Worst Before & After Photos from FAKE Cosmetic Doctors

Michelle - Patient Education & Patient Care Coordinator

How to spot the worst ‘Before and After’ Photos of fake Doctors

In order to find the best Plastic Surgeon for your cosmetic surgery, you’ll no doubt be looking at lots of photos of “before and after” results. But what should you be looking for? And how can you properly compare the results of different Surgeons to find the trick photos and fake Cosmetic Doctors?

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Top 12 Tips and Tricks for Comparing Cosmetic Surgery Images

1. DIFFERENT DISTANCES – Camera distances and poses should look similar

  • Comparing Cosmetic Surgery result photographs is easier when camera distances are equal and patients are in the same spot
  • Patients’ facial expressions (smiling vs frowning) and chin angles should be the same in the before and after; so should hip widths, shoulder widths and body stances
  • Watch out for different angle photography tricks or very different body-to-background ratios
    • If patient-to-camera distances vary in the photos, cropping out extra background colours is acceptable –
    • But only if the relative dimensions remain identical, and the cropping simply reveals more equal amounts of the treated areas
    • Protecting privacy by covering eyes or part of faces may be acceptable, but additional photo manipulation is against the guidelines

Solution: Look for even hip bone widths as described above. Compare background-to-body (or face) ratios. Colour corrections are not best practice for clinic photography.  That noted, adjusting colour typically won’t impact results.


  • It is a common trick to show ‘before and after’ weight loss photos as closer and further away views
  • Be wary of photos taken from very different angles, distances and perspectives.
  • Watch out for fake photos, where the hip-width looks a lot smaller in the after photo –  this can indicate the photo’s been manipulated in terms of height x width dimensions. Surgery can change body shape, but it can’t change bone hip-width!

It is AGAINST professional guidelines to edit or manipulate cosmetic surgery images that mislead patients on outcomes.

2. DIFFERENT LIGHTING – Lighting should be similar

  • Patients often attend post-op photo sessions at different times of the day
  • Photos may also be taken in different rooms by different team members
  • Shadows and lighting differences can make direct comparisons more challenging

Solution: special photography equipment and standard camera-distance-to-patient protocols give the best photographic results

Spot the FAKE – Many times the difference in skin features (wrinkles, blemishes, cellulite, stretch marks etc) is wholly related to angle of lighting with more or less shadowing

3. DIFFERENT POSTURE – Posture counts – look for identical body positions

  • Ideally, your Surgeon’s photos should have the same stance and photo composition
  • This allows for a more realistic comparison of before-and-after cosmetic surgery results
  • Look for arm positions, torso angles, foot distance and shoulder levels to match

Solution:  Look for similar stances, positions, angles and camera distances.  Beware of a slouching posture compared to one where the patient is standing up, or a smiling vs a frowning face for a facial procedure or injectables photo. Check for nearly-identical composition ratios (meaning the BODY/FACE-to-background colour ratio).

Example of equal widths and camera distance: You can see dramatic skin reduction changes in the tummy tuck and liposuction after photo, however, the hip widths and background composition are fairly similar. Note that results vary and all surgery has risks.

Tummy Tuck - Abdominoplasty Before & After Photo

Spot the FAKE – You’ll see patient photos taken closer and further away being shown for comparison

4. Just Showing their BEST PHOTOS – Remember that Surgery results vary

  • Every doctor and surgeon has a range of surgical results – make sure you see the range and not just the BEST one
  • Even if you feel you look similar to a “before surgery’  image, don’t expect identical results to that patient
  • That’s because every patient is unique – your after photo won’t be identical to someone else’s result
  • Patients have important differences you might not notice in a photo, and their procedure might not be the one that suits you best

Solution: Keep your expectations in check. A good Plastic Surgeon will show you a variety of patient types and still get good results. Be realistic about what Surgery can accomplish, and ask your Surgeon what to realistically expect.

Spot the FAKE – Just a few curated patient photos of the doctors results are available

5. JUST SIMILAR PHOTOS – Look for a wide variety of results and patient types

  • Are you seeing only dramatic cosmetic surgery results on a Surgeon’s website?
  • If yes, that Surgeon may only be posting their very best results.
  • These Surgeons may be unwilling to reveal the variety of surgery outcomes that occur

Solution: Look for variety in results and inpatient types. Avoid Surgeons who show photos only of nearly-identical types of body types or surgery results. Images will normally contain mild-to-moderate changes after surgery, plus a few photos with more dramatic results.

Spot the FAKE – The patients all look similar body types

See our 2022 Real Patient Plastic Surgery Transformations.


6. JUST ONE VIEW – Only one side of the surgery result is shown

  • Showing ONLY one side (or partial surgery results) of the body or face should raise your suspicions
  • It might indicate an unwillingness to reveal the full surgery result(s)
  • It may also indicate asymmetry issues (some asymmetry is normal, but it shouldn’t be excessive)

Solution: Look for multiple photos of the same patients. They should be seen from different angles (side, front, and 3/4 views are standard). If only one side of the surgery result is SHOWN – be wary.

Spot the FAKE – You are only seeing one Sided Photos

7. POOR Image quality and contrast differences hide a lot of mistakes and fake surgeons

  • Good Surgeons often use quality camera imaging systems and have consistent room lighting
  • Otherwise, their photos could be very low resolution and lacking in image clarity
  • The occasional blurry or low-resolution photos is okay, as no photography system is perfect; but if ALL images look to be low-res, or a bit ‘too clean’ or ‘too contrasted’ in terms of skin imperfections and scars, tread cautiously

Solution: The photography systems of your Surgeon are an integral part of getting good BEFORE & AFTER PHOTOS of their surgery results. If your SURGEON doesn’t have a good photography system or a variety of high-resolution photos to show you, ask why.

