Skip to main content

Chelsea Handler: What you see is not what you get!


Chelsea Handler is a really talented comedienne and Sciton is a great laser company, but the recent hype about her miracle treatment has been blown way out of proportion.  It can all be explained in the art of photography.  Any before and after cosmetic surgery picture needs to be standardized.  Same distance, same size, same lighting, same focus, same makeup (or none) and same background.

The pictures going around social media may look like a fabulous result to the untrained eye, but experienced cosmetic surgeons immediately realize that using these two pictures side by side is a misrepresentation.  The “before picture is taken sometime after laser treatment hence there are burns, scabs, swelling and other changes from post laser reaction.  The worst part is the fact that before image is taken without a flash or with minimal lighting.  Notice the dark circles around the eyes and the shadows around the wrinkles?  The picture is also taken very close up and is much larger than the “after” picture which amplifies the defects.  Also there is no makeup and she is smirking, and wrinkling her lower lids and forehead.

The “after picture is take zoomed out and is much smaller, which makes it look very different.  The lighting is bright and there are no shadows.  That in itself has the biggest effect in making the picture look better.  Chelsea is also not animating so there are no facial wrinkles and she is wearing makeup.  If the “before” picture was taken with the same standards as the after picture, then the perceived changes would be minimal.  This is a great example of photographic trickery.

These light laser treatments do have a positive effect, but it is minimal unless numerous treatments are performed.  A patient can get a better treatment with a more aggressive single laser treatment, although the recovery is longer.  Laser and fractional laser treatments are a great part of cosmetic surgery, but when uncontrolled before and after pictures are passed off as a miraculous treatment, the public suffers.  Many patients may go out and request this treatment thinking they will get these same results.  It won’t happen, or at least not with a single treatment.  I have performed thousands of facial laser treatments and the easier the recovery, the less the result.  For maximum results, patients require deeper treatment and must be sedated.  With the fractional treatment it can be done awake, but can also be very uncomfortable.  Different laser treatments are tailored to different patients based on numerous factors including their age, amount of sun damage, health history, how much time they can take off.  Based on this, there is usually a treatment for every patient.  If doing lighter, less aggressive treatments, don’t expect the “Chelsea Miracle”.

If you are considering any type of laser treatment, do your homework.  Ask the doctor to see 10-20 CONTROLLED before and after pictures, taken with same light, pose, animation, makeup, etc.  If they cannot show this to you then, beware.  Sometimes what you see is not what you get.

The picture below is a before and after image of one of my CO2 laser patients and is an example of a more controlled before and after picture.  Unfortunately she could not take off her earrings, but that does not skew the result.  The lighting, focus, size and pose are similar in both pictures and this is a controlled image.


For more information about cosmetic facial laser treatment click here and also view the related pages and before and after galleries.


Niamtu J. The Impact of Deceptive Photography on Our Profession. Plast Surg Prac. 2011; 21(10):26-28.

Niamtu J  Clinical Photography 9in) Cosmetic facial surgery Niamtu (ed), St. Louis, 2011, Mosby Elsevier. Pg 18-29

Niamtu J.  Clinical Photography Pg. 87-95. Saving and Archiving Images pg 113-118
In: Perfect Medical Presentations, Irwin & Terberg. Churchill & Livingstone, London 2004

Niamtu J. Image is everything: Pearls and pitfalls of digital photography and PowerPoint presentations for the cosmetic surgeon. Dermatol Surg 2004;30:81-91

Niamtu  J. Techno pearls for digital image management.
Dermatol Surg. 2002 Oct;28(10):946-50.

Niamtu J.  Digital Photography In: Textbook of Facial Rejuvenation The Minimally Invasive Combination Approach Editor: Nick Lowe, MD “Digital Imaging in Cosmetic Surgery” 2000, Martin Dunitz, London Pg 307-319


Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

Office Address

Joe Niamtu III, DMD
11319 Polo Place
Midlothian, VA 23113

Office Hours

Monday - Friday
8:00am - 5:00pm

Link to Cosmetic Facial Surgery home page
Making Virginia More Beautiful...One face at a Time
Meet Dr. JoeOnline ConsultationSchedule An AppointmentHome
Click to open and close visual accessibility options. The options include increasing font-size and color contrast.