thanks to social media. Less inhibition — Kylie Jenner and Alix Earle openly share their work.
DR. ROSSI: Alix was transparent about what you did for her.
DR. HIDALGO: Transparency is good. Social media can educate — but can also distort. Most people have just one thing that bothers them, and they’re realistic. They become informed consumers. But others compare themselves endlessly and feel worse.
DR. ROSSI: And filters and editing create unrealistic expectations.
DR. HIDALGO: True. But interestingly, I don't think social media creates artificial trends in patient requests. Most people come saying, “I don’t like this — what can we do?” Overall, it's more helpful than harmful.
DR. ROSSI: Speaking of trends — the deep plane facelift. Everyone’s talking about it.
DR. HIDALGO: Deep plane is mostly a triumph of marketing. All surgeons handle skin and SMAS. Deep plane lifts the skin and SMAS together — so you move it in one direction. SMAS facelifts separate them, allowing vertical SMAS lift and oblique skin tightening for better shape.
Deep plane creates bulk here (points to midface) and forces tension forward. Not ideal.
Nothing wrong with deep plane — some do it beautifully — but SMAS gives more control. Deep plane is one-size-fits-all. Facial anatomy varies too much for that.
DR. ROSSI: Exactly — it must be individualized.
DR. HIDALGO: Yes. Deep plane does the same operation on everyone. That’s the issue.
DR. ROSSI: And what about doing extreme lifts on very young faces?
DR. HIDALGO: Trends — they'll fade. The fox eye, ponytail lifts — five years from now no one will be doing them. Some people think Cybertrucks are beautiful too. Trends don’t equal longevity.
DR. ROSSI: In Korea they’re doing extreme reshaping — faces becoming homogenous.
DR. HIDALGO: Asian aesthetics differ. The anatomy differs. Jaw reduction, V-line shaping — it's a different discipline entirely. Valid for their population, but not the same as Western goals.
DR. ROSSI: The content is definitely being consumed — but safety is another issue.
DR. HIDALGO: Yes. Outside the U.S., oversight varies. The Brazilian butt lift (BBL) is the riskiest procedure in plastic surgery. Clinics with no oversight created disasters — particularly in Florida. If you don’t know the anatomy, people die.
DR. ROSSI: It’s so dangerous. And these results… I'm not sure how they age.
DR. HIDALGO: Neither am I. A 20-year-old looks great. At 40? Unknown. And it's irreversible — you can’t go back.
DR. ROSSI: I want to talk about your hyper-realistic drawings. When did that start?
DR. HIDALGO: Art came first. In college I had to choose art or medicine. I came to SoHo to see what an artist’s life would be like. I realized you can create the best art in the world, but if it isn’t marketable, no one sees it. So I chose medicine, but art never left.
Art and surgery are inseparable. Both require seeing.
My drawings take 300–500 hours, often a year apiece. It's like building a house — slow, disciplined. For me, it’s meditation. A pursuit of perfection with no risk — unlike surgery.
DR. ROSSI: And they feel emotional — not just technically impressive.
DR. HIDALGO: They must have soul. Robert Longo is the master, but his are almost photographic. To me, that lacks weight unless there’s a message. My drawings must reflect the human condition.
DR. ROSSI: And so much of facial aesthetics is light and shadow.
DR. HIDALGO: Exactly. Shape and nuance — in both art and surgery.
DR. ROSSI: What do you think about during surgery? Same as drawing?
DR. HIDALGO: Both require technique, but technique becomes instinctive with time. In both, I focus on the problem: What's wrong? How do we fix it?
DR. ROSSI: Advice for people thinking about plastic surgery?
DR. HIDALGO: Like wanting to be a pro golfer or actor — you must be all in. Seek out the best mentors. A mentors create A surgeons. Ambition, intensity, and finding the best teachers define your trajectory.
DR. ROSSI: We're seeing more regenerative medicine — senescent cells, gene expression.
DR. HIDALGO: Dermatology will advance in that realm more than surgery. Plastic surgery is about altering form. Dermatology is about altering biology.
DR. ROSSI: What about fillers? Boundary issues?
DR. HIDALGO: Fillers are strong tools, but patients often push them too far. No amount of filler in the cheek will lift a jowl. Faces start looking strange. The issue is knowing when fillers have reached their limit — then moving to surgery.
DR. ROSSI: Yes — reputable practitioners know those boundaries.
DR. HIDALGO: Exactly. Patients become loyal and want more and more. But we must say: this is as far as this tool goes.
DR. ROSSI: And fat grafting? Especially body sculpting?
