Fact or Fiction: Examples of Fake Before and After Photos and How They Were Created

In our recent "Fact or Fiction" post (you can read that here), we talked about the different ways in which it is possible to fake before and after photos, to help you be on the lookout for the real deal. This companion post includes some examples of FAKE before and after photos that we put together to demonstrate some common techniques. In each image below, NO procedure was performed between the before photo and the after photo. For each example, we offer a brief explanation of how the effect was achieved, and what you can do to recognize tricks like this when you are evaluating before and after images on your own. If you have any questions or comments, you can reach out to Dr. Smith directly in our Facebook group, which you can join by clicking here.

Photo 1 is an example of simulated neck liposuction. To achieve this effect, our model was asked to tilt her chin down slightly in the before picture and up slightly in the after photo. The images were then rotated so it appears that her head was being held at the same angle in each shot. The key to telling that this photo is a fake is noticing how far the tip of the chin is from the neck in each photo. In the before picture, the tip of the chin is much closer to the neck (causing the neck and chin to look full), and in the after it is further away (stretching out the neck and chin tissue so a tight result is perceived). 

Photo 2 is an example of simulated nasolabial line filler. In the before picture, the patient was asked to form a weak smile, which accentuated her nasolabial folds, and no flash was used. In the after picture, she was asked not to smile, which decreased the prominence of her nasolabial folds, and a flash was used to wash out any shadows, further diminishing the severity of these folds. You can identify tricks like this one by keeping an eye out for subtle differences in facial expression between photos, and also looking for the presence or absence of shadows and how light falls in each picture.

Photo 3 Here, we are simulating a before and after photo for upper arm liposuction. Our model's arm is flexed at the elbow in the before picture, and extended at the elbow in the after picture. The arm beyond the elbow is cropped out of the picture so the viewer can't tell if it is flexed or extended. To spot this trick, pay close attention to the way light is falling on our model's skin. Unlike in the before photo, in the after photo the model's arm is extended at the elbow, which causes subtle arm rotation. You can perceive this as subtle diagonal fine-line shadows in the after picture. You don't need to know that extending the elbow makes this happen; you just need to spot that something is different in the way the light is hitting the skin between the before and the after images. 

Photo 4 is an example of simulated tear trough filler. The before picture is taken with no flash and with our model's head tilted slightly forward to accentuate the shadowing under her eyes. The after picture is taken with our model looking straight ahead and with a flash. Together, these maneuvers minimize her under eye shadowing. To spot this trick, notice that you can see more of the bottom part of her iris (the colored part of the eye) in the top picture than the bottom. This is a giveaway for head position. Next, you can see the reflection of the flash bouncing off our model's pupils in the after picture, but there is no sign of a flash in the before picture. Again, it is not so important that you can tell exactly why these different effects are occurring. They key is to be on the lookout for subtle differences so you can ask about them if you have questions.

Author
Office of Darren M. Smith, MD

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