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For many years I have included on my website a number of pre and post-operative photos of plastic surgery procedures.  It was always considered something important to display on the website, as a way of demonstrating that the surgeon was capable of achieving good results.

The current situation with regard to patients’ photographs on the internet has become more complicated.  There are now very clear guidelines and indeed legal requirements concerning informed consent around publishing patients’ photographs even when they are anonymised.

Privacy is a fundamental requirement of the doctor patient relationship.  Increasingly it is very difficult to ask patients whether they would be prepared to have their photographs posted on the World Wide Web where they may be reproduced and disseminated.  Not surprisingly this is not something that many people would be comfortable with and there is an anxiety that patients may accede to this request out of a sense of duty or loyalty to their surgeon if they have had a good result whereas of course there should be absolutely no pressure to do so.  Very specific patient consent is needed to show photographs online.  Many patients however are much more comfortable about having their photographs shown to other patients within the private space of a personal consultation.

When the photographs relate to facial procedures it is particularly problematic in keeping the patient’s identity concealed.  Either you have a patient’s permission to show their face or you anonymise the picture with extensive pixelation which rather takes away from the aesthetics of the procedure that has been performed.

In terms of the photographs themselves it is also worth asking how much information these actually provide.  It is said rather cynically that almost any procedure can look good from one angle!  For example an operation like rhinoplasty can only be assessed with multiple photographs from different angles.  With advances in technology perhaps a 3D reconstructive photograph would be the only way of providing a true representation of the result.  Most plastic surgeons try hard to standardise the photographs.  However it is a reality that many patients who come back after a facelift for review will have changed their hairstyle and even their make-up and it is practically very difficult to ask them to remove it all in the middle of their busy day just for a post-operative photograph.  If you publish these photographs there are the criticisms of using non-standardised and favourable post-operative images.

In the light of all of this , we have made the decision to no longer post patients’ photographs pre and post-operatively on the website.  Within the practice we have over fifty years of experience in plastic surgery and of course have many photographs of procedures of patients who are very happy for them to be shown to other patients in the space of a personal consultation so all patients will be able to see good and clear examples which are representative of outcomes.

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