Plastic Surgery Before and After Photos: How to Interpret Them During the Consultation Process by @PhilipYoungMD

Plastic Surgery Before and After Photos: How to Interpret Them During the Consultation Process by @PhilipYoungMD

Being able to see Plastic surgery Before and After Photos is an essential process in evaluating a potential Plastic Surgeon. We are going to discuss a few things to look for, topics to consider, and other items that you can address during your consultation.

Taking before and after pictures is the most important step in the whole consultation process. There are certain things that you should be aware of when you interpret Plastic surgery Before and after photos based on how photos are taken. There is an industry standard that people follow so that photos can be more accurately compared from different time points and by different surgeons. The Frankfort Horizontal is the scientific model for how a photo should be taken. Essentially in all photographs of the face, the top of the inferior orbital rim, or the bone just under the eye and a line connecting this to the top of the ear canal should be level with the floor. There are 5 basic views that should be taken with that orientation, the frontal, both obliques and both laterals. The frontal view should be of the client looking straight at the camera oriented along the Frankfort horizontal. The eyes should be level as well. Sometimes leveling the ear canals is another way of doing this. The next view are the obliques. This is when the head is turned left or right and the nose is just tangent with the cheek on both sides. The laterals are when the person is turned to the side. In this view, you should just begin to not see the opposite sides eyelashes or eyebrows, or when they are exactly superimposed over the side that you are taking the photograph. If you are able to see the other eyebrow or other eyelash they are turned towards you too much and the photograph is different and is not adequate to evaluate the before and after's on an equal, comparable basis. With all of the views, the Frankfort horizontal should be adhered to and the eyes should be level. On top of all of this, when you take the photo it is more scientifically consistent to be at the same exact level of the patients face when you take the picture. The lighting, the area that it is taken, both should also be the same for the before and after pictures in order to more accurately compare them.

Why is the orientation of the Plastic surgery Before and after's so important? Well the different orientations that a picture can be taken with can make the face and different objects in the face look drastically different. One example is related to neck lifts. You can easily make a neck look tighter and more contoured by taking the pictures differently in the before and after's. Let's say that you took the before pictures of the lateral neck with the chin more inferior. In this situation, the Frankfort horizontal is downwardly slanted so that the chin is in a lower position in relation to the facial structures. The before picture in this state will show that the neck contains more laxity, more skin and more sagging. Then let's say that the after picture is taken with the chin in an upward posture and the Frankfort horizontal oriented with an upward slant. The after pictures will look as though the neck is tighter, more contoured, and less sagging than the before picture. All of this can be done with just the trick of picture taking and not from any actual procedure. For rhinoplasty, if you take the frontal before picture with the face slanted inferiorly more at the chin area the nose will appear lower as if the tip was hooked downwards. If the after was taken with the nose more up in the air, the illusion you can create is that the nose appears more rotated and refined.

The timing of the Cosmetic surgery before and after's is a critical element in interpretation. Face lifts can look much better early on after the procedure then later. Why is this? Well, aging is predominately a reduction in volume; we lose volume in the face as we age. Soon after a face lift, we tend to be more swollen. The swelling after the procedure gives the impression of volume added to the face. patients look better around 1-3 months after the procedure, then they would 3-6 months later. So knowledge of when the after images were taken can be crucial in interpreting the before and after's. With rhinoplasties, the tip size varies drastically depending on the amount of time from the procedure. So if the after pictures were taken 2 years later, you need to be aware of that. Often times the tip takes the longest to become contoured. All of the swelling takes place in the tip of the nose. Because it is the more inferior part of the nose all of the drainage occurs at this lowest point. The patient care coordinator showing the pictures should also let you know that if the images are earlier, they incisions and some of the healing may still be taking place. Images early on will show that the incisions are redder in the beginning and this improves. Other irregularities will also show more early on that will improve with time. Having pictures that show their resolution is very helpful. So seeing a progression of the improvement and the results over time can help you evaluate the results as well as the recovery. Most patient care coordinators will be reluctant to show you pictures in the first week and first month when most of the dramatic healing will take place. If this is something you are interested in, you should push them to divulge them to you. We are here to take care of you, the patient, and this is something that the office should be able to accommodate for you.

Another important question to ask is whether the particular before and after photos reflect the procedure performed by that particular medical practitioner. Not every medical practitioner presents his own photos and results. This should be noted to the client during the consultation. There are many times where people just don't want their pictures shown and hence allowing an office to show their pictures on a website or in the office can be few and far between. I think that as long as the doctor lets the client know that these images are not his own work but that it is a representation of what can be done is okay. You just have to be honest to the patient or client.

You should also make sure that the before and after images were not altered in anyway. There are a lot of programs out there that can manipulate images to make them look better. Photoshop, United Imaging, Mirror are all popular digital altering programs that could enhance pictures. You should ask whoever is showing you the pictures if they were enhanced at all, so you can know what you are really seeing.

Before and after photos like the old saying goes can say a thousand words and more. Images that are taken the scientific way can tell some truths that cannot be told just by words. They are an important tool for you to evaluate the particular medical practitioner you are interested in. There are other ways to get a sense of how well the surgeon is suited for you. Other things to ask and to think about are: how accessible is the doctor to questions; can I get a hold of him / her for emergencies; does he have an email address that we can send him / her questions; how many procedures has he done (specifically for the procedure that you are interested in); does he specialize in whole body cosmetic surgery or just the face and neck area; is he board certified in facial plastic / plastic / cosmetic surgery; does the cost include follow ups, anesthesia, and facility fees; how nice is the staff; what kind of feeling did I get after meeting him; does the office hold regular meetings to access their performance and discuss room for improvement.

In terms of permission to use the photos, most office will want you to sign a release to use the photos for medical purposes and for in office use. If this is something that you don't want you should let them know this. Read the consents carefully and ask these questions. Having your photos on a website or an advertisement should be further discuss with you obviously and this should be in a consent that is separate from the photos for in office use. A formal contract should be really brought into the discussion for your images to be used on the website and on advertisements. Most of the time the contract should have something in there that you will receive something for consideration such as treatments, compensation, etc. for the use of your images or videos. This is needed for the contract to be binding.

Before photos can also be taken for out of town consultations. Knowing how to take Plastic Surgery Before and After photos in a scientific way could help facilitate your consultation for the clincian. They will be more accurately able to suggest treatment over the phone. Also if you have the capability, you can set up a video consult with the doctor through services like Skype.

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