DR. HIDALGO: Fat grafting is unreliable. It's not vascularized. It must pick up circulation before it dies. Works well in muscle, poorly in mobile facial areas. Works in quiet areas like cheeks. Doesn’t work well in breasts — we tried fat breast augmentation, it never lasted.
Some surgeons believe fat works for everything. I don’t. It's inherently unreliable.
DR. ROSSI: Thank you — important to hear.
DR. HIDALGO: You don't want to do something that doesn’t work. People eventually figure it out.
DR. ROSSI: How do you maintain longevity in this field? Staying true to yourself?
DR. HIDALGO: I trained with the best — NYU had A surgeons in every subspecialty. I learned all procedures.
If you don’t know a procedure well, you won’t want to do it, and you’ll suffer a long learning curve. Plastic surgeons have the luxury of shaping their career over time, but you need broad expertise.
And if you focus on one operation your whole career, you may burn out — especially with highly labor-intensive procedures.
DR. ROSSI: Before and afters on your social are so refined — subtle and elegant.
DR. HIDALGO: Thank you.
DR. ROSSI: Thank you so much for being here. This is legendary.
DR. HIDALGO: I’m flattered you asked.
DR. ROSSI: Everyone should follow Dr. Hidalgo on Instagram — it's beautiful, it’s art.
DR. HIDALGO: Thank you.
DR. ROSSI: Thanks for listening to this episode of Give Good Face.
The Impact of Social Media on Plastic Surgery with Dr. David Hidalgo
On This Week's Episode:
In a world where likes can influence looks, social media is rewriting the rules of plastic surgery. Renowned surgeon Dr. David Hidalgo joins Give Good Face with Dr. Anthony Rossi to dissect the intersection of aesthetic trends, artistry, and patient safety. From the allure (and limits) of deep plane facelifts and SMAS facelifts to the evolving role of fat grafting, this conversation reveals how modern surgery balances creativity, precision, and realistic expectations.
Guest Bio:
Dr. Hidalgo began his practice at Memorial Sloan-Kettering Cancer Center (MSK) as a reconstructive microsurgeon. He reconstructed the most challenging facial, breast and body defects, often requiring complex microsurgical tissue transplantation techniques. He developed an innovative procedure for jaw reconstruction in cancer patients while there. This involved transferring the fibula bone from the leg to the face after shaping it into an exact replica of the jaw segment removed. The bone circulation was restored in the neck with microsurgical techniques. This seminal work was reported in five key publications that brought Dr. Hidalgo international acclaim. His method of jaw reconstruction became, and has remained, the standard of care around the world. He started a fellowship training program at Memorial and became the Chief of the Plastic and Reconstructive Service there. He served in that capacity for eight years before leaving to begin a private practice in aesthetic surgery in 2001.
Today, Dr. Hidalgo sees patients and operates within his Park Avenue facility that is affiliated with Weill-Cornell Medical College (New York-Presbyterian Hospital). He holds the academic title of Clinical Professor of Surgery at that institution. He is an invited expert at international, national, and regional meetings where he lectures on facial and body contouring surgery. He is a member of the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, the American Association of Plastic Surgeons, and the American College of Surgeons, as well as many regional societies.
Episode Transcript:
DR. HIDALGO: You're not really familiar with all the technique and the anatomy. You can get into some danger, and unfortunately people have died from that. The margin for error is millimetre. So if you have the free flap we were just talking about, you got to put blood vessels together under the microscope, there's no room for failure.
DR. ROSSI: Tell me your transition. I think a lot of med students and young doctors, you know, also want to know about that. You can see things that are not right. They're good, but to make them great, you've got to do a little bit more.
DR. ROSSI: Hi, everyone. Welcome back to Give Good Face, the podcast where we talk about all things aesthetic, beauty, medicine. And today, I'm super fortunate and honored to have Dr. David Hidalgo here of New York City. He's a world famous plastic surgeon. He was the chair of plastic surgery at Memorial Sloan Kettering, where I work. His name is still talked about in so many arenas, not only for his amazing surgical skills, but also his skills as an artist. So, Dr. Hidalgo, thank you so much for being here.
DR. HIDALGO: Anthony, a pleasure to be here.
DR. ROSSI: I'm super excited because, you know, I work at Memorial and everyone talks about how amazing you are. The scrub techs, the nurses — they all say how great of a surgeon you are and how great it was to watch you operate. And now you've been in practice for over a decade, right?
DR. HIDALGO: Over 20 years. Twenty years in private practice on Park Avenue.
