When reviewing your selected plastic surgeon’s photo gallery, you need to be very objective. The following outline is a guide to help you critique plastic surgery “before and after” photo galleries. This guide should assist you in noticing the subtleties between different plastic surgeon’s “before and after” photo galleries. After reading this guide, you should be able to be more critical when examining “before and after” galleries.
1) Standard poses. There are standards for medical photography. There are certain poses and angles for objectively photographing subjects. For the face, there are typically five views: frontal, right profile, left profile, right three-quarter shot, and left three-quarter shot. For the nose, there are typically six views: frontal, right profile, left profile, right three-quarter shot, left three-quarter shot, and a worm’s eye view from below. For the breast, there are typically five views: frontal, right profile, left profile, right three-quarter shot, and left three-quarter shot. For the abdomen, there are usually five views: frontal, right profile, left profile, right three-quarter shot, and left three-quarter shot. The patient should be in the same position in both the before and the after pictures. Deviation causes photographic irregularity and does not allow for an accurate comparison between “before and after” pictures.
2) Backgrounds. The background for the “before and after” pictures should be the same. The background should be the same color in the “before and after” pictures. Different background colors can subliminally change your thoughts and opinions about the “before” and the “after” picture. If the “before” picture has a black background and the “after” picture has a red background, you will have different opinions regarding each image. Additionally, a post-op selfie taken on a cell phone in a bathroom or at a bar is not a great “after” picture! Having the same background for the “before” and the “after” picture standardizes and makes pictures more objective.
3) Lighting. Picture lighting should be the same. Lighting can dramatically affect the way you interpret and feel about the “before and after” picture. Typically, lighting should be done from a single source from the front. If there are two light sources, shadows are eliminated. The elimination of shadows with multiple light sources, make the image look artificial and fake. Shadows allow for visualization of three-dimensional effects, especially skin contour irregularities. Too much light can obliterate these subtleties. Look no further than the cover of some glamour magazines where the model has been washed with so many light sources, that she does not have any wrinkles left at all. In a facial picture, to find out if it is a single light source, look into the eyes of the subject. The light will reflect off the black pupil. If there is a single white spot, only one light was used. If there are multiple white spots, then most likely, multiple lights were used. Always look for pictures with a single light source.
4) Expose the surgical scar. The surgical scar should be revealed in the “after” picture. The surgical scar should not be covered up. Any surgical scar can easily be covered with clothing. I believe it is essential to see a patient’s scars without clothing. If you are examining the “after” picture of a nose job, the nose should not be covered with a splint or a neckerchief. Likewise, if you are looking at the “after” pictures of a breast procedure, the breasts, areolas, and nipples should not be covered up. Furthermore, if you are looking at the “after” pictures of a tummy tuck or body lift, the abdominal scars should not be covered. If the incision is hidden, even with photographic panties, the plastic surgeon is probably hiding something. Regardless of what your plastic surgeon says about photographic panties, patients sign a waiver allowing their pictures to be taken. Extreme measures are taken to protect a patient’s identity in pictures placed on the Internet. Therefore, there is no need for photographic panties in “before and after” tummy tuck or body lift pictures. Your plastic surgeon should be proud of their scars and not cover them up with clothing. If you see photographic panties in a plastic surgeon’s “before and after” gallery, it should be a red flag.
5) Different scars. Not everyone heals the same. Some patients heal extremely well, and their scar almost disappears. Some patients do not heal as well and have more visible scars. Poor scarring does not necessarily depend on your plastic surgeon’s skill level, but may depend inherently on the patient’s healing capacity and genetic makeup.
6) Timing of the “after” picture. The sooner the “after” picture is taken after the procedure, the worse the scar looks. As time progresses, surgical scars fade. Scars never completely disappear. However, the longer the picture is taken after the procedure, the better the scar will appear.
I hope this guide for carefully evaluating “before and after” photographic galleries has been helpful. If you have any questions regarding any plastic surgery procedures, please call my office. I have offices in Beverly Hills, Las Vegas, and Dubai.