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Facelift Surgery Before and After Photos

I'm considering face lift surgery, and I want to talk with a few different surgeons. What should I look for in facelift before and after pictures? How will I know what is good?

Doctor Answers (43)

Facelift Surgery Before and After Photos

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This is really an excellent question and one that every person seeking plastic surgery should understand.  There are two aspects to this answer.  The first is the evaluation of the photography technique. Many seemingly improvements are the result of subtle photographic techniques. Second is an evaluation of the surgical result. 

Technique

1. lighting- watch to make sure that the same amount and direction of  the light is the same in the before and after.  If the photo is underexposed (darker) then wrinkles look worse and conversely if the photo is overexposed (lighter) then wrinkles and scars tend to disappear. It the flash is off to the side in the before photo it will make the wrinkles look worse and if the lighting is "straight on" in the after photo it will make the wrinkles/scars look better. The appearance of the color should also be the same.  (This is the color saturation and white balance which is easy to manipulate with digital photography.) 

2. focal length- watch to make sure the distance from the camera is the same in both photos.  While this may not be as important in evaluating facial surgery it is very important in body surgery.  A common "trick" is to make the before photo closer and the after photo further away making the patient look thinner. 

3. position of the head- this is very important in facial surgery.  If the preop photo has the head tilted down and the post operative photo has the head tilted up the result will look better just by photography alone.  When plastic surgeons take photos we strive to have the head in same "neutral"  position.  (it is called the Frankfurt line) in the before and after photos. 

4.timing of the photo- the photos should be at least six months after the surgery so that by that time any swelling (which will hide fine lines) has gone.

5. make up-  Is the before photo devoid of make up and the post operative photo with full make up. Make up can make a very dramatic result by itself. 

Surgical result

1. does the result look natural?  Is there improvement in the appearance of the neck, cheek, jowls. Is there any evidence of distortion. Look carefully at the corners of the mouth.

2. appearance and placement of the scars.   Are the scars fine and well hidden?

3. appearance of the hair line. Has the hair line been distorted?

4. look carefully at the ear position and appearance of the ear lobes to make sure they are not distorted.

With all of these points in mind don't worry to much about "what is good" - you will know. Remember beauty is in the eye of the beholder.

 


San Francisco Plastic Surgeon
5.0 out of 5 stars 8 reviews

Facelift before and after photos - Look closely at ears and hairline

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A good result from a facelift is a patient who looks natural, and not like they had had a facelift. There is a link to my facelift before and after gallery below.

When evaluating facelifts, look closely at the ears and the hairline. Look for scars in front of and behind the ears, and visible scars in the hairline. My goal is that even a hairstylist cannot detect scars. Just as importantly, look at the contour of the ear and the shape of the hairline and / or sideburns. "Pixie ears" and altered hairlines are not only dead -giveaways of facial surgery, but they make people look odd and unattractive. 

Prospective patients have a host of issues to consider when evaluating pre-op and postop images of cosmetic surgery patients. An outspoken plastic surgeon who is known for some keen observations is often quoted as saying that "A photograph is merely reflected light". Another telling maxim regarding cosmetic surgery photography is "Almost anything can be made to look good from at least one angle." Both of these observations speak to the fact that while such photographs should ideally communicate the true nature of a surgical outcome, there are inherent limitations to the two-dimensional nature of photography.

If a patient is wearing no makeup and a frown in the before image, and is fully made up and smiling in the after image, this is not a good representation of a surgical outcome.

The following are a few things that can distinguish some surgeons from others

1) Graduating from a top tier medical school at the top of their class.

2) Membership in Alpha Omega Alpha. THis is the medical honors society. Alpha Omega Alpha is to medicine what Phi Beta Kappa is to letters

3) Formal surgical training from prestigious medical universities. The minimum number of years of surgical training for plastic surgeons to be bord certified in five years. Some physicians have as many as ten years of formal surgical training. There simply is no substitute for stelar academic and practical surgical training.

