Before and After Photos, What They Can and Cannot Show
Medically reviewed by
4 independent reviewers
Andrew Conrad Barile, PT, DPT
Doctor of Physical Therapy (DPT) | Licensed Physical Therapist (PT) | CEO and Founder, Xtreem Pulse LLC
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Dr. Andrew Conrad Barile is a Doctor of Physical Therapy and the CEO and Founder of Xtreem Pulse LLC, the engineering company behind PureLift. He earned his Doctorate in Physical Therapy from Daemen College and is a licensed physical therapist.
He brings over two decades of clinical and entrepreneurial experience across physical therapy, craniosacral therapy and medical device innovation, built on a working knowledge of human anatomy and muscle physiology.
For PureLift LAB he reviews how current is delivered across all ten levels, from sub-sensory nanocurrent and skin-level microcurrent to motor-level EMS, and how the Infuse pass fits into the same ten-minute routine.
Bertica M. Rubio, M.D.
Board-Certified Physician, Dartmouth Medical School | Medical Director, Antiaging Regenerative Medicine Clinic
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Dr. Bertica M. Rubio is a board-certified physician and Medical Director of the Antiaging Regenerative Medicine Clinic in Redlands, California. She earned her Doctor of Medicine from Dartmouth Medical School and completed her pediatrics residency at UC Irvine Medical Center.
With decades of clinical experience, she specialises in age management medicine, regenerative medicine, wound healing and growth factor therapies, and her practice integrates evidence-based medical science with advanced aesthetic treatment.
For PureLift LAB she reviews articles for medical accuracy across the whole dial, from the gentle nanocurrent and microcurrent settings through to muscle-level EMS and the Infuse pass.
Daniel Grinberg, MD, FACS
Board-Certified Otolaryngologist | Head and Neck Surgeon | Fellow, American College of Surgeons | Mount Sinai
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Daniel Grinberg, MD, FACS is a board-certified otolaryngologist and head and neck surgeon at ENT and Allergy Associates in West Nyack, New York. He earned his medical degree from Columbia University College of Physicians and Surgeons.
He completed his otolaryngology residency at New York University Medical Center, serves as Assistant Clinical Professor at Mount Sinai School of Medicine, and is a Fellow of both the American College of Surgeons and the American Academy of Otolaryngology.
For PureLift LAB he brings a wider clinical lens, connecting at-home facial stimulation from microcurrent to EMS to the anatomy underneath, with the same rigour we apply to every device specification.
Prof. Dr. med. Ivo Buschmann
Chair of Angiology, Medizinische Hochschule Brandenburg | Clinic Director, University Clinic for Angiology
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Prof. Dr. med. Ivo Buschmann is Chair of Angiology at the Medizinische Hochschule Brandenburg Theodor Fontane and Clinic Director of the University Clinic for Angiology at the Brandenburg University Hospital.
He trained at the University of Hamburg, was a Max Planck Society Fellow at the Max Planck Institute for Heart and Lung Research, and held senior consultant posts at the Charite Universitatsmedizin Berlin before his appointment as Chair in 2016.
One of Europe's leading authorities on arteriogenesis, with over 150 peer-reviewed publications and US and EU patents, he reviews for PureLift LAB how the evidence on electrical stimulation is read and where its limits lie.
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Lighting, angle, expression and the hour of the day change a face more than three months of any treatment does.
This article covers what actually decides the answer, such as:
- What changes a face more than treatment does
- How to take a baseline worth having
- Then repeat it monthly
- Reading published before and after images
- What an honest expectation looks like
and many more!
Your own photographs can be genuinely useful, though, if you take them properly from the start.
Key Points:
Overhead light casts shadows that read as folds; light from the front fills them in.
Tilting the chin up by ten degrees tightens a jawline more than any device will.
Morning faces are puffier than evening faces, so the hour has to match.
Take the baseline photograph on day one, because you cannot go back and take it later.
Monthly, never daily; daily photographs record salt and sleep.
What changes a face more than treatment does
Light direction is the biggest one. A ceiling light casts shadow into the nasolabial fold and under the eye, and a light source in front of the face fills both in. The same face under those two conditions looks like two different ages, and no product was involved.
Head angle is second. Raise the chin a few degrees and the jawline sharpens; drop it and it softens. Photographers have known this forever, which is why the before shot in a bad advertisement so often has the chin down.
Expression is third, and it is subtle enough to be deniable. A very slight smile lifts the midface, and a neutral mouth held differently changes the lower face entirely.
Then time of day, since fluid collects overnight, and camera distance, because a phone held closer distorts the centre of the face outward.
How to take a baseline worth having
Take it on day one. This is the single most common regret, since three months in there is no way to reconstruct the photograph you did not take.
Face a window, in daylight, with the light in front of you rather than above. Do it at the same hour, and morning before makeup is easiest to repeat.
Mark where you stand and how far the phone is; propping the phone on the same shelf beats holding it at arm's length.
Neutral expression, chin level, eyes forward. Take a straight-on shot and a three-quarter turn on each side, because jawline change is easier to see at an angle than head-on.
No makeup, and the same hair position, since hair falling across the jaw hides exactly what you are trying to watch.
Then repeat it monthly
Monthly, not daily. Muscle thickness does not move on a daily timescale, so a daily photograph records how much salt you ate and how well you slept.
The research window is the horizon to hold in mind: Kavanagh and colleagues ran their protocol for 12 weeks and measured an 18.6 percent increase in cheek muscle thickness across 108 women (10.1111/jocd.12007). That is category evidence rather than a trial of a consumer device, and the twelve weeks is the useful part.
Compare month three against day one, not month three against month two.
Reading published before and after images
Check the light first. If the shadows fall differently in the two photographs, the comparison is already worthless whatever else is true.
Check the chin angle, the expression, and whether makeup appears in one and not the other. Check whether the crop is the same, since a tighter crop in the after shot changes the apparent proportions of the face.
Then ask how many people this happened to. A single dramatic pair is a best case selected from an unknown number of attempts, and a brand showing you one person is telling you about one person.
None of that means every published pair is dishonest. It means an honest pair is identifiable by how boring it looks: same light, same angle, same expression, modest difference.
What an honest expectation looks like
A modest change in contour over about three months, visible in a controlled photograph, more obvious to you than to anyone else.
Not a change in volume, since EMS works muscle and no current replaces fat. Not a change in skin texture from the muscle work itself. Not a change anyone will comment on unprompted at week six.
The immediate freshness an hour after a session is drainage, and it is gone tomorrow; keeping that separate from the cumulative work is what stops people abandoning a routine in week four.
Practical notes
Three minutes per side is the maximum on any PureLift model, and the ten minute session ends on its own.
Keep a note of the level you use alongside the photographs, since a drift upward over months is worth knowing about when you review them.
For what to expect from each band on the dial, see how the nine PureLift technologies work, and for reading brand claims generally, how to read a facial device study.