Joe Niamtu III, DMD – Cosmetic Facial Surgery

Repairing a “Pixie Ear Deformity”

This post is aimed at surgeons and cosmetic surgery patients.

A Pixke Ear deformity is a complication of facelift surgery and a dead give away that someone had a bad facelift.  Although this is generally caused by improper surgery technique, it can occasionally occur from wound contraction.  This deformity is most often seen from novice surgeons or those surgeons that do not understand facelift surgery.  The pointed earlobe is a stigmata of surgery gone wrong and many patients don’t realize that it can be repaired.  This video shows Dr. Niamtu repairing a pixie ear lobe deformity.

For more information about facelift surgery or cosmetic facial surgery in general, visit


Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virgina

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A New Paradigm for Cosmetic Facial Surgery Education

For the past 6 years Niamtu Cosmetic Surgery Education has been providing high definition teaching videos in a DVD series.  We have sold thousands of DVDs to doctors and student of all cosmetic specialties in virtually every civilized country in the world.  Although our original series has been highly successful, DVDs are waning from popularity in favor if live streaming and downloading.  Think about the music industry.  To continue our teaching series and become more contemporary, we have released our first totally digital series that is now available for streaming and downloading.  Now you can watch teaching videos in high definition on  your own terms, on any device 24/7/365.  When the series is purchased the user has ownership of the videos and can download them into their personal collection if desired.


The new 2 hour Injectable Filler Series is now available for immediate viewing for $99.


Dr. Niamtu is working on the entire video collection and will have new volumes available in 2016 that will include:

  • Neurotoxins
  • Brow and Forehead Lift
  • Blephaorplsty
  • Facial Implants
  • Face and Neck Lift
  • Minimally Invasive Face Lift
  • Otoplasty
  • Chemical Peeling
  • Laser Resurfacing
  • Scarless Mole Removal
  • Surgical Lip Enhancement

For more information click here or on the picture below.

 Vimeo blast

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Cosmetic Surgery Season is Here              


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The holidays are nearing and I look forward to the “crunch time” in cosmetic facial surgery.  I am lucky to have a seasoned practice and we are busy all the time, but there is no doubt that more people have cosmetic surgery in the winter months for obvious reasons.  It is easier to recover as the days are shorter, we spend more time indoors and there is less sun exposure.  Due to this, the end of summer and early fall is an attractive time for patients to have surgery to be at their best for the upcoming holiday season.  There is a slight dip in surgery during the holidays (although some people desire this time for surgery) and then surgery ramps up again for patient who want to be healed by springtime.

The most common surgical procedures we perform are facelift, cosmetic eyelid surgery, cheek and chin implants, brow lift and laser skin resurfacing.  Patients in their 4th decade may present for smaller procedures such as eyelid surgery, laser and facial liposuction.  Patients from their 5th decade on up frequently perform multiple procedures at the same surgery.  These include facelift, eyelid surgery, midface augmentation and skin treatments such as laser or chemical peel.  The smaller surgical procedures have approximately a one week recovery and the larger procedures have approximately a 2 week recovery.


How do we know when it is time?


Obviously, cosmetic surgery is elective and while some people will never embrace it, many people want to look as young as they feel.  Patients in their 30’s are great candidates for skin care, lip plumping and preventive measures such Botox.  Patients in their 40’s may be candidates for Kybella or liposuction for double chin, chemical peels or laser to improve skin and Botox and wrinkle fillers.  Patients in their 50’s on up will notice changes to their lower face and neck and will be candidates for the aforementioned procedures as well as face and neck lift.


What about the “miracle” procedures you see on TV?


Like anything else, cosmetic surgery is subject to trickery, misrepresentation and falsehoods.  If something sounds too good to be true it probably is.  Although we have made many advances in technology there has been no viable replacement for eyelid surgery and facelift surgery.  Any procedure that promises “minimal downtime” will probably have minimal results and minimal longevity.  There is simply no substitute for the safe and effective procedures that have been time tested for decades.  If a doctor offers some “new and amazing” technology, do your homework and check out the procedure and the results of the individual surgeon.  If a doctor can’t show you 50 high quality before and after pictures of results 3 months after surgery, they probably have something to hide or aren’t doing much surgery.  Procedures that truly produce significant results and are long lasting require a longer commitment to recovery.  For a patient in their 50’s, taking two weeks off of work or play is not a bad deal to reduce a half century of aging.  You get what you pay for…………not in money, but in recovery.  Procedures with very short recoveries don’t do much and don’t last long and may need repeated multiple times.  Surgeries with longer recoveries usually produce much more dramatic and longer lasting results.  For patients that simply cannot take time off work, small procedures may be the only options but there is always a trade off in result and longevity.


