April 22, 2021

…for Aesthetic Clinicians

celebrity paparazzi photo cameraThere are many moral and ethical issues related to publicity images, social media, and fakery, so do aesthetic clinicians have a duty to show real before and after images in their online content, and call out the fakes?

In this blog, Dr Tim Pearce will delve into the recent online furore surrounding Khloé Kardashian and her use of faked or airbrushed images on social media, which became even more talked about when a REAL photo was published in error.

Tim asks if, as curators of online content surrounding cosmetic enhancement, whether aesthetic practitioners have an obligation to break the myths, call out fakery, and fight back by publishing real before and after images which demonstrate the true aspirational results of aesthetic treatments.

Dr Tim will be discussing more medical aesthetic training tips as part of his upcoming webinar series, so if you’re looking to increase your CPD-certified learning and want to learn more skills to make you a better practitioner, then step one is to register for the free webinars by Dr Tim

Khloé Kardashian and THAT unfiltered pool photo 

Yet again the Kardashians have broken the Internet with the accidental release of THAT photo of Khloé Kardashian poolside in a bikini. Khloé, who has over 137 million followers on Instagram, regularly poses in swimwear, but this time a photo was published by her team apparently erroneously and she was not best pleased.

The image of Khloé, taken by her grandmother, appeared to show her REAL body. This contrasts with the apparently edited, airbrushed or Photoshopped versions of public-facing images that she usually shares with her followers. This caused uproar and accusations of past fakery. Efforts by the Kardashian crisis management team to retract the image failed – we all know that once something is ‘out there’, there is no taking it back or making it appear as if it ‘never happened’.

Many commentators were happy to see the unmanipulated image of Khloé and felt that she should stop trying to present unrealistic body images to her audience. Celebrity influencers with a global profile and considerable public following, like the Kardashians, create a culture around themselves which can have both a positive and negative effect on society, especially in the case of vulnerable individuals. Crossing the line where images released to that audience are so edited that they bear no resemblance to reality fuels anxiety, low self-confidence and encourages suffering in those who are crippled by personal insecurity but who can never hope to achieve such an unattainable look which has been fed to them as REAL. The audience or culture surrounding the Kardashians are mostly young, impressionable females. Many parents of teenage girls will be anxious that they are being fed fake aspirations which may push them towards eating disorders, unnecessary cosmetic treatments, and mental health concerns such as body dysmorphia. Celebrities and influencers should be setting a better example in the eyes of many.

In a statement published on her Instagram feed, Khloé Kardashian defended her right to edit her photos and use filters as akin to wearing make-up and getting her nails done to look good.


View this post on Instagram


A post shared by Khloé Kardashian (@khloekardashian)

Aesthetic practitioners with REAL images versus the Kardashians and FAKE images – the debate

As aesthetic practitioners, we are selling a service which helps people to improve their appearance, enhance their existing looks, and rejuvenate ageing characteristics, thus the problem with faking images of achievable results from aesthetic treatments is that clinicians would be guilty of giving their patients an unrealistic and unachievable goal.

Should I fake, edit, or tweak my before and after images?

If your before and after images are not real because you decided to touch them up in an art package, for example, then you are giving the public an impossible image to attain and are no better than the celebrities and social media influencers who share filtered and manipulated images to appear ‘perfect’ to their followers.

This could well backfire on you because you will inadvertently create an unsolvable problem when patients expect you to be able to produce such dramatic improvements or enhancements for them with the treatments that you provide. Patient expectations become unrealistic, and you have fuelled that problem. Ultimately, this leads to suffering because no matter what you do, you will not be able to give the patient what they want – because what they want is faked.

We all have a duty to be more REAL. There is a fine line between clinical photography, the like of which you may see in a published clinical paper, and creative or well-presented before and after photographs used to ‘sell’ your services on your website or social feeds. Be wary of using clever angles, creative lighting, lip balms or other finishing products which give rise to false colouring, shine, or gloss, as well as inconsistencies in patient positions or expressions – they can all add to what the viewer sees or does not see. Think about how you take your photographs and the messages they may send to your audience. Are you inadvertently creating an unsolvable problem with your photography techniques – artistic versus clinical?

Ethically presenting before and after images for aesthetic treatments

Rightly or wrongly, we all value youth and beauty, but if you create something to aim at that a person can never reach, then you have created a value that is impossible to achieve, and this becomes unethical.

Aesthetic clinicians will, by the nature of comparing a before and after photograph, be fuelling the concept that after visiting a clinic for treatment, the patient looks ‘better’ in the after photograph and did not look so ‘good’ beforehand. This concept of ‘better’ must be honest, considerate, and achievable for others. The focus can, however, be moved away from beauty and towards psychological improvement or a ‘better’ mindset. For example, an imperfection on the nose may appear ‘better’ and more beautiful after non-surgical rhinoplasty with dermal fillers, but in discussing the image, you may prefer to highlight the improvement in self-confidence that the treatment gave to your patient, over an above any perceived beautification of their nose.

Educate your patients about what is real and what is fake. Explain what is normal when it comes to skin and skin ageing, what they can expect from aesthetic treatments and the promotion of good skin health. As aesthetic practitioners, our overall aim is to make our patients feel happier in their own skin, free them from the things which may be holding them back; it is not to remove or airbrush away every imperfection. You cannot do that in clinic, you need someone proficient in Photoshop for that, not an aesthetic clinician.

For more information…

See our recent Aesthetics Mastery show, where Dr Tim and Miranda Pearce discuss the ethics of beauty and aesthetics.

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Dr Tim Pearce MBChB BSc (Hons) MRCGP founded his eLearning concept in 2016 in order to provide readily accessible BOTOX® and dermal filler online courses for fellow Medical Aesthetics practitioners. His objective was to raise standards within the industry – a principle which remains just as relevant today.

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