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This feature complements the article "Photography for Aesthetic Practices," by Ron Scherl, which appeared in the September/October 2009 issue of Healthy Aging.
Consistent and high-quality patient photography helps you communicate your aesthetic services to patients and manage expectations. You can achieve these goals by designating a space solely to photography and equipped with professional lighting gear. Here are tips for setting up a photo studio in your practice.
Figure 1 illustrates one possible installation. This is a basic two-light setup with stands on the floor. The typical cost is about $2500. The lights are placed above the patient's head to cast small shadows that reveal texture. They are diffused by the umbrellas to control the highlights and shadows, keeping them from becoming too extreme.
The patient is prepared so as to isolate the treatment area; in this case we're only interested in the face, so we want to eliminate everything else from the photo. The black background will disappear. The subject is wearing a black headband to cover any possible changes in hairstyle or color and a black cape to cover clothing changes. The cape will also standardize reflected light.
A white blouse worn at the pre-treatment photo session would reflect light back up into the shadows and soften facial features. If she were to wear a black sweater at the post-treatment session, there would be no reflections and the increased contrast in the face would cause wrinkles and folds to appear more prominent.
Light Sources
Lights can also be suspended from the ceiling to accommodate smaller spaces Figure 2. Kits designed to suspend lights from an acoustic tile drop ceiling cost less than $200.
Different kinds of light sources create different effects and can lead to drastic changes in perception. We see this most often in photography intended to document the effects of cellulite treatments when the addition of a camera flash creates a definite smoothing effect. (Click here to view slideshow.)
Light from the flash reflects back into the lens obscuring the texture of the skin. This can be difficult to see, but look for the highlights and shadows. The overhead light casts a shadow below the buttocks that is not there with the flash, and the flash will always create that  highlight sheen that makes the skin looks smooth.
You can mitigate this effect by using an external flash mounted on the camera but aimed at the ceiling instead of the subject. This will turn your ceiling into one large diffused light source and is the best alternative when you cannot dedicate a space solely to photography. Keep in mind that a standard flash will never provide the detail that you'll get with an umbrella light kit because a flash is not nearly as bright.
Selecting Digital Camera Technology
A digital camera sensor gathers light and converts it to electrons that will become the image file when converted to digital bits. The larger the sensor, the more light it can gather, the more information is available for the picture. And when we're photographing skin, information is textural detail.
Sensor size can be more important that pixel count, because not all pixels are created equal. A super compact pocket digital camera may have the same megapixel count as a digital single lens reflex model, but the size of the sensor and the pixel size may be vastly different. Compact cameras will pack pixels into a sensor close to half the size of a professional camera.
Factor in the sophistication of the built-in processor and the quality of the glass in the lens and you can see why a good digital single lens reflex camera is essential for patient photography. These cameras range in price from $1500 to $3000.
A fixed focal length lens with macro capability is preferable to a zoom lens. Fixed lenses generally resolve detail better, and eliminate the variable magnification resulting from inconsistent zooming. A typical fixed lens such as the Nikon 60mm Micro or Canon EF-S Micro costs about $500. A dedicated flash that can be bounced off the ceiling is $400-$700. (Click page 2 for sidebar: Tips for evaluating patient photos.)
Ron Scherl has been a professional photographer for more than 30 years specializing in editorial portraiture and performing arts. Previously on staff at Thermage/Solta for six years, he now works for the San Francisco Museum of Modern Art and is also a consultant to the medical device industry on photography.
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