4) Very experienced surgeons with meticulous surgical technique and natural looking outcomes will have photgraphic evidence of their work. Patients should be able to view many photos of the surgery of interest, photgraphed from three different perspectives all with similar lighting, distance from the camera and cropping

The elite experience extends beyond the surgeon to the facility, and the surgical team. You should be able to see the surgical theater and know who else will be in the OR with you during surgery. The Joint Commission (JCAHO) is an organization that provides certification to hospital OR's. The Joint Commission and AAAASF are two of the organizations that can provide certification to surgical suites. Some plastic surgeons elect to have their surgery centers dually certified.

The anesthesia experience is critical to a safe and comfortable surgical experience. A board certified anesthesiologist can administer general or MAC anesthesia. My preference is to have a board-certified anesthesiologist at the bedside of my patients for the duration of surgery.

Plastic surgeons who cater to high profile individuals who place a high value on privacy will have a private first floor entrance and exit so patients never need to be in a public lobby or elevator for pre-operative or post operative visits.

Look for Consistency in photographs
For this reason, as a consumer you should insist on consistency in preoperative/postoperative photography. The positioning of the subject and the size or 'aspect ratio' in the photographs should remain consistent. If one photograph appears to be taken from five feet away and the other from eight feet away, there is no way to meaningfully interpret the 'transformation'. The lighting and color saturation in all of the images should also ideally be identical, or at least comparable. If the pre-op image is in shadow and the postop image is well-illuminated, there is no way to determine how much of the postoperative 'improvement' was provided by surgical technique and how much is just better lighting. A bright flash can conceal a whole host of flaws.
You should also insist on seeing images from multiple angles, as this is the only way to get some idea of the quality of a surgical result in three dimensions when reviewing two-dimensional photographs, and to confirm that it isn't just from one direction that the result looks acceptable. The photography set-up and photographic background should be consistent. Images taken in the pre-op area in front of a bare wall with an exposed electrical outlet and the patient's gown pulled up but hanging down into the image should not inspire much confidence. Body position and facial position should also be consistent. I have seen breast lift (mastopexy) before and after photographs in which the patient's arms were at her sides in the 'before' images, and then the arms were lifted above the head in the 'after' images. Raising the arms overhead produces an instant 'breast lift', so it is impossible to objectively assess the effect of surgery in photographs where body position is inconsistent.
Likewise, if the pre-op image of a facial rejuvenation surgery patient shows a sleepy-looking person in a hospital gown at 6:30 a.m. on the morning of surgery, and the postop image shows that person in full make-up at 2:00 p.m. on the day of a follow-up appointment several months later, you have absolutely no way of accurately determining what in the 'after' photo is due to surgery and what is due to a good night's rest and some make-up. You may not be aware that all board-certified plastic surgeons receive training in photography as they are trained as surgeons, so that they have a means to accurately document and communicate their surgical planning and the results of their handiwork. I personally believe that a surgeons's photographic technique and documentation provides a person who is considering surgery a very clear statement of how organized, meticulous, compulsive and attentive to detail that surgeon is. If I were a prospective patient I would not expect any of those qualities in the operating room if I did not see them in the 'before and after' photographs. I believe that consistency and quality in photography is a reflection of consistency and quality in one's approach to patient care.

When evaluating photographs, also keep in mind the fact that many examples you see of a particular procedure may not look like you. Part of what makes the practice of plastic surgery so interesting and rewarding for me is the fact that no two patients are exactly alike, and thus each patient requires a fresh and personalized approach. Rather than trying to dissect how a particular result relates to you personally, view it in terms of that patient's particular 'starting point', and whether or not the surgical enhancement is aesthetically pleasing and natural-appearing.
Don't limit your investigation to an examination of photographs. Review the content of a cosmetic surgeon's website thoroughly, and get a feeling for that doctor's individual approach and practice philosophy.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 46 reviews

Facelift Photos

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Good for you ..a great question. And a simple answer. Look at the photos and if the patients look just like themselves but fresher, more rested, happier and more youthful with NO distortions of the natural features, you have found the facelift artist you want.  If anything about the patient after surgery photos looks like they had a facelift, say thank you and move on. If you see pictures that look like Bruce Jenner or Kenny Rogers or Wayne Newton to name a few.....RUN, don't walk, for the nearest exit.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 15 reviews

Face Lift Before and After Photos

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I agree with you, it is important to see your plastic surgeon's before and after face lift photos before deciding to undergo a face lift with that surgeon.  Here are a few things to look for in before and after face lift pictures:

1.  Look at the before and after face lift surgery results.  Do the patients have a decrease in forehead wrinkles, a tighter neck line, less jowling, less marionette lines, and a refreshed look?  Are these results that would make you happy?

