Is a lack of before/after photos a red flag?

Ive recently consulted with a surgeon that I really feel is the right surgeon for my primary rhinoplasty. I really want to move forward with the procedure, but his lack of before and after photos makes me a little skeptical. He has maybe 12 cases of before and after photos on his website, and during the consultation, his assitant told me that they are a smaller "boutique" style office that prefers to establish relationships with their patients. Is this a red flag?

Doctor Answers 8

Lack of before and after photos could be an issue.

Thank you for your question. All surgeons start out from ground zero. As we do more surgeries we have more patients that are willing to have their photos shown to others. Your selected surgeon may not have many photos because he hasn't done that many yet. Seeing before and afters is valuable for establishing the surgeon's skill level. In cases like yours I would ask to talk to some of his prior rhinoplasty patients. Also look for online rates and reviews to try to get sense if he is good at rhinoplasties.

Good luck and I hope this helps.

Dr. Wayne

Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 61 reviews

Not very many before and after rhinoplasty photos is this a red flag?

Dear Melissa, Many surgeons have patients who do not want their photographs on the internet however the surgeons in office collection of before and after photographs should be much more vast then the website. I personally have many photographs on my website however in my office I have many more multiple books full of many photographs that are not on my site that patients have allowed to be shown in office just not on the world wide web. As surgeons we all establish relationships with our patients and my patients are like a second family to me so I am not sure that only a "boutique" surgeon cares about this. To me 12 before and after photographs total is a possible lack of experience in the field of rhinoplasty surgery. If you found the surgeon on realself I would suggest reading the surgeons reviews. If there are many reviews and the majority of those are regarding rhinoplasty surgery then likely the surgeon denotes a large portion of his/her practice to this speciality. And since the surgeon in their own words has spent so much time establishing  great relationships with his patients then certainly they would be thrilled to post reviews. Before and after photographs will help you see noses similar to yours and ensure that the surgeon provides natural looking rhinoplasty results. See examples of before and afters on my rhinoplasty link below and imaging process in the video above. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Is a lack of before/ and after photos a red flag?

Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so  it's important to look at the surgeon's before and after photo gallery. A large photo gallery usually indicates the surgeon has dedicated a significant component of their practice to the discipline of rhinoplasty. Many happy patients have given us written permission to use their photographs on our website, and we're also a boutique practice. For more information and an extensive portfolio of before-and-after rhinoplasty patients, please see the video and the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Is lack of before and after photos a bad sign?

Hi Melissa,

 I don't think that it is necessarily a bad sign. A lot depends on what the procedure is. For example, I do a lot of facelifts, but the greater majority will not allow me to post their photos. The same for rhinoplasties.

Perhaps you could ask your surgeon if some of his patients could call you and discuss their experience or you could look at his reviews on the various sites. Not all reviews are accurate, but you can get a sense of the surgeon from the majority.

Hope this helps a bit.


Dr. Christine Rodgers

Christine Rodgers, MD
Denver Plastic Surgeon
4.9 out of 5 stars 89 reviews

Concerned About Lack of Before/After Rhinoplasty Pictures

Website design may influence the number of before/after pictures. I have many rhinoplasty pictures on my website but some rhinoplasty specialists do not. Some patients do not want their pictures shown in public but any experienced rhinoplasty surgeon will have many results of previous patients that they can share in their office during consultation. Rhinoplasty surgery is one of the most challenging cosmetic operations that we do; I would want to see results. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Finding the right surgeon

Hello and thank you for your question. It is very important that you thoroughly research your surgeon before committing to surgery. It is a good idea to research your surgeon's educational background, online reviews, before & after pictures, and speak with anyone who you may know who has had surgery with that surgeon. During your consultation, make sure that you don't feel rushed and make sure that you have adequate time with your surgeon and not just their patient coordinator or nurses. If the majority of your consultation is spent with someone other than the surgeon, this is usually not a good sign. The most important aspect is to find a surgeon you are comfortable with. If you feel comfortable with this surgeon, then I would not worry too much.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Before and after photos of plastic surgery.

Before and after photos CAN be a useful guide, but the particular situation you describe doesn't sound particularly concerning. But here's a tip: if your surgeon has a dozen rhinoplasty before-and-afters yet has zillions of breast augmentation before-and-afters it gives you a sense of where the surgeon's interest, case volume, and expertise lies. If, on the other hand, you see roughly similar numbers of cases across the board it may indicate that the surgeon merely hasn't bothered (or is busy enough not to need to bother) to put up as many photos as possible. Add to that the fact that a majority of patients are unwilling to consent to having their pictures shown...especially when it's the face. In short, I don't see any red flag here.

All the best,


Pearson Facial Plastic Surgery®

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Before and after photographs

I wouldn't call this scenario a "red flag". Keep in mind that it's very difficult to get patients to agree to let us use their images online. That's why you'll always see more examples of before/ after in person. Even then, some patients don't want their photographs shown at all.  Regardless, each nose is unique, so it's sometimes helpful to see a projection of what the doctor's plans are for your nose with a computer morphing program -- this will also give you insight into the surgeon's aesthetic ideals. 

If you and this doctor mesh well, he/ she is board certified and specializes in nasal surgery, you are comfortable with the office staff, you clearly understand his/ her surgical plan (e. g. via a computer morphing program), and you liked the before/ afters you saw, then I would lean heavily towards proceeding with this doctor. 

Get a second or third opinion and see what your gut tells you. 

Good luck!

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 47 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.