For my liking- The pictures have to be not "Out Of Frame" with what we know a real enema session is.
There's a pun intended- flow- to an enema scene. From getting set up for the procedure to doing it- to expelling and of course cleaning everything, then restowing anything not kept on display or out for drying.
We normally do not walk into a room and - Zapp, there's an enema bag filled with the right temperature solution hanging magically there- hose purged of air and nozzle lubricated so we can go to it right then.. But in the detached freeze action media of pictures- it appears to be just that "click" it's all there.. Same with how long it takes to get a full enema bag emptied into a person- candles or ciggys or incense sticks serve as an impromptu "time continuity" check too. Yes- that applies to expelling as well! How many of us light a scented candle etc for our enemas? and, we know how long it takes to give ourselves an enema then expell it. Quite long enough to see a candle or incense stick burned down a visible measure, eh? After those things?
Back to what makes a piccy work for me- That look in the eyes we all know and cherish. If we see it or not. The distention of a belly is not always so hugely obvious and can show up a Gimpfixed or 'shopped bulge by it's disproportions. Same with clamps closed or open and bags that are obviously not water filled..
The rest of what sets fake aside from real are points I'd love to hear raised by others :}
But as always in my mind- there's what makes a pic do more. A perfect capture of person digesting fluids and showing all the details that make it what a good enema scene really is. We've all seen our own sessions enough that the "fly on the wall" view becomes easy to envision. Seeing a woman in a few pic sequence take bag out from storage- rinse/fill it thence lube nozzle and assume her favorite position- before doing that which is near and dear to us all. Followed by a shot of belly rubbing or just wriggling with the internal sensations. Seeing a messy expulsion is often anything but romantic for me, but knowing that we all have to do that adds to empathy. A bidet is so rare of an accessory in enema piccys as to defy belief.
Seeing males using enemas or getting from females is so subjective a like/dislike for me. some meltingly erotic ones were "Enema Couple" with him OTK and her lifitng the bag high above him. It made me wish I were in that position. Any picture that we want to BE in- yeah- that's a winner.