2.  Look at scars in the hairline, in the upper eyelid crease, lower eyelid crease, in front of the ear, and behind the ear.  Do these face lift scars seem acceptable to you?

3.  Look at the new hairline and side burns.  Do you notice differences before and after facelift surgery?  Is this acceptable to you?

4.  Look at the ear lobe.  Does the ear lobe look natural or stuck to the side of the neck?  There should be a normal break between the lower portion of the ear lobe and the upper neck.

5.  How long postoperatively were the pictures taken?  Does the surgeon show any long term results (5-10 years) of patients?

6.  Consider the number of before and after face lift photos the plastic surgeon is showing you.  Are there only one or two photos that represent the very best results, or a wide array of patients, types of surgeries, and results?

7.  Consider the quality and lighting of the photogragphs.  Are there shadows and a lack of makeup making the preoperative phots look worse?  Are the before and after photos standardized for each patient?

 

Jaime Perez, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 37 reviews

What to look for in photos

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First make sure the surgeon has before and after pictures to show you. Second, make sure those photos are of his or her own patients and not stock photographs. You would be surprised how many of these types of photos are out there.

As others have mentioned look at lighting to make sure it is the same in the before and afters. Also make sure you ask to look at multiple angles so you can examine the ear lobes and the hairline to make sure these are not distorted. Good results are those that look natural and not pulled or overdone.

Giancarlo Zuliani, MD
Rochester Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

Facelift pics

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Its critical to look at multiple angles of the same patient before and after surgery. All should be taken with the same camera, the same lighting, and the same background.  At least a front, both sides, and oblique photos should be used.  If you only see 2 front views (before and after) a scar or asymmetry may not be visible on one of the side views.  Dates are important.  Patients often look great several months following surgery because some residual swelling can efface wrinkles.  The final result should be visible at 6 months to 1 year.  Good luck!! 

Jason R. Hess, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 8 reviews

Facelift photos

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Do not get a face lift by anyone who can't show you books of results that you would be happy to have yourself. I can't even imagine asking someone to let me do their facelift and not showing them dozens of patients similar to them in age and aesthetic concerns. Any good and successful facelift surgeon has loads of good results and happy patients and should be thrilled to share them with you, if not make a quick exit to someone else. Look to see that all the patients had a "natural" looking result. Make sure the overall result addressed any noticeable aging problems. Make sure nothing looks too extreme and that all the parts seem to fit together in age and character..i.e. eyes, cheeks, brows, neck etc. You need to say to yourself " Gee, I'd love that result!", after you look at the surgeons pictures.

Facelift before and after

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Before and after pictures are good indicators of a surgeon’s skill and outcomes. The more pictures they have the more experienced they are. A good result from a facelift is a patient who looks natural, and not like they had had a facelift. Look at the photos and if the patients look just like themselves but fresher, look rested, and more youthful without over filled cheeks and lips, then you have found the right facelift surgeon for you want. When analyzing facelifts before and after pictures, look closely at the ears and the hairline and incision lines.

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 103 reviews

Facelift Surgery Before and After Photos

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What a great question! You are on the right track. First the photos should be taken with the same angles, distance,and lighting. Consistency is import in comparing before and afters. Then, when you view the picture, concentrate on the after photo. Does it look natural? Look for the signs of surgery such as hair loss (raising the hairline, loss of side-burns with the hair shifted above the ear, hair-loss behind the ear on the neck), distortion and movement of the ear (loss or distorted tragus, loss of the pretragal sulcus, anteriorization the the lobule), and visible or wide scars that are misplaced. Check the ears and hair-line. Please search through the gallery on my website listed below. Best wishes in your search for the facial artist you like.

James Shire, MD
Chattanooga Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Facelift photos

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That's a good question. The patients  should look natural. Also you should see if scars are detectable or if there appears to be any distortion of the ear,  particularly the earlobe. If the ears are covered by hair in the after photos, you should wonder to yourself what is being hidden?

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 13 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.