In computing terminology, WYSIWYG, or “what you see is what you get,” is an attribute of software programs that enables the user to display a document on a computer monitor in exactly the form the document will take when printed. It is essential for the accurate reproduction of images, type displays, and other graphic elements.

“What you see is what you get” is likewise an essential guidepost when presenting photographic results of aesthetic procedures to patients and colleagues. High-quality, clinically accurate photographs allow the surgeon to demonstrate the results of a particular procedure to prospective patients. They are equally important for documenting the efficacy and aesthetic benefit of new approaches, techniques, or instrumentation in presentations to scientific meetings or publications in medical journals. The expanding role of electronic communications tools that allow even wider dissemination of photographic images to both patients and physicians through physicians’ personal Web pages, society Web sites, and online educational forums and professional journals only underlines the importance of high-quality clinical photography in aesthetic surgical practice.

However, it has been our experience that contributors to medical journals and scientific meetings often submit photographic documentation that is deficient in both quality and consistency. Deficiencies that compromise the clinical results detract from the effectiveness — and, possibly, the acceptability — of the author’s presentation.

The key to effective clinical photography is consistency. Consistency is necessary first of all in the choice of equipment. Always use the same camera, flash, lens, film, and lighting in taking preoperative and postoperative photos. Ideally, you should set aside an area to be used solely for clinical photography so that you may ensure consistent lighting and background, as well as patient privacy and comfort. A seamless medium-blue background is ideal.

Similarly, consistency in the preoperative and postoperative appearance of the patient being photographed is essential to providing an objective, accurate demonstration of results. Patients should be posed at the same distance, using the same angle, facial or body position, and facial expression. They should wear little or no makeup (or, at least, the same makeup) for both preoperative and postoperative views. Jewelry should be removed and hair, including bangs, pulled back wherever possible.
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Digital photography is becoming increasingly popular, but not all digital photography is acceptable for publication. Requirements for reproduction in print versus Web formats are significantly different. For accurate print reproduction, high-resolution gray-scale and color images (at least 300 pixels per inch, or PPI) are required. In submitting images for publication, it is advisable to ascertain the publisher’s preferences with respect to image size, image format, and medium (eg, CD-ROM, Zip disk). Most publishers include their requirements in their guidelines for authors. It is also useful to include copies of the images, printed on high-quality glossy photographic paper, to ensure accurate color reproduction as intended, because colors can vary depending on the computer, software, and printer used.

In addition, provide whatever information is necessary to document and define the results. Useful information includes the age of the patient, the type of procedure performed, the time elapsed between surgery and the taking of postoperative photos, and ancillary procedures performed, if any. Other applicable information, depending on the specific procedure, can include the patient’s height and weight, the type and size of implants, the preoperative and postoperative bra size, and the type of laser or other specialized equipment employed.

In general, it is far easier to anticipate and resolve possible technical problems relating to clinical photography, and to obtain the necessary authorizations and documentation, before taking a shot than it is after the fact. Careful preparation and record-keeping will result in a clinically accurate, well-documented photographic record for use in both private practice and in the preparation of manuscripts for publication.

For photographic standards, including digital photography guidelines, for submissions of clinical photography to Aesthetic Surgery Journal, please see Information for Authors on page 233.