An entertaining aspect of being a plastic surgeon is the kind of conversations that invariably arise at parties.  Everyone has a question that they’ve been eager to ask, but didn’t have the person or the context in which to ask it.  These conversations always turn out to be a lot of fun, and, interestingly, generally fall within three categories. The first is weird science: what is and is not scientifically possible. Will I ever be able to get a face transplant like John Travolta in “Face Off”?; Is it possible to build a nose on a forearm?; Does laser surgery burn the skin?; Is it true that you can fat transfer from one part of the body to another? For these, the answer is usually, “Yes, its possible.”  Another source of curiosity is whether or not a product seen on an infomercial actually works: LED flashlight facial rejuvenation? over-the-counter anti-aging miracle creams? a procedure that touts “no downtime but incredible results”? For these, the answer is usually, “No.”  The third category is the authenticity of before and after photos. This video which uses the work of photographer Ben Cope reminded me of those questions. Cope shows several convincing before and afters as you might see on weight-loss flyers or cosmetic billboards.  The catch is no procedure was performed, and the “results” are due to changes in lighting and posture.

As this video demonstrates, navigating the heavy, direct-to-consumer advertising by diet companies, medical companies, and medical technology companies can be difficult.  If you want to be a savvy consumer, ask these questions:

1) Are the before and after photographs standardized?  High-end aesthetic and reconstructive practices typically have a room in the office that is dedicated to accurate photography (with a blue screen backdrop and standardized lighting), and a professional photographer.  That way, each photo is the same, and any visible result can be attributed to the procedure.

2) Are the featured photographs in the flyer from a practice or from a medical company?  The latter is usually the case, since the companies that promote the product also provide doctors with marketing material.  If this is the case, the photographs will attribute the photos to specific doctors from around the country.  The reason that this is significant is this: the photos in the flyer are the absolute best results that the company can find from all of the various physicians that use the product.  So if the results are kind of noteworthy but kind of not, then it’s worth taking a closer look.

3) Does the advertisement emphasize a gimmick?  My co-residents and I would joke that our lifetime goal was to have a billboard advertising the “Laser-guided, Robotic-assisted, Trans-umbilical Breast Augmentation.”  If the technology or product appears to come from the minds of the creators of Go-Go-Gadget, then you may want to think twice.

So if those before and after photos look convincing, be sure and question what they are promoting and how they are being promoted. Is there such a thing as a dynamic, compelling result?  Absolutely, but you need to know where to look.