Clinical Photography for Periorbital and Facial Aesthetic Practice

Abstract

External cutaneous photography involves photographic documentation, which helps in treatment planning, documentation of facial features, teaching, publishing and pre- and post-procedural comparisons. The key is not simply documenting, but documenting it the right way and ensuring that photography is standardised and reproducible. In this review, basic photography techniques, standardised and reproducible angles such as frontal, oblique and lateral views and specific photographic angles for conditions such as facial rejuvenation are discussed. Use of photography accessories and a few tips on how to click good photographs in the examination room and how to achieve consistency in standardised photography are also presented. External photography in ophthalmic and facial plastic surgery like any other speciality too has standardised guidelines. Even small variations cause a drastic change in the photos and it's clinical and research value. Unless stringent criteria are met, the photographs lose their relevance and impact.

Keywords: Aesthetics; camera; dermatology; documentation; facial photography; guidelines; photography; plastic surgery; standardization.

Figure 1

Types of cameras – a digital single lens reflex (left) and a simple point-and-shoot camera (right)

Figure 2

A typical softbox. The lights within are called strobe lights and are closest to natural day light in terms of colour temperature

Figure 3

A speedlight (left) and a speedlight with a diffuser over the light (right) that softens the harsh bright light retaining facial features

Figure 4

Two different photographs of the same subject. The photograph on the left is shot with no additional lighting and with ambient room light. The photograph on the right is shot with softboxes. Observe the difference in the skin tone and exposure and the masking of the tear trough deformity in the photograph on the left

Figure 5

An overhead view of how a mini photography suite can be set up. A uniform background is required. The camera is placed atop a tripod in a fixed position. Note the 45° angulation between the two soft boxes

Figure 6

(From left to right) – left lateral, left oblique, frontal view, right oblique, left lateral

Figure 7

(Above) a 28-year-old female with dark circles around the eyes and a prominent tear trough deformity. Below is the photograph after treatment with Juvederm (hyaluronic acid). Observe how the only thing that has changed in the two photos is the patient and the treatment; therefore making the change appreciable. Furthermore, only the area of interest has been shown