Practical Tips

With flash, stand further away and use the zoom capacity of the camera to get the close up view. With good ambient lighting, do not use flash. Most cameras have a “low light compensation,” which will still give you a good quality image even when ambient lighting is low.

9.5 Background

The important aspect of clinical photography is to display the subject matter clearly. In very close up shots, the image fills the entire field and so background issues are not as important. With a more distant facial shot the background presents some issues. Too much clutter in the background distracts from the subject (Fig. 9.6).

Practical Tips

Doors and walls provide good blank backgrounds. Avoid a highly reflective background. Avoid window and door frames and watch for door handles. Plain curtains provide good background. Dull plain colors work best: mid-blue, burgundy, grey, and beige.

9.6 Advertising and Ethics

A discussion of advertising and ethics is not out of place in a chapter on facial imaging. The images we generate in our practices, although essential for our own records and our own professional monitoring of results, are often used as marketing tools to attract potential customers. To avoid privacy problems, certain clothes and jewelry that may identify the patient should not be photographed (Fig. 9.7). We have all seen advertising which feature “Before and After” photographs. Such advertising of itself is not out of place and can be a very useful method of conveying

a

b

c

Fig. 9.6 (a) A generally cluttered background provides distractions. (b) The appearance of straight lines in the background of this photo is a particular concern. (c) Sometimes the camera is focused on a particular point in the background and so the subject becomes blurred

accurate information to patients. Used in this manner photographs are a valuable resource. However, the pictorial display needs to be honest and accurate. If not, then it is simply misleading and preys on patient vulnerabilities.

9.7 Before and After Photos

The accuracy and honesty of “Before and Afters” is so important. We want to be able to display our results in an honest and informative fashion. We should not be engaging in cosmetic photography rather than showing off the results of our cosmetic practice. There is nothing wrong with presenting good flattering photographs of patients but we must make a distinction between the great “glamour shot” and the genuine results of our treatments.

The author adheres to a Code of Practice for Advertising which includes Before and After photographs. This is essential for a number of reasons, not the least of which is just simple accuracy and honesty. There are a number of jurisdictions in the world where the Regulatory Authorities are very much against advertising cosmetic procedures because of the inaccuracy often portrayed. This is often considered to influence patients to have a procedure by suggesting better results than what may realistically be obtained.

If the subject of these photos (Fig. 9.8) was to advertise the value of say microdermabrasion (which the patient genuinely has had) then this would be very misleading since the photos also demonstrate the result after microdermabrasion,

thread lifting, and fillers to lips. Then consider that the pose, lighting, hair, and makeup differences and it can easily be seen how patients might have the wrong impression of the potential results from microdermabrasion.

Reproduced below is the section of the Code of Practice for the Australasian College of Cosmetic Surgery dealing with Advertising, and I believe it provides an excellent template from which to consider one’s approach to advertising and photography.

ACCS Code of Practice Section 2

(Full code available at www.accs.org.au and hit the icon on the Home Page).

2. Advertising and promotion.

2.1Advertising must not contain false, misleading or deceptive statements, or create misleading impressions about the doctor or clinic or the services offered. It should provide balanced information on the procedures or products advertised and should not suggest these are risk free. Critical omissions can also be misleading.

2.2Members must not mislead consumers about the need for any procedure.

2.3Superlatives should not be used in any advertising unless they can be readily proven to be correct and as such are not misleading. For example,

to claim that a particular breast implant has the “least” risk of a specific complication would be acceptable if true and supported by the peer reviewed literature. Such information is of value to consumers. To claim a practitioner is the “best” in any way is not permissible as it is a value judgment, not readily proven, which could mislead consumers.

2.4Members must be able to substantiate any claims made in their advertising at the time the claims are made.

2.5Comparative advertising should be used with caution. It can be valuable in conveying information to consumers but it must be correct and readily proven. For example, to claim a type of treatment is safer than another type of treatment is acceptable if true and supported by the peer reviewed literature. Again, such information is of benefit to consumers.

2.6Photographs may be used to display the results of treatment and or complications. “Before and after” photographs should be presented with similar pose, presentation, lighting, and exposure. Any uncomplicated results shown should be typical and be likely to be reproduced in a similar patient. Photographs must not be altered in any way other than to protect a patient’s identity. “Before and after” photographs must be of the advertising doctor or clinic’s own patients and contain accurate and informative captions.

Where before and after photographs are used the procedure being referred to must be the only change that has occurred to the person being photographed. Further, a clear statement that the procedure being referred to is the only change that has occurred to the person being photographed should be included when photographs are used in advertising.

2.7Testimonials should not be used in advertisements.

2.8Medical or surgical procedures should not be offered as inducements or prizes in competitions or contests, or as a way of generating business.

2.9Offers of gifts or other inducements (e.g., time sensitive discount periods) shall not be used in order to attract potential clients.

2.10Discounts for early payment should not be used as an inducement to commit to a procedure.

2.11No member will offer finance facilities as part of the services provided, except a credit card facility. In no circumstances should a member accept any commission from a credit provider.

Cosmetic Photography is the term the author uses to describe “improvements” after treatment, which exaggerate the benefits. Figure 9.9 shows how lower eyelids can be remarkably improved. These photos show what might be a great result from “lower lid” blepharoplasty and repositioning of intraorbital fat. However, in fact, the photos show how manipulating