Spot the FAKE – Bad Photography – blurry & out of focus images

8. NOT THEIR WORK – photos are actually from a different Surgeon than the Fake one being advertised

  • Surgeons sometimes advertise cheap cosmetic surgery offers because they are new  and/or not RACS recognised
  • Junior Surgeons or non-RACS sometimes post colleagues’ or overseas website photos as examples, because they lack their own BEFORE and AFTER photos
  • If so, these should include a disclaimer that the BEFORE & AFTER SURGERY IMAGES are not their actual patients; but this may be intentionally down-played on certain types of websites

Solution: Read the fine print on photographs. Look for copyright stamps. Check the photos to see if they are results of the Surgeon being advertised. Be sure you read the fine print and search for online reviews and comments from prior patients

Are they even registered? – Check their registration with AHPRA (be sure you drill down to speciality areas)

Spot the FAKE: Ask to see numerous patient surgery examples of the surgery you have in mind.  NOT ALL patients WILL consent to show their surgery photographs on websites; however, long-experienced Surgeons will have a lot of example photos to show you during a consultation or event.

9.  DIFFERENT HAIR and makeup! – Fake Photos with ‘make-up’ vs ‘no make-up’

  • Facial makeup highlight features and reduces flaws (this includes mascara, eyelid makeup, foundation and bronzing powder)
  • Makeup use may even change after plastic surgery, because of boosted appearance confidence
  • Images with properly-applied makeup will nearly always look better than ones without makeup (as seen in Celebrity images), so it’s best if photos match

Solution:  Look for photos where makeup use is similar or matched. E.g., (a) makeup on BOTH images or (b) NO makeup on either image.  TWO SETS OF PHOTOS – One set with no makeup and another set with makeup is even better!

FAKE SURGEONS may Show you a photo that has bad hair and makeup vs an after photo with great hair and makeup.

10.  TAN vs NO TAN! Tanning differences may also have an effect on  surgery results photos

  • Patients often wear more revealing clothing – and spend more time at the beach – AFTER having cosmetic surgery (especially after a Breast Augmentation, Reduction or Tummy Tuck)
  • Patients do need to AVOID TANNING scars after breast augmentation or a tummy tuck and reduce sun damage and melanoma risks
  • But they often have more sun exposure in their after photographs than in their BEFORE images, especially when surgery is performed in springtime or over summer.

Solution:  Tanning from sun exposure seems to be an inevitable part of Australian living. Good photos are those taken the same time of year, so that tanning differences are less extreme in the before and after pics.

11. IMAGE FILTERS – Many Social Media Posts on Instagram and Facebook can be using image-enhancing filters making them look great

  • People often post social media photos shortly after having a cosmetic procedure – some with image Enhancement
  • The trouble is that photos taken just after surgery DON’T tend to reveal the photo enhancing
  • Patients MIGHT be happy for the first few weeks, months or few years, then find their results (or filler injections) deteriorate more quickly than expected –

Solution:  Don’t rely solely on Instagram photos of “fresh” or enhanced results. Look for PHOTOS taken a few years or decades after the original procedure. A series of photos, up to five (5) years after surgery, would be ideal.

TIP: You can investigate your Cosmetic Surgeon’s online reviews on sites such as Google –  or forum sites NOT controlled by your Surgeon – to get a better sense of what patients are saying about how long their surgery results have lasted.

WATCH ABC’s Four Corners video about low-cost boob jobs once promoted on Instagram.

Review the before and after photos of Melbourne Plastic Surgeons


12. NO SMILE vs SMILE Patient Photos

This one is a simple trick – get the ‘before photo’ to frown and the ‘after photo’ to smile.

Make sure you don’t just buy the smile – look closely at the quality of the surgical result.

Further Resources to avoid Photo Scams,  FAKE Surgeons and Bad Medical Practices

Read the ASPS Guidelines for Photography and Photographic Standards.

Also the ASPS Match Photo Standards

*Disclaimer – Individual results can vary significantly from patient to patient.
The information we provide is of a general nature.  For information in relation to your own situation, a consultation with a Surgeon is required. Phone us on 1300 264 811 to arrange to see one of our Melbourne or Sydney Plastic Surgeons to review your health and medical history and attain a surgical consultation and surgery quote. Visit our Disclaimer page for information on why results can vary from patient to patient.
Last updated: 08/05/2022
Author profile image
Michelle Staughton
Michelle Staughton - Patient Liaison Manager at Coco Ruby Plastic Surgery in Melbourne, Victoria, Australia. As a past patient, Michelle has insider knowledge of the journey our patients embark on. A busy mother of 3, and independent business owner, Michelle appreciates the organisation required to get things done in today’s hectic life. Her role as Patient Experience Manager Michelle is a great guide for your plastic surgery journey.

Coco Ruby’s Specialist Plastic and ENT Surgeons

With a wealth of experience and training, our Specialist Plastic Surgeons are dedicated to best practice patient care and education, customising Breast Enlargement Surgery for each and every patient to best meet their needs and desired surgical outcomes.

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What to do next?

Our Patient Liaison Team can assist with any questions you may have when considering a procedure. You can send in an enquiry form below or call our Melbourne Clinic between 9 am – 5 pm Monday to Friday.

Phone 1300 264 811, Email us: enquiries@cocoruby.com.au or Book a FREE 15-minute Phone Chat with our Patient Liaison Manager or a Virtual Consultation with a Surgeon.

Disclaimer: Results depend on individual patient circumstances and can vary significantly. Results may also be impacted by a variety of factors including your lifestyle, weight, nutritional intake and overall health. Consult your Specialist Plastic Surgeon for details. This information is general in nature and is not intended to be medical advice nor does it constitute a doctor-patient relationship. Surgery risks and complications will be covered in detail during a consultation with your Surgeon.