Hi, everyone. I want to revisit a topic I had posted about some time ago. We had our beautiful patient come in from New Zealand, and she had a breast reduction, liposuction, and a full tummy tuck. Now, one thing, though, was that she did not stay in town for a particularly long time. She stayed the appropriate two weeks after surgery, but not long enough to get really true before and after photos. So that begs the question, what is the appropriate time for a after photo after a procedure? Because, look, you’ll see a lot of people who will post stuff right on the table immediately after surgery, and you know what? That can show a result, but things change over time, and sometimes you need to show photos that have been taken much, much later after the operation to give you a true sense of what happened.
And of course, this is a small portion of a larger conversation I have all the time: talking about the importance of photos, representation, and all that stuff we do on social media. Because, listen, there’s a lot of trickery, there’s a lot of shenanigans that people will put out to try to convince you that they have a great result.
Pretty incredible, right? Well, you know what? That was the same person, and funny enough, her after photo was actually taken first. The before photo was taken after, and the only thing that changed was makeup, lighting, and her little smile. So you can really, really trick people without changing their bodies at all.
Now, back to the topic at hand, what is the right time to take photos? Well, I’m going to give you the example of one of my patients who had a breast augmentation a while ago, and show you how things have changed over about a year after her operation. She’s a perfect example, because look, she had a very straightforward breast augmentation, she had beautiful breasts before, she had a great result afterwards. She wanted a natural, subtle look, and we chose to place 300cc moderate profile implants.
I’ll show you a bunch of pictures along her course. Here she is at the very beginning:
Take a look at her pre-op. Very standard. Nice breast shape, and a great candidate for an augmentation. The operation went perfectly, and here she is with a picture that I took immediately at the time of surgery:
Whoa. That wasn’t subtle. That wasn’t natural. That wasn’t a conservative breast augmentation, which is what she wanted, but that is because of the way I took her photos and the way she looked immediately after surgery on the operating table. And you know what? That is not how she is going to ultimately look! I say that because you’re going to see a lot of pictures of people on the operating table on Instagram, and the key there is to understand that things definitely change, and some surgeons actually will post pictures there because that’s the best it’ll ever look, and it kind of goes to crap afterwards. Some surgeons do it because they just need to get content out, and whatever they can get, they’re going to put up, even if it doesn’t look so great. There are a lot of reasons why you see pictures like this, and you have to be cognizant of that.
Now, let’s take a look at her photos from one month after her operation.
Okay. We’re getting there. Looking good. Nice round shape, but do notice, it is still rather full up top. They look like they’re kind of standing up there, and that is going to change, as you can see in this picture taken three months after surgery:
Three months is, in general, when many operation results start settling in to their “final result,” for at least things like breast augmentation. Now, I say that because in other operations, for example, with rhinoplasty, you usually still want to wait a good bit of time before you consider something a final result – often a year or more. And you can see, even with this breast augmentation, she continued to have changes over the course of the year. Let’s take a look at her now after one year:
So what you see at a year is that actually the implant has continued to drop down a little. Now, what is important is that usually after about four or five months, the implant just settles into where it is going to be, and the goal is that over the ensuing months and really years, it stays locked in there, and that’s exactly what happened. After that three month point, it dropped down a little bit, but then it just settled in and at one year it was basically in its final position and looking great.
After that three to five month settling in period where the implants ultimately end up taking their final position, that’s where they are. But remember, you can’t control death and taxes. You also can’t control gravity and aging. Over time, your breasts and with them, the implants, will continue to drop. And that is different from the settling in from normal surgery. That is just aging.
And you can see that with these kind of time lapse videos I made showing the progression of her augmentation from before surgery, over the course of (a bit more than) one year, looking pretty good:
There is an educational point here! That point is: look, whatever photos you guys see, be it on social media, be it when seeing a plastic surgeon, really even anywhere in life, you have to always think about the context of the photo. Think about the timing of the photo. Ask yourself, “Are things going to change? Are things being misrepresented?” Really, really just dive into the photo and consider it, rather than simply taking it as something given.
I can’t underscore that enough. You guys have to understand that we live in a world of consumerism now. Everything is basically made for consumption. So one of the earliest, earliest lessons I learned in one of my economics classes in high school was the parable, “Buyer beware.” You should always, always be really sharp and just dig into everything that’s given to you, and analyze it, think about it.