Lip photos for documentation: rest, smile and profile

The lip is the area where patients have the most opinions and where the photo is least forgiving. A few millimeters of difference in head position, a lipstick, a freshly licked lip or a slight tension change the shape, the vermilion border and the proportion between upper and lower lip. If your record is imprecise, the planning conversation and the results conversation both become subjective.

Here is the short sequence that covers the essentials, the patient prep and the points where the photo misleads most. The clinical approach to the area is on the lips page and in thin lips: assessment.

What sequence of photos covers the lips?

Four photos are enough for most cases, and each answers a different question.

The resting photo is the basis for comparison. The smile photo shows the dynamics, and smile detail is in smile photo in facial assessment. The profile follows the rules in profile photo of the face in the clinic, and the oblique, those in 45-degree photo of the face.

How to prepare the patient?

Preparation is worth more than equipment. Ask them to remove lipstick and gloss before entering the room (or offer a wipe), and to wait a few seconds without licking, biting or pursing the lips. A freshly moistened lip shines and looks fuller; a freshly bitten lip is redder and swollen; a tensed lip looks thinner. In every case the photo lies, and the conversation that follows starts from a false premise.

Some simple adjustments:

• talk for a minute so the face loosens up;
• ask them to close their lips, breathe through the nose and release;
• say "relax your mouth as if you were falling asleep";
• take the photo on the exhale;
• repeat if you notice tension in the chin or the muscle around the mouth.

The chin is a case of its own: it tenses easily when the lip is tense. See the relationship in chin profile photo for planning.

What lighting to use on the lips?

Diffuse frontal light is best. Light from above creates a shadow under the upper lip and under the nose, and deepens the philtrum groove. Light from below creates a shadow on the lower lip and accentuates the chin. The phone flash is the worst case: it creates a glare on the vermilion that erases the border and the white roll of the lip, exactly the points you want to see. The general rule is in lighting for clinical facial photos.

Which anatomical details to check in the photo?

• Cupid's bow, sharp and symmetric, or pre-existing asymmetry.
• Philtrum, height and depth of the columns.
• Upper and lower proportion, the lip proportion.
• Commissures, whether they are at the same level and not drooping.
• Mucosa and border, including scars and previous herpes, which should be noted in the chart.

If the patient has asymmetry, it must be recorded before the procedure. See asymmetric lips: assessment. For future comparison, what you photographed today is the only proof that the asymmetry came first.

What about teeth and braces?

Teeth appear in the smile and in speech. If the patient wears orthodontic braces, record it, and if there are cracked teeth, restorations or stains, a close-up helps, as in cracked teeth in the lip photo. Do not retouch tooth color. Braces change the position of the upper lip; note that the patient was wearing them.

How to use the speech video?

Speech shows what the photo cannot: how the lips meet during pronunciation, how the upper lip behaves and whether there is a dynamic unevenness. A short video, ten to fifteen seconds, with the patient counting from one to ten or reading a sentence, complements the record. It requires specific consent, per consent for clinical video, and the technique is in speech video to assess the lips.

How to use the photos during the consultation?

Show the patient the frontal at rest and ask what bothers them. Many patients describe themselves with terms like "thin lip" or "sad mouth" that do not match what the photo shows. Point out what you see and let the patient point out what they see. Record both readings in writing: that is where expectations line up, as in aligning expectations of a natural look.

What mistakes to avoid?

• Photographing with lipstick or gloss.
• Accepting a tensed, bitten or freshly licked lip.
• Using flash.
• Changing distance and lighting between visits.
• Recording only the frontal.
• Forgetting to note the prior asymmetry.

Lips change shape in seconds. The useful record is the one that shows the lip at rest, clean and always the same way.