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?
Facelift Surgery Before and After Photos
Doctor Answers (38)
Face lift before and after photos
There is no denying the fact that 'before and after' images are the most powerful and effective means for a surgeon to communicate their aesthetic sensibility. They give the prospective patient an immediate sense of what that surgeon envisions as a favorable postoperative result, and thus allow an individual to make a relatively quick decision as to whether or not that surgical practice is one that they should investigate further.
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.
Look for Consistency
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.
Look for the incisions in "before and after" facelift photos
A major skill in face lifting is to make inconspicuous incisions that only the surgeon and a very observant hairdresser can see, because they are hidden in the hair and not visible. Some doctors will show face lift results where you can only see the improvement in the neck and the face, but you can't see the incisions because they have the patient's hair pulled down to cover them. You should be able to clearly see the front of the ear and behind the ear in all photos so you can judge if you'll be able to wear your hair up after surgery. The careful surgeon can hide your incisions within the hair and will also preserve the hair so you don't lose your normal hair tufts.
facelift surgery before and after photos
1. make sure your surgeon has performed the surgery shown in all of the photographs!
2. make sure the lighting is the same in the before and after photographs
3. make sure the position of the patient is in the "chin neutral position", not with their chin down in the before pictures chin up in the after pictures
4. make sure the distance is the same from the camera to the patient in both the before and after photographs
5. make sure the before pictures have not stripped the patient of their makeup, and after pictures are "glamorous shots"
For many examples of our work, please see the link below tour facelift photo gallery
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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!!
Beware of before and after photos
Be very careful of before and after photographs. Although they can tell you what type of work a surgeon performs, they can be quite misleading. Sometimes, surgeons will show generic before and after photographs, possibly not even patients they have performed surgery on. The photos will be of a limited number of patients and will only show the surgeon's best work. A better choice would be to see 5-10 consecutive patients. Unfortunately this is unreasonable as patients are understandably wary of sharing facial photographs.
Results from a surgery will be dependent on a number of factors including the person's age, underlying medical conditions, intrinsic and extrensic aging factors, the actual procedures performed, and the postoperative care provided the patient. To match all of these factors is very difficult.
In summary, although before and after photographs can be rather alluring, they don't tell the entire story.
Evaluating Before and After Facelift Photos
This is a great question, and brings up a lot of important points. First, I agree with the others here that the photography technique should be consistent to ensure accurate comparison. Leaving that aside, the meat of the question is "how do I know that something is a good result?" Foe each patient, there is an ideal facial aesthetic. This varies by individual, age group, and even somewhat by geography or local culture. That said, in my opinion, the best facelift result makes a patient look refreshed, younger, healthier and happier in a natural way -- no changes to the hairline, no tight or wind-swept look, no surprised face. A great result shouldn't be obvious, except to the patient, the surgeon, and perhaps a few close friends and family. If you can tell that a stranger had a facelift from more and a couple feet away, it's not a great result.
Facelift Surgery Before and After Photos
When looking at photographs of preop and postop facelift patients you should look at the angle of the lower jaw with the neck. This angle should be about 110 degrees without loose hanging skin. In the face, look for rejuvenation of the infraorbital area and perioral area with fat transfer grafts. The look of aging is caused by loss of soft tissue and bone which causes the face and neck to droop down. The main goal of a facelift and necklift is to tighten the underlying muscles and move them upward and remove some excess skin. My aim is to get a facelift not a face pull.
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.
Facelift Before and After Photos
It is important that you identify with surgeon and the types of patients you are seeing in the photo. In general, you want to see if the patient looks natural. Do you like the jaw line? Do you like the way the corner of the mouth changed position, if at all? Many photos will look great in the post op. The patients have makeup on. . .their hair is done. . .they're smiling. . .etc. The real test of natural results is how do they look in the photo if the hair and makeup is unchanged. Also, if you notice that the skin quality is better or the chin is stronger, the patient may have has laser resurfacing and and chin implant. Ask your surgeon was anything else done to enhance the patient in this example you're showing me. Most facelifts are benefited by some laser resurfacing, chin implants, or volumization with fat transfer or other fillers. Ask for the complete treatment regiment.
Best of luck
Chase Lay, MD
Just as in surgery, photographic technique is important
When reviewing a surgeon’s facial photo gallery, you should pay attention to the technical details of the photographs - are they cropped the same, is the patient angled the same, are they looking at the same point in the distance, is lighting the same? Not every pre and post operative photo set will be the same due to some uncontrollable variables (patients may wear different color clothing in the pre vs post op shots, which will effect automatic exposure control and lighting on the pictures), but in general you will be able to get a feeling if the surgeon is trying to be uniform with their pictures and honest with the results. Once you see uniformity in photos, then you can assess their work. Watch out for “cheaters” - if you notice all post op pictures have patients wearing makeup, looking upwards to improve their neck appearance, or smiling to flatten the jowls, then keep looking for other surgeons.
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.