When looking at before and after plastic surgery pictures, there are several things to looks for:
Is this an actual patient of the plastic surgeon or is this a model? It should be clearly labeled as such.
Compare the photos with each other. Many times, after photos will be a different size compared to the the before photos. This is a trick to make the before and after plastic surgery results to look more than they actually are.
Also compare the lighting and other factors. Often, lighting is changed to improve results.
Were there other procedures performed? If you notice other changes not mentioned, something else may have happened (weight loss) or another procedure, that produced the claimed results.