A Short Introduction to Clinical Photography for the Plastic Surgeon

DEAR EDITOR Photography is an essential part of plastic surgery given the visual nature of our specialty. Its uses are innumerable; it enables us to document form and function, helps us plan an operation, assists us in teaching, serves a medico-legal purpose and may even assist with research.1 This is by no means an exhaustive list. Yet, despite its indispensability to the proper practice of plastic surgery very few surgeons receive any sort of formal teaching or training in clinical photography. In this manuscript the author attempts to provide some of the theoretical essentials of clinical photography required to take adequate clinical images for the patient’s record. The aim of clinical photography is to present the patient most accurately as opposed to portrait photography where the aim is to iron out inconsistencies in the physical form.2,3 The key principle underlying good clinical photography is consistency i.e. taking every picture of the patient under the exact same conditions. This may sound relatively simple but is in fact quite difficult to achieve in practice. The principal factors to consider are (i) Lighting which is the first and most important aspect. Lighting conditions under which the photographs are taken must remain exactly the same as variations in lighting may very easily alter the appearance of pre and post-operative photographs;2,3 (ii) Pose that refers to the position of the patient when the photograph is taken and the “perspective” or “angle” from which the camera “looks” at the patient. This must be kept as consistent as possible and is one of the more difficult competencies to achieve in photography;2,3 (iii) Patient exposure that adequate patient exposure over the anatomical location of interest is essential. Hair should be tied back, distracting jewellery removed and the patient clothed appropriately. Ideally the same cloths should be worn if possible for pre and post-operative photographs;2,3 (iv) Background that refers to the peripheral space around the patient. It should be free of distracting influences and preferably be of a uniform plain colour (such as light blue or green);2,3 and (v) Magnification that all images should be of the same consistent magnification or size. The introduction of digital cameras with the “zoom” function has made this a much easier process.2,3 Apart from the above discussed principles, one should also have an awareness of basic photographic concepts such as lens aperture, shutter speed and exposure although this is now much less important with contemporary point and shoot digital cameras. Digital cameras tend to automatically adjust for these settings and Letter to Editor