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 (39)
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.
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.
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.
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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.
Facelift Surgery Before and After Photos
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.
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.
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.
Face Lift Before and After Photos
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?
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.
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!!
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 pictures
EXCELLENT question! Like classic art and literature, in my opinion, nobody should tell you what is good and what is not good. YOU decide for yourself by careful analysis of before and after pictures. Look closely at the patient before the procedure. See their aging features, and try to understand what might have bothered them when they look in the mirror. The before photograph is a window into another's soul, because you are looking at someone who was dissatisfied enough with their facial appearance to endure the discomfort, pay associated costs, and sequester enough time for recovery associated with facelift. Then, look at the after. What did the patient get for their investment?? Are they younger looking? Are they more handsome, or prettier? Do they appear natural, or surgical? The answers to these questions speak volumes for the surgeon's patient selection criteria, surgical judgment, technical skill, and aesthetic sense. You learn much more about a surgeon from his or her before and afters than by focusing on publicized techniques. Techniques serve the end result, but the converse is not true. Beware the surgeon who advertises his or her technique. Two years after your procedure, the technique is irrelevant, but the result still stands.
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.