Why do I ask cosmetic patients for an old graduation or wedding photo? Because it tells me what they are really chasing, and it puts expectations on the table early. I ask for a photo from graduation, high school or college, or from a first marriage. There is a running joke, with truth in it, that people smile more in the first marriage photo than the later ones. What I am after is whether they want to return to a smile they used to have, or reach for one they never had. That distinction shapes the whole anterior esthetics conversation. With [...]