Standardisation of image acquisition in Aesthetic Plastic Surgery is critical to accurately communicate changes from cosmetic surgical and non-surgical interventions. Depth of Field, Exposure, Perspective and point of view are the four factors that need to be replicated between photographic sessions to accurately represent these changes without the introduction of photographic bias. Despite many excellent articles on standardisation in plastic surgery photography, no paper fully discusses the four areas that lead to consistency in photographs taken at different times. Depth of field, exposure, perspective and point of view cover all the variables required. We have a system which locks many variables in place, leaving final composition matching to the photographer, the only area that needs intelligent input. There are also misunderstandings in the literature about some of these that need explanation, particularly exposure and perspective.