In aesthetic surgery, before/after photos are both the most convincing proof and the riskiest content. Convincing, because they show a concrete result. Risky, because they touch on the patient's image, professional ethics and platform rules. This article is not legal advice: it describes a rigorous shooting method and principles of caution, and invites you to check what is permitted with your medical council (ordre des médecins).
Why Before/After Photos Are Sensitive
A before/after photo can easily mislead, even with no bad intent. Different lighting, a more flattering angle, a different posture or make-up are enough to exaggerate a result. A patient comparing two images must be able to trust the comparison: it is the foundation of honest communication.
They are also sensitive for privacy: they concern a person's body, sometimes an intimate area or a subject they do not want exposed. Finally, advertising them is often governed, even limited, by medical ethics and by platform policies.
Standardising: Distance, Lens, Light and Pose
A comparison has value only if everything is identical except the result. That requires a fixed, recorded and reproducible method.
- Distance: a floor mark and a fixed distance between camera and patient
- Lens: always the same focal length, preferably medium, to avoid distorting proportions
- Height and axis: camera at the height of the area concerned, perpendicular, no high or low angle
- Light: same lighting, same direction, same intensity, in a controlled space independent of daylight
- Background: neutral, plain, identical each session
- Pose: same positions, same angles (front, profile, three-quarter), same expressions, same arm and shoulder placement
- Patient preparation: same hairstyle, no jewellery, same make-up status, depending on the area
Record all these parameters in the file. An "after" photo taken months later must be reproducible under the same conditions, by the same person or by someone following the same technical sheet.
Watch the framing too. Tighter framing after than before gives the impression of a different volume or shape. Keep the same framing, and if you crop for publication, crop identically.
No Retouching of Results
This is the simplest and strictest rule: you do not retouch a result. No smoothing, no shape correction, no colour or brightness change applied to one side only. Even a small tone correction applied only to the "after" image makes the comparison dishonest.
What you may do is apply exactly the same technical correction (exposure, white balance) to both images, or better, do nothing at all if the shot is controlled. Phone filters, "beauty" modes and automatic enhancements must be banned from any device used to document clinical cases.
If an image is modified for confidentiality, for example blurring a face, it must remain anonymisation and not enhancement.
Publication-Specific Consent
Consent to clinical photographs for follow-up is not consent to publication. They are two separate agreements.
To publish, the patient must give written, free, informed and specific consent stating:
- which specific images will be used
- on which channels (website, social media, brochure, presentation)
- for how long
- whether the face or distinctive features appear
- how to request removal
The patient must be able to change their mind and obtain removal. Build internal organisation that lets you quickly find and remove an image from every channel. A patient who refuses publication must suffer no consequence for their care.
Where Such Images May and May Not Be Published
There is no universal rule. What is allowed on a website may be forbidden on an ad platform, and vice versa. Three levels should be examined separately:
- Your medical council: depending on the country, it sets what a practitioner may or may not publish as images of results
- Platforms: social networks, search engines and ad networks often restrict body-transformation images
- Your facility: some clinics have their own internal rules
We cannot tell you what is permitted where you practise. Check with your medical council, your legal counsel and each platform's policy before any publication. When in doubt, do not publish until it is clarified.
Ethical Limits of Medical Advertising
Medical ethics generally governs practitioners' communication: it calls for fair, restrained information, with no promise of results or encouragement to undergo a procedure, and no disparagement of colleagues. Images of results, especially in aesthetic surgery, are often scrutinised because they can be seen as promotion.
A few common-sense markers:
- Never present a result as guaranteed or typical
- Do not select only the best cases without saying so
- Give context for each case: procedure performed, time between photos, possible variability
- Avoid commercial tone, promotional offers and pressure
- Do not use these images for sensitive ad targeting
Your medical council remains the reference. Ask it for written clarification if the texts seem ambiguous.
Alternatives When Publication Is Not Possible
If publication is forbidden, restricted or refused by a patient, you have honest alternatives.
- Anonymised images: framing that excludes the face and distinctive features, with written consent all the same
- Restricted access: a protected section reached through a deliberate step by the visitor, where the rules allow it
- Consultation-only presentation: the practitioner shows cases during the appointment, with the consent of the patients concerned, avoiding any public distribution
- Educational content: diagrams and explanations of the procedure, follow-up and recovery, with no result images
These alternatives remain effective. A clear site, a professional portrait and an explanatory video often reassure as much as a gallery, without the associated risks. Our articles on the surgeon portrait and on patient testimonial video detail these options.
Preparing the Patient and Team for the Photo Session
A clinical photo session is a sensitive moment for the patient. They are showing themselves in a vulnerable situation, often in an intimate setting. How the team conducts it shapes the quality of the images, and also the relationship of trust.
- Explain beforehand why photos are taken, how they will be stored and who will have access
- Guarantee a private space, with a closed door and a team member present throughout
- Use suitable garments or drapes that reveal only the necessary area
- Let the patient refuse an image or stop at any time
- Designate a person trained in the method, so sessions remain comparable from one patient to another
Standardisation is also a matter of team training. A written protocol, a technical sheet displayed in the room and regular checks ensure photos remain comparable over time, even if staff change.
Organising and Storing Clinical Photos
Good documentation is an asset well beyond communication. Rigorous filing (anonymised identifier, date, protocol used, associated consent) lets you quickly find a record, prove the patient's agreement and honour a withdrawal request. Store these files in a secure space, separate from communication content, with limited access. Clinical images are health data: protecting them is an ethical obligation before it is a marketing topic.
Finally, train everyone who handles these images in their sensitivity. A photo sent by personal messaging, left on a shared phone or used in a presentation without agreement can be enough to break a patient's trust. Define who can access the files, how they are transmitted, and what to do in case of error or leak. This rigour protects the patient, the practitioner and the facility. It also makes audits, second opinions and internal reviews far easier, because every image can be traced to a date, a protocol and a documented agreement, rather than living in an unmanaged folder on someone's phone.
Conclusion
Honest before/after photos rest on three pillars: rigorous standardisation, no retouching of the result, and publication-specific consent. As to where and how to distribute them, the answer depends on your medical council and the platforms: always check before publishing. At Codini, we help practitioners set up a consistent photo protocol and build a site that reassures, with or without a results gallery.
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