Do most doctors take photos before Botox treatment?

Physicians' practices vary tremendously. While not standard of care to take before and after photos for Botox, it is nice, especially with the first treatment, to document the effect of the treatment. I would focus more on your physician's bedside manner and treatment results than on the fact that he/she does not take photos. If you would like photos done, perhaps he/she would be inclined to do so at the next visit.

Thank you for your question. You ask an interesting question about a contrast between doctors, as your previous doctor took photos before Botox® treatments and during follow up visits, and the new doctor doesn’t take photos. You are asking if this is something to be concerned about.

I can certainly share with you my feelings about photography and its benefits in our practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years, and can share with you the purpose of photos in cosmetic medicine and cosmetic surgery.



Using the example of Botox®, when I meet a patient for the first time, I think photos are very important to help communicate with the patient what Botox® can and cannot do. What I typically do is I take several different photos with the face at rest, and then with the expression of the muscles of the areas of interest. It gives me a baseline of what the person has when they first came in. When I see my patients in follow-up, I’ll take another set of pictures. I don’t do that every time once they are an established patient, but I tell patients that if they like the way the Botox® looks and this the result they like, then I take a photo of that result to help me understand what they prefer.  This way, as the relationship goes on, they come back for repeat visits and I have references of what they prefer. There is such an art to what we do, and I think photographs have a very important role.



As far as the frequency of photographs, I always ask what the purpose of taking these photos is. As a surgeon, I take photos pre and post-operatively at different visits to document the level of the person’s healing and what they look like at different stages. For hair loss, we take very regimented photos to establish a standard and make comparisons as the person progresses and improves with treatment. It’s always about the purpose of the photos, and more importantly, I think about the consistency. I had colleagues who show me photos they take and it was very difficult to see and understand what they are actually documenting because they did not consistently do that. They took photos because they probably saw one area of interest that is important, and then they take a photo of a different angle which I don’t is of value.



I think you need to have this conversation with the doctor you’re going to. Often, people who have extremely busy, high volume practices will not do this because they have patients coming in looking for deal or special offer. They come in and want X numbers of units, then they’ll just do it, and then that will be it. With something like Botox® because it wears off, it’s kind of safe on both ends, but I’m personally not comfortable with that. I feel like everybody, regardless of what I do for them, I have a set of photos I do at a minimum prior to treatment. After treatment, I make decisions as far as to taking the photos by asking the question: “what I am documenting?” If I do a non-incisional Asian eyelid surgery, I take a photo at 1 week, at 1 month, to 3 months for the purpose of documenting the progression of improvement, as another example.

You need to be comfortable with your doctor, so bring this issue up with them and ask why they chose not to take photos. If it might be a simple reason like the camera is broken, even though everyone carries phones with cameras. I don’t think it’s the best reason, but ultimately you have to be comfortable with the doctor. It is very important for people to choose a doctor especially for injectable treatments, and have a relationship with the one doctor so you and the doctor figure out the ideal outcome for you, and the doctor gets to know you and your personal aesthetic style. I have patients who have been with me for years, and it really works to have that long standing relationship. I hope that was helpful, I wish you the best of luck and thank you for your question.

It is very common for injectors to take photos before and after each treatment in order to assess improvement after injections. Since Botox affects muscle movement and appearance of fine lines, it is nice to have pictures in order to discern if the treatment was effective or not. It is certainly not a requirement for photos to be taken and an experienced injector will be able to evaluate results regardless. Be sure your new doctor is well qualified and is experienced with Botox injections. Best of luck!