By Candace Crowe
In a world where patients can research, simulate, and even digitally “design” their own outcomes, how does a facial plastic surgeon balance marketing, patient education, and high-touch care — without burning out?
I recently had a heart-to-heart with Dr. Eric Carniol, a facial plastic surgeon in New Jersey who works alongside his father, Dr. Paul Carniol. Fellowship-trained, nationally recognized, and a father of three.
High-Touch vs. High-Volume
Early in his practice, Eric faced the classic challenge: grow fast or grow smart? He says:
“I don’t like the churning kind of McDonald’s experience. It makes me exhausted. When I have really great high-touch patients, I may not see as many people in a day, but I still have energy. I can still go home to my family and do all the fun family things.”
Instead of chasing a high-volume, transactional model, he focused on patients who value the process, understand the art of surgery, and are willing to do the work. These are the patients who give him energy at the end of the day — not drain it.
Early Learned Lessons About Before-and-After Photos
In the early days, Eric did boots-on-the-ground marketing, visiting pediatricians to educate them on newborn ear deformities. It wasn’t glamorous, but it worked: he became the go-to specialist in his region. Through this process, he learned something critical about before-and-after photos:
“Patients who spend time looking at before-and-afters understand that surgery is an art, not a science. They come in with realistic expectations. They meet me in the middle. And those are the patients who give me energy at the end of the day.”
Before-and-after photos aren’t just marketing tools — they educate patients, set realistic expectations, and foster collaboration.
But the catch-22: when you’re new and just starting out, you don’t have many before-and-after photos!
You need photos to get patients… but need patients to get photos. And getting consents can be difficult.
Dr. Eric Carniol’s solution: When patients hesitate about photo consent, he explains:
“The reason you found me was because you looked on the website and saw someone who looked similar to you. If you want to help the next patient go through that journey and see what the before and afters look like, that’s where the photo comes in. It’s an appeal to help others. And it works.”
It’s an appeal to help others — and it works. Here is his, game-changing strategy:
- Circle “optional” on the consent form.
- Offers to black out eyes or partially obscure faces.
- Eric’s appeal to patients’ desire to help the next patient.
A rhinoplasty photo with covered eyes? An otoplasty with a partially hidden face? “That’s still infinitely better than not having that photo.”
View Eric’s partially obscure faces here: https://drcarniol.com/photo-gallery/
When Patients Come Pre-Photoshopped
The landscape is shifting. Patients are digitally empowered. They often arrive at consultations with ultra-high expectations, sometimes having morph-edited their own “after” photos before even meeting the surgeon.
“Patients are able to edit their own photos to be exactly what they want. They’ve spent more time morphing their images than it takes me to do their surgery,” says Dr. Carniol. “What’s tough is making sure they understand this is not Photoshop. This is actuality. This takes time.”
This reality makes authentic before-and-after photos even more valuable:
- Real patients
- Real results
- Real timelines
- Real imperfections that patients can live with
Turn Every Photo Into a Powerful Practice Tool
Eric uses BRAG book to showcase standardized, medically accurate patient before and after photos, making it easy for potential patients to compare results, educate themselves, and arrive informed. The outcome? Patients who meet surgeons in the middle, understand the journey, and energize the practice instead of draining it.
Eric’s advice is clear:
“Photograph everyone, even functional cases, from day one. Get in the routine. The perfect photos will come.” And remember: “A partial yes is a win — you’re in the game. A rhinoplasty photo with covered eyes is infinitely better than no photo at all.”
Final Thoughts
Dr. Eric Carniol’s approach is a blueprint for modern plastic surgery practices. It balances high-touch patient care, educational marketing, and authenticity, all while protecting the surgeon’s energy.
In an era where patients can edit, simulate, and pre-visualize their desired outcomes, a high performing professional before-and-after gallery has never been more critical.
Want to see how BRAG book can help your practice?
The Legacy Question
I asked Dr. Carniol about legacy in our conversation. He’s still young enough that it’s not top of mind, but his answer was clear in how he lives:
He wants to go home with energy for his three (soon to be four) children. He wants to do the school pickup. He wants to be present.
He’s built a practice that allows him to be excellent at work AND excellent at home. He’s working alongside his father, seeing both sides of the coin that most people never see.
That’s a legacy worth building.
What’s your approach? Are you building for volume or for sustainability? I’d love to hear your thoughts in the comments.
About the Author: Candace Crowe has served the aesthetic practice industry for 26 years, specializing in software development and digital marketing for aesthetic practices. Her company’s flagship product, BRAG book, helps practices showcase before-and-after photos in a way that attracts the right patients.
