“Use a picture,” newspaper editor Arthur Brisbane famously told the Syracuse Advertising Men's Club in March 1911. “It is worth a thousand words.” When it comes to choosing an aesthetic physician, this adage could not be more relevant. Patients are evaluating the surgical and nonsurgical skills of physicians online and during the consultation process on the basis of “before” and “after” pictures. In order for doctors to excel in this competitive environment, it is imperative that they take quality before and after pictures for all aesthetic patients. Patients sometimes forget what they looked like before a surgical or nonsurgical procedure, and therefore it is very helpful to have the documentation of patients in their charts. The “after” picture also provides proof for the physician of the outcome for unsatisfied patients. In addition, you will want to showcase your talents by publishing some of your before and after pictures for in-office and online marketing.

Oftentimes, we hear the following from clients as to why they are not taking or using their before and after images for marketing purposes: “We don't take before and after pictures for nonsurgical procedures,” or “Our patients don't want their pictures online,” or “We don't have the money to update our equipment.”

Getting Started
The increased importance of before and after images to the growth of your practice necessitates addressing all these obstacles. Here's what you need to get started:

Commitment. Get assurances from all providers and staff members to take before and after pictures for every aesthetic patient. Staff members can help streamline the process by informing patients.

Training. It is important to train all providers and staff on the equipment, settings, lighting, and protocol that the office will use. The more uniformity between the pre-op and post-op images the better, and this will come only with a disciplined approach to taking the highest-quality pictures.

Dr. Marina Peredo, a dermatologist in Smithtown, NY, hired a professional photographer for a half-day to train the physicians and staff on the proper use of the camera, settings and lighting to ensure repeatability of images. Although all members of the practice team should be trained, it is also helpful to have in the practice one or two “experts” whose responsibility it is to maintain the equipment and keep everyone up to date.

Equipment. Quality equipment ranges from lowend digital cameras ($600 starting point) to fully integrated, high-end imaging systems ($2,000 starting point). Regardless of the system you choose, you need to ensure the repeatability of the camera, patient positioning and consistent, proper lighting. Mark the floor with tape or use a positioning stage ($225), where the patient should stand for facial and body shots. You can also mark the back wall with tape to be sure you are positioning the patient in the correct spot consistently. This will also help with lighting and shadows. A stabilizing device can hold the camera in place, and a blue or light-colored backdrop will give a professional image with good contrast. When working with very small areas of the face or body (i.e. a mole), including a ruler in the image can provide some context to give perspective on size. This also helps in determining if the mole or lesion has changed in size over time.

Consent forms. The use of consent forms is absolutely essential so patients can authorize images before and after the procedure. There should be an additional consent form to authorize the use of the photographs for publication online or in the office. Many medical photography consent forms will provide a yes/no check box requesting permission for the following uses:

• Placed in medical record for future treatment.
• E-mailed to treating health care professional.
• Use by health professionals for education and training.
• In paper or electronic health publications.
• In commercial broadcast.
• In marketing materials (Web site).

Many consent forms will also have the statement, “provided my identity is not revealed by the pictures.” If you are using the photographs strictly for medical records and Web site, keep the consent as such, so as not to confuse the patient. Be able to show patients how their pictures would look on the Web site if identity is a concern. You should research your state laws and any societies of which you are member to ensure that you are in compliance.

Online consent language. In order to help protect your patients and yourself, it might be helpful to use the following language online: “The photos displayed are actual patients of Dr. Cosmeticderm. These patients have provided their consent to display their pictures online. All photos contained in this website are protected by copyright and may not be copied, distributed or linked in any form.”

Grow Your Practice
Now that you have high-quality professional images, how can you use them to help grow your practice? First, you need to gain the consent of your individual patients to use the photographs in marketing materials. Many patients are proud to show their results to others, and you won't know until you ask. Using your own images in the office and on the Web—as opposed to stock images from manufacturers or web developers— is important in gaining the confidence and trust of consumers. Aesthetic consumers today are well educated and want to see your results.

Invest in before and after books for each exam/treatment room and the reception area. These high-traffic areas are perfect for displaying your photographs. Make sure to label the pictures by procedure and basic demographics, e.g. “Fractional resurfacing, 48-year-old female.” Online websites such as Snapfish and Kodak make creating before and after books convenient and cost-effective.

We know through Google Analytics that before and after pictures are the highest-traffic areas of aesthetics websites. It is important to have as many high-quality images with stellar results as possible. Display the photographs under each procedure, as well as in a photo gallery including links to that specific procedure page. Supporting the images with text describing the patient and procedure will provide additional unique content to your website. Note: When posting photos, it is recommended to consult with your attorney to make sure you are in compliance with state laws, copyright laws and any member societies.

Important Investment
Taking high-quality before and after pictures is a necessity in today's competitive marketplace. Make an investment in your photographic equipment and accessories and in training yourself and your staff to ensure that you maximize the potential.