Quantifying Facial Distortion in Modern Digital Photography.

Document Type


Publication Date


Publication Title

The Laryngoscope


washington; everett; prmc; Humans; Face; Plastic Surgery Procedures; Smartphone; Photography; Physical Examination


BACKGROUND: Advancements in digital cameras and the advent of smartphones have magnified the importance of clinical photography in facial plastic surgery. Here, we aim to examine the effect of different camera types, focal lengths, and distances from subjects on facial distortion.

METHODS: Twelve subjects underwent a series of frontal photographs using a smartphone camera and a full-frame digital single-lens reflex camera. Photos were captured at six distances from the subject. Seven focal lengths were used at each distance for the full-frame camera. Measurements of facial landmarks were made for each photo, with those made at 60 inches using the full-frame camera considered the gold standard and used for comparison.

RESULTS: Distortion of facial features using the full-frame camera occurred when photos were captured 8 inches away using short focal lengths. A 12%-19% increase in vertical stretching of the midface occurred when using focal lengths of 24, 35, and 50 mm (p < 0.05 for all). The same features were distorted when a smartphone camera was used at 8 inches (18% increase, p < 0.01) and 12 inches (12% increase, p < 0.03).

CONCLUSIONS: Distortion of midfacial features using both smartphones and full-frame cameras occurs with short, 'selfie' distances between the camera and subject.

LEVEL OF EVIDENCE: 2 Laryngoscope, 134:1234-1238, 2024.