DR. ROSSI: You've seen your focus shift. At Memorial it was a lot of reconstruction for cancer.
DR. HIDALGO: Yes.
DR. ROSSI: And now you're more in the aesthetic space.
DR. HIDALGO: Yes.
DR. ROSSI: But the two blend.
DR. HIDALGO: They do. Memorial was more hardcore surgery. You did the first fibula free flap mandible reconstruction.
DR. ROSSI: Wow.
DR. HIDALGO: So I was like six months out of my fellowship. And it was daunting — you're at the most famous cancer institution in the world. But the tools we had at that time weren't very good. What I did was adapt a trauma technique to cancer reconstruction. There was an opportunity to do that with a supportive institution, and we took the leap. It moved the field forward and transformed thousands of lives worldwide. It was a big leap.
DR. ROSSI: I mean, the free flap is amazing. And to pioneer that takes so much guts.
DR. HIDALGO: Well, just for the audience: a free flap means taking tissue — bone, muscle, skin — from one part of the body, detaching it entirely, and reattaching its blood vessels under a microscope. Sutures as fine as human hair. You restore circulation, then shape it. It was a giant advance. We learned how to mine different parts of the body for different tissues.
DR. HIDALGO: The institution was very supportive. My colleagues were, too, because the tools we had weren't cutting it. We were welcomed with open arms.
DR. ROSSI: And that innovation — we don't always see that in medicine. You were at Memorial for how long?
DR. HIDALDO: About 14 years.
DR. ROSSI: And then tell me your transition, because med students want to know.
DR. HIDALGO: Doing something for the first time takes courage. You're like a soldier — maybe not a great analogy — but you want to go to war and learn how to do things. Memorial was like that for me. Foundational.
Plastic surgery is a continuum. Reconstruction and aesthetics are the same principles — shape and form. Morphing from reconstruction to cosmetic surgery wasn't a big leap for me. But you can't close one door and the next day do cosmetics. I transitioned over years.
Plastic surgery careers are long. You won’t get tired of things, but you can explore new directions. You can shift your practice to what interests you at that moment.
DR. ROSSI: That's great advice. And function follows form — or vice versa.
DR. HIDALGO: Yes. In reconstruction and aesthetics, the margin for error is millimeter.
With free flaps, a millimeter makes a huge difference. With a 16-year-old with a nasal bump, the concept is simple, but it has to be perfect because it must last 70–80 years. It’s as demanding as a free flap. The consequences are different but just as important. The principles are the same.
DR. ROSSI: People always say you're meticulous. And every millimeter counts.
DR. HIDALGO: It does. You have to be unforgiving in the pursuit of perfection. And sometimes you pay a price with the clock. You schedule a surgery for three hours, and you're five hours in — still not right. But you know you can get it right. So you keep going. You blow up your OR schedule and your family schedule.
But the goal is paramount. It's about doing right by the patient.
DR. ROSSI: Patient first — especially now with the boom in plastic surgery. How do you feel about the mindset around it?
DR. HIDALGO: It's always been popular — but underground. People wouldn’t talk about it but would quietly share referrals. Vogue articles would flood your office.
Today it's omnipresent thanks to social media. Less inhibition — Kylie Jenner and Alix Earle openly share their work.
DR. ROSSI: Alix was transparent about what you did for her.
DR. HIDALGO: Transparency is good. Social media can educate — but can also distort. Most people have just one thing that bothers them, and they’re realistic. They become informed consumers. But others compare themselves endlessly and feel worse.
DR. ROSSI: And filters and editing create unrealistic expectations.
DR. HIDALGO: True. But interestingly, I don't think social media creates artificial trends in patient requests. Most people come saying, “I don’t like this — what can we do?” Overall, it's more helpful than harmful.
DR. ROSSI: Speaking of trends — the deep plane facelift. Everyone’s talking about it.
DR. HIDALGO: Deep plane is mostly a triumph of marketing. All surgeons handle skin and SMAS. Deep plane lifts the skin and SMAS together — so you move it in one direction. SMAS facelifts separate them, allowing vertical SMAS lift and oblique skin tightening for better shape.
Deep plane creates bulk here (points to midface) and forces tension forward. Not ideal.
Nothing wrong with deep plane — some do it beautifully — but SMAS gives more control. Deep plane is one-size-fits-all. Facial anatomy varies too much for that.
DR. ROSSI: Exactly — it must be individualized.
DR. HIDALGO: Yes. Deep plane does the same operation on everyone. That’s the issue.
DR. ROSSI: And what about doing extreme lifts on very young faces?
