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    Creating quality clinical photography takes only some skill in standardization

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    Dr. Niamtu
    A picture speaks a thousand words. As such, the before- and-after images used in clinical photography can be a powerful marketing tool for cosmetic physicians who use the pictures to promote their practice and trade. There is much need for improvement in the art of clinical photography, however, and one of the key steps in taking impressive and honest images is to standardize the photography techniques used, says Joe Niamtu III, D.M.D., F.A.A.C.S., a board-certified oral and maxillofacial surgeon with a practice limited to cosmetic facial surgery in Richmond, Va.

    Patient medical pictures have been used for education and marketing since the inception of photography. The digital age and social media have created a milieu in which using patient images is more popular and useful than ever. However, many physicians still have not mastered the skills of good clinical photography, which could potentially hurt their practice and reputation in the long run, Dr. Niamtu says.

    "It is virtually impossible to discuss, evaluate, teach, market or publish cosmetic surgery without photographic images. I feel that the best doctors take the most pictures, but not necessarily the best pictures. Many doctors take and/or use substandard pictures, and they may be judged by the quality of their pictures by savvy consumers or colleagues," Dr. Niamtu says.

    Clinical photographic images are part of the patient record and have medical-legal purpose, he adds. They can serve in diagnosis and treatment planning and as instructional tools for lectures and publication, and they are a tremendous marketing adjunct. Poor and/or inappropriate clinical images can skew the viewers' perception of a result, Dr. Niamtu says, leading other doctors or patients to adapt a technique or device based on false comparison.

    "Making high-quality and standardized clinical images requires more than owning a camera, and in my opinion, the biggest contributors to poor quality images are naiveté, apathy and laziness. That may sound harsh, but making small adjustments towards standardizing photography techniques are actually very simple and it takes very little effort to make huge improvements. Adhering to simple guidelines can help the average doctor or staff person take high-quality, standardized clinical images," Dr. Niamtu says.

    BASIC TOOLS For the average practitioner, Dr. Niamtu says that any name-brand pocket camera from a major company will usually take great images. A high-quality lens that preferably extends from the camera when focusing, automatic and manual settings, a fast recharging flash and the ability to take excellent macro images are all very positive attributes of a camera, as is the ability to quickly focus on the subject or area. In terms of image resolution, Dr. Niamtu says 7 to 10 megapixels is more than adequate for the average office, and anything above that could be overkill for clinical photography purposes.

    "As a rule of thumb, investing in an easy-to-use camera is often the better option. Choosing a point-and-shoot digital camera is usually more than sufficient for high-quality photos and can ensure that your staff can take before and after images if you are not available on short notice for any reason," Dr. Niamtu says.

    KEEP IT SIMPLE Before taking any clinical photos, Dr. Niamtu says he directs the patient to remove any visible jewelry or makeup. In case the before images are made with jewelry or makeup, the postoperative pictures should be made the same way to ensure continuity throughout the images.

    The patient's hair should be pulled back to expose the face (and neck), which can be accomplished with the help of a simple headband. Before pushing the shutter button, Dr. Niamtu instructs his patients to widen their stance to shoulder width, drop their shoulders, relax their neck, stare directly into the camera and relax all facial muscles with no animation.

    In his practice, Dr. Niamtu has devised a system that allows clinical photos to be taken with a standardized background in any room without disrupting office traffic. Behind each door of each treatment suite, an aluminum picture frame is mounted along with tracks that allow for the frame to be raised or lowered to accommodate patients of any height or even wheelchair-bound patients. A photographic background cloth is then attached to the picture frame, serving as a standardized, non-reflective background.

    "These mounted frames offer a standardized background in my clinical photos and help avoid extraneous visual noise which can disturb and detract from the continuity and harmony of the images. Nothing looks worse than to see office equipment, pictures frames and furniture in the background of a clinical image. Simplifying the ability to conveniently take professional pictures at any time without disrupting office flow is also a huge advantage in a busy, high-volume practice," Dr. Niamtu says.

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