A before-and-after comparison is only meaningful if both photos are taken under the same conditions. Change the light, the angle or the distance, and the image shows something other than the treatment result. A shadow can deepen a fold, a short focal length can widen a nose, and softer light can erase fine lines. Patients, peers and platforms notice. Some medical advertising rules also treat a comparison that was not made under identical conditions as misleading.
The good news: you don't need a studio. With a dedicated corner of a room, two lights and a written routine, a recent smartphone is enough to produce very consistent series. Here is the protocol.
1. The principle: fix everything except the patient
The goal is simple: between the before and the after, the only variable should be the result. In practice, you fix once and for all:
- the camera (and lens);
- the shooting distance and height;
- the lighting;
- the background;
- the patient positions (the "views");
- the camera settings and image processing.
Write it down on a laminated card next to your photo corner. That card keeps the series consistent when someone else takes the picture.
2. Camera and focal length: avoid distortion
Perspective distortion is the most common mistake. Photographed up close with a wide-angle lens (a smartphone's 1x camera at 30 cm, for example), the centre of the face looks larger: the nose grows and the ears recede. If the before is shot close and the after from further away, you "create" a change that never happened.
- DSLR or mirrorless: a "portrait" focal length of roughly 85–105 mm full-frame equivalent is the classic recommendation for faces in medical photography. For full-body views, a shorter focal length with more distance works.
- Smartphone: use the telephoto lens (2x or 3x) rather than 1x, and step back. Turn off portrait mode (artificial background blur), beauty filters and skin smoothing. If you can, also turn off automatic HDR, since it can change the shadows from one shot to the next.
- Always use the same device for the before and the after. Two different phones render colour and contrast differently.
3. Distance and height: mark the floor
- Tape marks on the floor for the patient and the photographer. This is the highest-value step in the whole protocol.
- Place the camera at the height of the area being photographed, with the lens parallel to the subject. A camera that is too high or too low changes proportions: a chin can look more or less defined, a stomach more or less flat.
- A tripod or wall mount solves this permanently. Otherwise, write the camera height on the card.
4. Lighting: diffuse, symmetrical, always identical
Light changes an image more than anything else, especially for wrinkles, scars, skin texture and volume.
- Don't rely on daylight as your main source. It changes with the time of day, the weather and the season. If there is a window nearby, block it.
- Two diffuse sources (softboxes, or LED panels with diffusers) at about 45° on each side of the patient give even lighting with few cast shadows.
- Use lamps with a fixed colour temperature (often around 5,000–5,600 K) and switch off the ceiling lights. Mixing sources creates colour casts.
- Avoid the phone's built-in flash. It flattens contours and creates shiny hotspots.
- Keep the same power settings and lamp positions at every session. Write them down or tape the lamp-stand positions on the floor.
5. Background: neutral, matte, plain
- A plain matte backdrop (mid-grey, light blue or black, depending on your specialty's habits) removes distractions and makes comparison easier. Avoid glossy white, which fools the exposure, and textured walls.
- Leave some space between the patient and the backdrop (about 50 cm to 1 m) to avoid cast shadows.
- Remove anything from the frame that identifies the clinic or another person: posters, screens, mirrors, plants. This also matters for patient privacy.
6. Standard views
For each area, define a set of views that are always taken in the same order. For the face, the classic set is:
| View | Typical use |
|---|---|
| Frontal | Symmetry, volume, eyes |
| Right and left oblique (≈ 45°) | Cheekbones, folds, facial contour |
| Right and left lateral (90°) | Nose, chin, jawline |
| Specific views (nasal base, smile, upward gaze…) | Depending on the procedure |
For head position, a common reference in clinical photography is the Frankfort horizontal plane: the line from the lower edge of the eye socket to the top of the ear canal, held parallel to the floor. For the body, define frontal, oblique and lateral views the same way, with the arms in a fixed, documented position.
Small details make a big difference:
- Neutral expression, mouth closed and relaxed, unless a dynamic view is planned (smile, muscle contraction).
- Hair tied back, forehead and ears clear. No make-up, no jewellery.
- Neutral clothing or a drape, the same at every session.
- For skin, photograph without cream or shiny products.
7. Framing: a "ghost" of the before
The hardest part of the after shot is matching the original framing exactly. Two tips:
- The camera grid (the "grid" option in your camera app): always line up the same anatomical landmarks on the same lines, such as the pupils on the upper-third line.
- Overlay: some clinical photography apps show the "before" image semi-transparently while you shoot. Otherwise, keep the before open on a tablet next to you for comparison.
8. After the shoot: minimal, identical processing
- Never retouch the result. No smoothing, no line removal, no reshaping. It's a matter of honesty towards patients, and many medical advertising rules prohibit it.
- Global corrections (exposure, white balance) are acceptable when applied identically to the before and the after, only to compensate for a small technical difference.
- Use the same crop and scale for both images. Align on anatomical landmarks, not on the result.
- State the interval between the two photos ("3 months after"). A result at day 7 and at 6 months means very different things.
Printable checklist
- Same device, same lens or zoom (telephoto on a smartphone), filters and portrait mode off.
- Patient and photographer on their floor marks; camera at the height of the area, on a tripod.
- Two diffuse lights at 45°, same settings, with daylight and ceiling lights off.
- Plain matte backdrop, nothing identifying in the frame.
- Standard views in the same order; head on the Frankfort plane; neutral expression.
- Hair tied back, no make-up or jewellery, neutral clothing.
- Framing aligned using the grid or an overlay of the before.
- No retouching of results; identical global corrections; interval stated.
What about the layout?
Once both photos are taken under identical conditions, you still need to present them cleanly. Lumipair places the before and after side by side or stacked, in Instagram 1:1, 4:5 or Story 9:16 formats. You adjust each image's zoom and position to line up the same landmarks. You add your logo, your colours and Before/After labels. The tool also helps you mask what needs masking. Everything runs in your browser, no photo is ever uploaded to a server, and every export is stripped of its metadata.
A good photo protocol makes your results credible. A clean, consistent presentation does the rest.