Picture perfect
Dr Emmanuel Elard exposes the secrets of good clinical photography and video
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The most perfect before and after pictures have the patient in an identical position and an identically lit environment prior to and after the procedure—so it’s understandable that as clinicians, taking photos of patients is probably one of the least favoured part of a consultation. Some delegate the job to assistants in a dedicated room, others more adventurous and more professional take pictures by themselves with varying degrees of success. But how can we improve what we do?
How do we create the perfect pictures?
Clinicians are not professional photographers, so an average photo taken on the clinic camera is unlikely to do justice to a procedure. There are many mistakes that are made, but one of the most common mistakes is the use of flash, creating a distorted reality. Other things to regulate as a photographer are white balance, patient positioning and light.
Mastering white balance
White balancing is a camera setting that adjusts for lighting in order to make white objects appear really white on the photo. Most of the time, when two pictures shot at two different moments don’t show the same colour, it is because ambient light is not the same and the sensor of the camera is tricked.
The only way to make white objects appear white in the picture is to use a white card that you need to put in front of the camera. This card will tell the sensor that “what he is seeing is white”
Patient positioning
Once white balancing is mastered, next it’s important to think about setting up the patient positioning. This must be exactly the same on the before and after picture. It could be wise to mark places to stand on the floor in your office, or lines on a wall for patients to stand between in order to create consistency.
Lighting
One of the most important parameters that we need to master is lighting. Aesthetic injectors all know that we need to restore the balance between lights and shadows. Light alone can change our perception of the reality. If you want to get two pictures perfectly comparable, ambient lights must be always the same.
The reality of video
Everybody can be a photo-shopper today. So nobody trusts a picture of a before and after conversion. I recently treated a patient with high intensity focussed ultrasound (HIFU) using ultherapy to lift her jawline. Despite wonderful results, when I showed her picture to my other patients very few of them trusted me when I tried to convince them the benefits of HIFU. I replaced photo with video and it changed totally the perspective that a potential patient can have and the work that I am proposing to them.
It is possible to cheat with a photo, but it’s impossible to do the same with a video. My observations about mastering all these photography parameters like light, white balancing, patient positioning and the video concept of not being able to cheat, pushed me to create a tool that allows creation of standardised videos of patients really easily in less than one minute—Next Motion. This is really powerful because with a video you can see the emotion of the patient. You can see the patient kiss, smile, doing some positive or negative expression that they would do in everyday life.
A motorised device piloted by Bluetooth allows the camera to make a video while traveling around the patient. Using only the ambient light in your office is adequate—no additional light is necessary. Traveling movement is really important because it is the only solution that allows light and shadows on the face of the patients to be exactly the same before and after the procedure.
A smartphone is plugged on the frontal arm and steers the machine by Bluetooth. Via an app it records the before and after video and it adds a final mounting.
This is a complete solution. The heart of the platform is the smart phone, but basically you buy a machine that does the travelling around you, and you have the full system via your iPhone & Android app to steer the machine, record your before/after videos, manage your products. An iPad pro app can be used to display and sign consent forms, display your before and after videos. A powerful backend (webpage), similar to a CRM that allows you (or your assistants) to manage your patient’s files and optimise your workflow
Summary
Knowing that we can now standardise with this tool, I think we can go further. I see the potential for leading larger studies with, involving many doctors, to show the reality and the efficiency of all treatments. With that I think it is possible to improve the image of our work and to improve the transparency of the work we do with all of our patients.
Dr Emmanuel Elard is a medical doctor specialising in aesthetic medicine. In addition, he is an entrepreneur, founding Next motion, a doctor-friendly solution of standardised before and after video creation, editing and sharing, with a digital management system to share with his peers. Dr Elard is a holder of a state Diplomas (IUD) in mesotherapy, in morphological medicine, anti-ageing and injectable techniques. He is a member of several scholarly communities, including the AFME, SoFMAA, SFM and LED Academy.
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