Nasal Photography – new directions

“In the frontal view, delicate, 3-dimensional (3D) anatomic structures require special photographic skills. Lighting is crucial for detail rendition and 3D reproduction of the nose, and for apparent photographic bias.”

The observation is provided by authors Benedikt Strub, Konrad Mende, Claudia Meuli-Simmen, and Stephan Bessler in a new paper for the Aesthetic Surgery Journal, entitled: ‘The Frontal View of the Nose: Lighting Effects and Photographic Bias’. The authors experimentally investigated 7 different symmetric and asymmetric lighting techniques to find out which might be preferable in advantageously depicting noses in photographs.


Figure 1.
Schematic of lighting arrangements A, B, and D. (A) Classic “quarter-light arrangement”; (B) “quarter-light arrangement” with an additional light reflector on the patient’s right side; and (D) “quarter-light arrangement” with reduced (2 m) flash-flash distance.


“In the frontal view, the shape of the nose is strongly influenced by the lighting technique for photographic documentation. The classic symmetric quarter-light arrangement—a commonly applied, practicable, and technically simple lighting technique—has substantial limitations in detail rendition and 3-dimensionality in the frontal view. Asymmetric light greatly improves detail rendition and 3-dimensionality in frontal photographs of the nose, but as we have shown, strongly asymmetric lighting may lead to apparent changes in nasal shape because of increased lateral shadowing leading to photographic bias, depending on the side of illumination. Consequently, documentation of the nose with asymmetric lighting should always be performed in duplicate from both the right and left sides, to prevent misleading interpretations. We found that slightly asymmetric modifications of the classic quarter-light arrangement offer a perfect but time-consuming and technically demanding compromise. A standardized setting with identical lighting conditions is essential for comparable pre- and postoperative photographic assessment of the nose.”


Note: As a courtesy, Improbable has obscured the identity of this participant whose photos are featured in the paper.