I get asked about my photography setup regularly so I decided to share our current set up. It has been a reliable setup for me if you do not have a photo studio room and are just looking to take some quality and consistent photos from your exam rooms. I think my team does a great job with the photo lighting and keeping our before and afters standardized. Hopefully this information will get you on the right track and save you some headache.
The Backdrop:
I use retractable, wall mount blue screens in my room. They can be placed behind the doors and do not tend to be too much of an eyesore. I recommend blue for plastic surgery simply because it is easy to discern facial borders for surgeries like rhinoplasty or necklifts – for patients of any color skin. If you are raising and lowering it regularly, they can take some getting used to and you may need to tighten or loosen the winding mechanism, so hang on to the instructions that come with it.
Link to purchase: http://www.belgerphotography.com/25X5-Rollup-Background-System_p_45.html
The Camera:
I am currently using a Nikon D3400. Camera quality is so good these days that this is probably the least important piece of the puzzle. That being said, I like using a DSLR because I like to shoot at a certain focal length – which is easier to do when you have a DSLR. The memory card pops out easily which allows easy and fast downloads as well.
Link to purchase: https://www.nikonusa.com/en/nikon-products/product/dslr-cameras/d3400.html
The Lens:
The lens currently on my D3400 has a pretty large focal length range, 70-300, which is not necessary. I really just use the 100-125mm range. I simply mark the focal length on the lens and the photographer lines it up before shooting. You can also purchase a dedicated 105mm Nikon lens but they tend to be a bit more expense. For an explanation of focal length, see the bottom of this post.
Link to purchase: https://www.nikonusa.com/en/nikon-products/product/camera-lenses/20068/af-p-nikkor-70-300mm-f%252f4.5-5.6e-ed-vr.html
Other options: https://www.nikonusa.com/en/nikon-products/product/camera-lenses/2213/af-s-dx-nikkor-18-140mm-f%252f3.5-5.6g-ed-vr.html
Full collection of Nikon Lenses here: https://www.nikonusa.com/en/nikon-products/camera-lenses/people-and-events-lenses.page
The Flash:
If you have a dedicated photography room, I would recommend a dual flash set up with mounted flashes – one in each corner. If you do not have that luxury, I am getting nice results with my Nikon Speedlight SB-500.
I am angling the flash upwards at a 30-45 degree angle instead of directly at the subject, see below. This prevents flooding of the subject with light.
Link to purchase: https://www.bhphotovideo.com/c/product/1082606-REG/nikon_sb_500_af_speelight.html
Positioning of the patient:
Frankfort Horizontal Plane
Frankfort Horizontal Plane: Patients are kept in the Frankfort Horizontal plane. Notice the alignment of the top of the ear canal/tragus and the inferior orbital rim. This is also maintained on the frontal view to prevent over rotation of the head up or down. Patients always tend to put their heads up in photographs and need a constant reminder to put their chin down a bit.
Importance of focal length
Again, focal lengths are kept in the 100-125 range. This is marked on my cameras so that all photographs are taken at a standard focal length. Using a lens with a dedicated focal length is also easy (i.e. 105mm).
I often see injectors show me photographs of patients taken with their iPhones up close to the patient’s face. This is equivalent to a very small focal length and creates a large amount of distortion – creating warping of the sides of the head and enlarging the nose. This makes it nearly impossible to objectively assess photographs and, in my opinion, makes it useless to even take such photographs.
If you are confused about the effect of focal length, see the images below. Another work-around if you have to use an iphone/ipad is to back up and zoom in. This increases the distance from the patient and creates less warping at the edges of the photo.
Hope that helps you all take some consistent photographs of your patients! Feel free to contact me if you have any questions or thoughts – jordan@rihanimd.com
JR
