Why you will not find before-and-after photographs on this site

"Do you have photographs of results?" It almost always arrives in the first message, ahead of the price. And the answer, which is no, sounds bad: it sounds like there is something nobody wants to show.

It is a good question. Whoever asks it wants two reasonable things: to know what this actually looks like, and to check that the person operating can do it. Both deserve an answer. What will not give them one is a gallery of before-and-afters.

The legal reason, which is the short one

A clinical photograph is not a photo. It is health information about an identifiable person, and in Peru that makes it sensitive data under Law 29733 on the protection of personal data. Handling it requires consent that is prior, express and informed — and specific to what will be done with it.

That is the distinction hardly anyone draws: permission to take photographs in the consulting room is not permission to publish them. They are two separate consents. One exists to document your case, compare it at follow-ups and let you make a claim if something goes wrong. The other turns your body into a business's advertisement, and it is signed separately or not at all.

On top of that, advertising health services is regulated — by the General Health Act, the Consumer Protection Code and the Peruvian Medical Association's Code of Ethics — and they all say the same thing: you may not lead anyone to expect a particular result. An image does exactly that, and it does it without saying a word.

The honest reason, which is the long one

Suppose every permission had been signed. It would still be no use, because a gallery of results has a problem built into it: nobody publishes the ordinary case.

What gets published is the patient who healed well, who had good skin, who did not smoke, who followed the instructions and whose photograph happened to flatter her. It is a real result and there is no trickery in the image. The trickery is in what is missing:

• The cases nobody photographed, because they did not turn out well enough to show.
• The ones that needed a second operation, which exist in any surgeon's practice.
• The women who never came back for the six-month check, who are precisely the ones with most to say.
• Time. A photograph at three months is not a scar at two years, and the scar at two years is the one you will be looking at.

A gallery is not a sample. It is a selection made by the person who wants to sell you the surgery, and adding more photographs does not fix that.

And without touching Photoshop

There is something else worth knowing, because it changes how you look at any pair of images. Nothing needs editing for a before-and-after to exaggerate. It is enough to change:

• The light. Overhead light picks out every irregularity; soft light from the front erases them. Same skin.
• The posture. Shoulders dropped and abdomen relaxed in the before; back straight and abdomen held in the after.
• The angle and the distance. Moving the camera closer or further away alters the proportions of a nose or a profile more than surgery would.
• The colour. A tan, some make-up or a different backdrop does half the work.
• The clothing. Pale and loose underwear before, dark and fitted after.

When two photographs do not share light, posture, distance and background, you are not comparing two moments. You are comparing two photographs.

A before-and-after does not show what could happen to you. It shows what happened to the person whose photograph came out best.

So what is shown, and where

In the consulting room, and from your own case. It is less spectacular and a good deal more useful:

• Your photographs. Taken with standardised light and positioning, so they can later be compared with you, not with anyone else. They stay in your records and go no further.
• Where the scar goes, how long it is, how it looks at one month and how it usually looks at one year. This is what no gallery shows and what shifts expectations most.
• What is possible in your anatomy, discussed over your body rather than someone else's: your skin, your weight, your pregnancies, your previous operations.
• What is not possible, which is the part of the conversation that decides whether the surgery makes sense at all.
• Clinical images with no identity — a detail, an area, never a face — when they are needed to explain a technique.

If you want more than that, you can ask whether a former patient would be willing to speak to you. The question gets asked, sometimes the answer is yes, and what someone who lived through the recovery tells you is worth more than any photograph.

How to decide without a gallery

What actually predicts a good result is not in an image. It is in this:

1. Who operates. Full name, CMP registration number and a specialty registered as plastic surgery. Both registers are public.
2. Where the surgery happens. An authorised facility, with an anaesthetist and resuscitation equipment. Not a consulting room.
3. What you were told about the risks. If none came up, the consultation was incomplete.
4. What conditions you were set. Lose weight, stop smoking, wait. Setting them costs patients, which is why they mean something.
5. What the consent form says, read before the day of surgery and not on the trolley.
6. What happens if there is a complication: who deals with it, where, and at whose cost.

If you are going to look at photographs anyway

You will, because they are everywhere. At least look at them like this: check that the before and the after share the same light, the same posture and the same background; find out how much time passed between them; notice whether the scars are visible or always just out of frame; and be wary of the account where every case turns out equally well, because no practice looks like that.

One practical warning too: a photograph online does not prove who performed that surgery. Stock images and other surgeons' cases circulate freely. If an image matters to you, ask whose it is.

What is up to you

Asking for photographs is not wrong, and nobody should make you feel the question is out of place. What is worth changing is what you ask of the answer.

A gallery tells you how someone else turned out. A consultation done properly tells you what is reasonable to expect in your case, what scar you will have and what might go differently. The first takes a minute to look at. The second is what you will be wearing.