Every category, rendered.

Draft body, not yet adapted

The photography room is deliberately boring and it is one of the more important rooms here. The camera is on a fixed column at a set height with a fixed focal length and a marked distance. There is tape on the floor. The two lights are locked at an angle nobody is permitted to adjust, and the background is a single matte grey that does not shift with white balance. The head is positioned to the Frankfort horizontal, which is a reproducible anatomic plane rather than whatever felt level that morning. The reason for all of this is not aesthetics, it is comparability: if the setup is identical at every visit then a difference in two photographs is a difference in the patient rather than a difference in the photograph. It also means our images look flatter and less flattering than the ones you will see elsewhere, which we have decided we can live with. Standardised photography is unglamorous and it is the only thing that makes a series of images evidence rather than decoration.

Draft body, not yet adapted

A surgical consultation here is partly a conversation and partly a measurement session, and the measurements are not ceremony. Nasofrontal angle and nasolabial angle describe how the nose meets the forehead and the lip, and they constrain what a projection change can do without looking odd from the side. Tip projection and rotation are recorded because they trade against each other and a plan has to state which is being prioritised. Brow position relative to the orbital rim decides whether an upper lid complaint is actually a brow complaint. Lid-cheek junction height explains most lower-lid shadowing. Skin thickness, assessed by pinch, predicts how much of the underlying framework will show through and how long swelling will take. Facial thirds and the position of the chin in profile set the context, because a nose is judged against a chin whether anyone says so or not. All of it is recorded on standardised photography, and you leave with the numbers and the drawing. Several patients have brought that sheet to a third surgeon, which is entirely fine and occasionally useful to us.

Draft body, not yet adapted

A surgical consultation here is partly a conversation and partly a measurement session, and the measurements are not ceremony. Nasofrontal angle and nasolabial angle describe how the nose meets the forehead and the lip, and they constrain what a projection change can do without looking odd from the side. Tip projection and rotation are recorded because they trade against each other and a plan has to state which is being prioritised. Brow position relative to the orbital rim decides whether an upper lid complaint is actually a brow complaint. Lid-cheek junction height explains most lower-lid shadowing. Skin thickness, assessed by pinch, predicts how much of the underlying framework will show through and how long swelling will take. Facial thirds and the position of the chin in profile set the context, because a nose is judged against a chin whether anyone says so or not. All of it is recorded on standardised photography, and you leave with the numbers and the drawing. Several patients have brought that sheet to a third surgeon, which is entirely fine and occasionally useful to us.