Physician Spotlight

Todd E. Schlesinger, MD, FAAD, is director of Dermatology and Laser Center of Charleston and Clinical Research Center of the Carolinas. He is also Clinical Instructor at the University at Buffalo Department of Dermatology, and an assistant clinical professor of Medical University of South Carolina Department of Family Medicine and clinical preceptor at the Medical University of South Carolina College of Health Professions in Charleston. Dr. Schlesinger discusses why before and after images are the “life blood” of a successful dermatology practice and shares his tips on how to use photography for successful patient accrual and retention.

Why is it important to optimize and standardize photographs?

Dr. Schlesinger: Because dermatology is a visual specialty, photographs are paramount in communicating clinical information. Just like one needs to speak clearly to be heard in the courtroom or classroom, good quality photographs are a form of effective communication.

How do you optimize and standardize photographs in your practice?

Dr. Schlesinger: In day-to-day practice, my offices utilize handheld cameras for routine imaging of lesions to be biopsied or removed, to document skin conditions and for lesion localization and identification preoperatively. Cameras purchased for this use must have a memory register for the storage of standardized settings for consistency from user to user. We also use a consistent zoom setting for lesion documentation and location and incorporate anatomical landmarks into the photograph where available.

In the cosmetic setting, we are employing standardized photography with multiple systems including the Canfield suite of products. However, we also use handheld cameras for many cosmetic cases as it is practical, affordable, and allows imaging of multiple body areas conveniently. We employ standardized techniques and image capture sets that are used by all staff. For example, to image the face, we obtain six photographs. One frontal relaxed face, one frontal full smile face, and two sets of oblique images at different angles.

Why should you always get a full frontal smile and relaxed frontal face?

Dr. Schlesinger: The purpose of this technique is to identify any asymmetry or functional attributes associated with the relaxed face as well as the animated face. While our aesthetic goal may not be to stamp out asymmetry, it is important to know what is present pre-procedure to aid in peri-procedural counseling.

How do you utilize before and afters in terms of patient satisfaction/new patient accrual?

Dr. Schlesinger: Our photographs are used to demonstrate treatment progress as well as for the marketing of procedures during consultations, on social media, and on our website (with permission). We have a Powerpoint presentation with before-and-after images of most procedures available on every computer in an exam or procedure room to aid in the consultation process and conversion of medical patients to cosmetic services when the patients are interested. We also maintain a master file of representative before-and-after images as a reference.

If a picture is worth a thousand words — how much are two pictures (a before and an after) worth?

Dr. Schlesinger: Before and after images are the lifeblood of aesthetic medicine. Many people considering a cosmetic service, product, or procedure, like to look at the images to gain a better understanding of the expected outcome. Sharing realistic images of typical results is a great way to facilitate that process.

What type of camera/imaging/digital photography systems do you use?

Dr. Schlesinger: Primarily, we use Sony handheld digital single-lens reflex cameras and a few compact cameras for routine imaging. We also employ several Canfield systems for cosmetic indications and research. There are many interesting and feature-laden systems on the market.

Any tips on how to get patients to agree to let you use their before and afters in your marketing materials?

Dr. Schlesinger: We are not bashful. We simply ask permission and have a consent form loaded into our electronic medical record for that purpose. We gladly accept whatever choice a patient might make and thank them for their participation. We may also offer a discount in exchange for their photo rights.