DR. HIDALGO: Trends — they'll fade. The fox eye, ponytail lifts — five years from now no one will be doing them.
Some people think Cybertrucks are beautiful too. Trends don’t equal longevity.
DR. ROSSI: In Korea they’re doing extreme reshaping — faces becoming homogenous.
DR. HIDALGO: Asian aesthetics differ. The anatomy differs. Jaw reduction, V-line shaping — it's a different discipline entirely. Valid for their population, but not the same as Western goals.
DR. ROSSI: The content is definitely being consumed — but safety is another issue.
DR. HIDALGO: Yes. Outside the U.S., oversight varies. The Brazilian butt lift (BBL) is the riskiest procedure in plastic surgery. Clinics with no oversight created disasters — particularly in Florida. If you don’t know the anatomy, people die.
DR. ROSSI: It’s so dangerous. And these results… I'm not sure how they age.
DR. HIDALGO: Neither am I. A 20-year-old looks great. At 40? Unknown. And it's irreversible — you can’t go back.
DR. ROSSI: I want to talk about your hyper-realistic drawings. When did that start?
DR. HIDALGO: Art came first. In college I had to choose art or medicine. I came to SoHo to see what an artist’s life would be like. I realized you can create the best art in the world, but if it isn’t marketable, no one sees it. So I chose medicine, but art never left.
Art and surgery are inseparable. Both require seeing.
My drawings take 300–500 hours, often a year apiece. It's like building a house — slow, disciplined. For me, it’s meditation. A pursuit of perfection with no risk — unlike surgery.
DR. ROSSI: And they feel emotional — not just technically impressive.
DR. HIDALGO: They must have soul. Robert Longo is the master, but his are almost photographic. To me, that lacks weight unless there’s a message. My drawings must reflect the human condition.
DR. ROSSI: And so much of facial aesthetics is light and shadow.
DR. HIDALGO: Exactly. Shape and nuance — in both art and surgery.
DR. ROSSI: What do you think about during surgery? Same as drawing?
DR. HIDALGO: Both require technique, but technique becomes instinctive with time. In both, I focus on the problem: What's wrong? How do we fix it?
DR. ROSSI: Advice for people thinking about plastic surgery?
DR. HIDALGO: Like wanting to be a pro golfer or actor — you must be all in. Seek out the best mentors. A mentors create A surgeons. Ambition, intensity, and finding the best teachers define your trajectory.
DR. ROSSI: We're seeing more regenerative medicine — senescent cells, gene expression.
DR. HIDALGO: Dermatology will advance in that realm more than surgery. Plastic surgery is about altering form. Dermatology is about altering biology.
DR. ROSSI: What about fillers? Boundary issues?
DR. HIDALGO: Fillers are strong tools, but patients often push them too far. No amount of filler in the cheek will lift a jowl. Faces start looking strange. The issue is knowing when fillers have reached their limit — then moving to surgery.
DR. ROSSI: Yes — reputable practitioners know those boundaries.
DR. HIDALGO: Exactly. Patients become loyal and want more and more. But we must say: this is as far as this tool goes.
DR. ROSSI: And fat grafting? Especially body sculpting?
DR. HIDALGO: Fat grafting is unreliable. It's not vascularized. It must pick up circulation before it dies. Works well in muscle, poorly in mobile facial areas. Works in quiet areas like cheeks. Doesn’t work well in breasts — we tried fat breast augmentation, it never lasted.
Some surgeons believe fat works for everything. I don’t. It's inherently unreliable.
DR. ROSSI: Thank you — important to hear.
DR. HIDALGO: You don't want to do something that doesn’t work. People eventually figure it out.
DR. ROSSI: How do you maintain longevity in this field? Staying true to yourself?
DR. HIDALGO: I trained with the best — NYU had A surgeons in every subspecialty. I learned all procedures.
If you don’t know a procedure well, you won’t want to do it, and you’ll suffer a long learning curve. Plastic surgeons have the luxury of shaping their career over time, but you need broad expertise.
And if you focus on one operation your whole career, you may burn out — especially with highly labor-intensive procedures.
DR. ROSSI: Before and afters on your social are so refined — subtle and elegant.
DR. HIDALGO: Thank you.
DR. ROSSI: Thank you so much for being here. This is legendary.
DR. HIDALGO: I’m flattered you asked.
DR. ROSSI: Everyone should follow Dr. Hidalgo on Instagram — it's beautiful, it’s art.
DR. HIDALGO: Thank you.
DR. ROSSI: Thanks for listening to this episode of Give Good Face.