@magnumpi,
Hi mate, I was in Berlin in 1992, mate, pre HT though!!! Went over to Cottbus ..am arbeiten.
Spent a few great years in Germany. Hope das Bier is still cold!!
Bet there are some who would meet you, what about the German forums, or Hattingen HT patients, they have some nice results

If not apples-apples, then the difference should be explained fully: the change in lighting, hair length, hair style, time of day,season, etc........ Sometimes it isn't possible to re-create the exact conditions of the original pictures; this should be transparent for the potential client to make an informed decision.

So, let me add my 2 cents.

1. The photographer should try to be consistent. Although I'm the first to admit that I'm not a great photographer...I am consistent. Our before's and after's are taken in front of the same blue background and under the same lights, and when I use flash and it makes a difference, I almost always point it out in the discussion. This was a bit easier before the forum changed a few years ago, when every picture had a caption.

Consistency is even more important in face pics... and again, not being a great photographer, its critical to be consistent, lining jaw lines and ears up, as its perfectly easy to make a patient have a better or worse facelift result just by altering the posture of the cervical spine. Meaning look up and the results are better, look down and you can make a preop worse.

2. Its tough to get that apples to apples comparison we all want. People grow at different rates, and change their hairstyles, sometimes for the better sometimes for the worse. Just like facelift patients almost always come back for postop pics with makeup...these are the very same people who complained that the afters they saw looked made-up.

3. Sometimes people have an agenda. There are plenty of ways doctors can make a bad result better...but you guys can usually pick this up from your experience in looking at gobs of pictures. Similarly, sometimes patients want to make it look worse than it actually is. I've encountered this as most doctors have. From a biased point of view, I think that this is less jumped on by forum members than when a doctor "alters" pics, but nevertheless, most of you guys can pick this up too.

Bottom line. Most of you forum regulars can tell which clinics make an honest attempt to present consistent pictures, and most of you regulars can pick up bullxxxx when you see it.

And you often point it out, increasing the knowledge base of the entire network.

Dr. Lindsey McLean VA

__________________
William H. Lindsey, MD, FACS
McLean, VA

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

Hi Dr lindsey,thanks for commenting on this thread as I'm glad someone in the hair restoration industry understands potential patients concerns! I think angles of peoples heads,lighting,and flash can give varying results,and although that can't be perfectly replicated it is always appreciated if every effort is made to do so. What I think is a real problem is when the hair is styled in not the way the patient or anyone else would style it pre op,or when the pre op photos have hair pulled right back,not at the hair line but just behind it or at the half way back there for exposing thin or bald areas that would already be covered if the hair was combed over them,but on the post op the hair is shown with the hair styled over them areas and basically looking its best! Don't get me wrong I think that must be shown as an example of how it can now look,but I also think there should be a replica photo of the pre op photo so we can clearly see what hair and density is now present the previously bald/thinning area,and a pre op photo showing what the patient could achieve prior to his surgery.this would guve a nest vs best and worst vs worst comparison which I think would be a great platform to assess what has actually been achieved! Some physician's already do this,but I think its fair to say some don't,which is a shame! Hopefully more will start to do apples for apples comparisons,can I also say I think it great that you took time out to comment as it shows physician's do care about what people look for and try there best to replicate as close as possible the most accurate comparison!

Best vs best,excuse my spelling!

Hey Mate,

Since, there a many different people taking pics, it be good to know photo you are referring too. I find people on this forum pretty straight. I know that often in the before images, the hair is pulled back to see the hairline, temple or other transplanted areas. Also, many patients change their hairstyle because they actually now have hair. HT is a bona fide natural, permanent and proven method to restore hair. Results do differ, I respectfully disagree. I don't think anyone is trying to show people to be balder then they actually are at all. HTN has one of the most ethical independent forums on the web bar none! All the Best, Michael

__________________
Michael James is a Patient Advocate for Dr. Parsa Mohebi, who is recommended on the Hair Transplant Network; and not a physician. Visit Us On: Facebook | YouTube | Twitter | LinkedIn

Comments give here are only for intellectual consideration and in no manner to be construed or accepted as medical advice. It is important to seek the advice of a physician in all medical circumstances including hair restoration, dietary or others directly or indirectly related to the subjects in this forum

Hi Michael, I dont think its necessarily showing people to be balder as such,its exposing the areas clearly that need the work doing,some of that problem area would in day to day be covered by native hair but that person wants to address that area,and as I said that should be shown in all its glory but I think that should also happen post op as well! It's not for me to name names and discredit anyone,the physician's who post like that know that they do and the physician's who don't know that they dont! Some show far more photos from all angles,hair in the same pre and post and they need to be commended,and some not so much! Like I said I dont want to throw mud,just an observation and certainly something I have personally looked at when trying to choose a doctor for my surgery!

The number one way to level the playing field among clinics and to get the most out of photos is the complete elimination of flash photography. Flash can be used in very creative and useful ways if you are taking professional portraits of models, architectural photography and even landscape photography. But we are not models and the use of flash COMPLETELY distorts what you see were you to meet the patient in the photo.

If you are taking a photo of a hairline with a flash, the density will appear to be twice as high. This is a fact and I've proven it in the past. Each hair in the hairline creates a shadow of itself thus acting like a "Toppik shadow" of sorts. Anyone can prove this to themselves if they like. Just take a picture with and without flash of your hairline from a few feet away, roughly eye level and you will see what I'm talking about.

In photography, one of the prime rules to follow is Fermat's Principal in that the angle of incidence equals the angle of reflection. This principal is violated time and time again in hair restoration photos and it is easy to see when taking pics of a crown. When you have a camera on a tri-pod or at a similar height and the patient tilts his head up for the clinic to take a shot of the crown the crown is essentially facing the lens at a right angle, perpendicular. There are variations on this but you get the idea. Once the flash is fired the light from the flash bounces off of the crown and reflects directly back into the open lens. The result is washout and this means that some or even all of the hair in a thin crown can literally disappear before your very eyes. I can take a picture of my crown with flash, then take a second picture without flash and tell you I had 2000 grafts and that both pictures were taken a year apart and no one would think otherwise. The image without flash would show more hair that was always there to begin with.

In the past nine years that I've been taking photos of my own hair as well as many many other patients I've learned a lot but this is one of the first things I learned when I started in this business. Since then, I've moved into amateur photography and it took me a long time to want to buy a flash because I am so against it in HT photography. However, I'm learning to love using a flash because there are great things that can be done with one (or multiple) but it has no place in hair restoration photos AT ALL.

__________________
Hasson & Wong NEVER use flash photography to improve our results. H&W is the ONLY clinic to standardize on HD video and high resolution images so you can see the real difference that matters, the details.

See my results and my story at Hair Transplant Repair

View the greatest hair transplant videos of all time at Hair Transplant Videos

The highest quality hair transplant results can be seen at Hair Transplant Photos

All opinions are my own and may not be the same as Dr. Hasson and Dr. Wong

Jotronic is a camera pro. He's even personal messaged me a few tips in the past. In spite of that, I do still use flash occasionally and if folks check back in the threads, most of the time, I say that I used flash and I'll frequently put up a non flash too.

Its less of an issue at our current office, but as a true ameteur photographer, I do still use flash on occasion.

I do endeavor for consistency in preop/postop pictures.

Excellent thread.

Dr. Lindsey McLean VA

__________________
William H. Lindsey, MD, FACS
McLean, VA

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

Guys,

This is a great post and one of particular interest to me since I've often shared the same concerns. While I agree with Blake and others that top clinics are not intending to deceive patients by using trick photography or inconsistent lighting, backgrounds or hairstyles, I've had to work hard over the years with many top level clinics to teach them how to take the most realistic and accurate photos. That was the primary purpose of my public post "How to Take and Present Realistic and Compelling Photos".

I'll admit that I'm not as dogmatic about flash as Joe is however, I agree that photos taken without flash and under natural lighting are more accurate than those with flash, especially indoors. Flash can create shadows making hair appear thicker or thinner depending on the angle whereas photos taken without flash are more consistent. That said, background lighting (whether it be indoors or the angle of the sun or taken in the shade) can also make hair appear thicker or thinner depending on the angle.

Thus, to me, the key is consistency. I believe reputable clinics do their best to showcase accurate results but I also know from experience that many leading clnics, while they have no intent to deceive prospective patients, don't understand the basics and importance of photography. What's even more unfortunate, I have seen clinics (none of which are recommended by this community) attempt to use trick photography in a way to make a result appear thicker and fuller than it really is.

I remember reading an article presented by the ISHRS (International Society of HairRestoration Surgery) on the importance of taking accurate photos. Thus, the hair restoration doctor community as a whole (at least those who are members of the ISHRS) are at least aware of the importance of taking good quality and realistic photos. The vast majority of them are also well aware of our community, how we prescreen surgeons and how serious we are about taking and presenting detailed and consistent photos showing multiple angles of the scalp before, immediately post-op and after surgery. How many surgeons work to adopt these valuable picture taking and presentation techniques however, is another story.

Best wishes,

Bill

__________________
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and the Hair Loss Forum and Social Community

View our hair loss articles on EZineArticles.com

Follow us on Facebook | Twitter | YouTube

Subscribe to our Newsletters | How We Recommend Physicians

-----

To learn about how I restored my hair, view my my hair loss website.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.