Is there an easy way out?


Technology has improved and neurotoxins like Botox, fillers like Restylane and Juvederm, fat dissolvers like Kybella, fractional lasers, Pelleve (radiowave skin tightening) can keep aging at bay and improve minor to moderate aging.  As we age, we must bite the bullet and consider surgery.


How do you pick a surgeon?


Choosing the correct cosmetic surgeon is a big choice and fortunately there are many well qualified men and women from numerous specialties that a qualified to perform safe and effective cosmetic surgery.  Some important things to look for include:


  • Find a surgeon that is board certified in his or her specialty.
  • Find a surgeon you like and that is easy to talk to.
  • Find a surgeon that is easy to get a hold of. If it is hard to speak to your surgeon;

You chose the wrong one!

  • Find a surgeon that with a supportive staff that are friendly and compassionate and focus on you.
  • Find a surgeon with a fully accredited surgery center in his or her office. Most cosmetic surgery is no longer performed in the hospital.  Full office accreditation such as the AAAHC, JCAHO or AAAASF means the office and staff have met rigid policies for safety, anesthesia, emergencies, infection control and numerous other important safety factors.
  • Find a surgeon that can show you properly taken and standardized before and after pictures of the procedures you desire. Experienced surgeons should have hundreds or thousands of pictures of their work.
  • Surgeons that publish, teach, and are involved in academics are frequently abreast of the latest techniques and safety measures.


The decision to have cosmetic surgery is multifactorial and patients must consider their health, recovery and budget.  You have to be healthy enough to tolerate surgery and anesthesia, have enough time for a relaxing and healing recovery and be able to afford the procedure(s).  There is usually something for everyone in this mix of health, recovery and budget.


To find out more about facelift and cosmetic facial surgery visit


Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia


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Lower Eyelid Synechia: A Complication of Periorbital CO2 Laser Resurfacing

I recently had a scientific article published in the American Journal of Cosmetic Surgery on laser treatment.  This is mainly of interest to doctors that perform laser and eyelid facial procedures.


Figure 141

Click here to view or download PDF



For more information about cosmetic facial surgery visit


Joe Niamtu, III DMD

Cosmetic Facial surgery

Richmond, Virginia

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You don’t often get to meet a legend!


Tommy Lasorda and  his Baseball Hall of Fame ring on my hand.


Several weeks ago I was a speaker at the California Academy of Cosmetic Surgery and had the pleasure to spend an evening with baseball legend and hall of famer Tommy Lasorda.

Tommy has been a pitcher, coach, manager and poster boy for the Brooklyn/Los Angeles Dodgers for six decades.  He was elected in to the Baseball Hall of Fame in 1997.

He still maintains a very active speaking schedule and does not charge for speaking to military groups or children’s groups.  This means he passes up $30,000 for each free talk, so he is obviously patriotic and compassionate.

Tommy is 88 years old (he says that God can’t find him) and has the energy of a 25 year old.  He is an amazing speaker and held court for an hour of not stop jokes and funny stories.  He told one story about Yogi Berra getting a large 4 foot grandfather clock as an award in NYC and Tommy and Yogi were walking out the revolving door of the hotel and a drunk slammed into Yogi and knocked the clock on the street shattering it to pieces.  Yogi yelled at the guy “why don’t you watch where you are going” and the drunk fired back “why don’t you wear a wristwatch like everyone else”.   There were another 50 jokes back to back.  He is truly a character, buy enjoys shooting the breeze with people like he lives next door.  As we went to dinner, every step of the way, someone recognized Tommy and shook hands or asked for a picture.  He loves to oblige them and did.  Rock on Tommy L!

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia


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A Great, Affordable Camera for Clinical Photography

Most of my practice blogs relate to cosmetic facial surgery and related topics.  The blogs also go to my social media links so I realize that many people don’t necessarily have an interest in some of the topics.  This blog is aimed at doctors that take pictures in their offices and includes many types of physicians, dermatologists, surgeons, dentists and pathologists.

The best doctors take a lot of pictures to document the medical record, educate patients, and learn from their work.  I have over 7,000 pictures on my website and my before and after pictures are important for me to judge and learn from my work.  They are important to the patient as well to see their results.  I have always be a student of clinical photography and have published many articles and book chapter on the subject.

Standardized photography is an absolute necessity for contemporary surgeons.  Unfortunately, many docs use very shoddy and deceptive pictures.  You can make a bad result look good by manipulating the lighting, poses, posture, etc.  Fortunately, the public is pretty educated and can spot “fake” results quickly.

All surgeons that take pictures need a sophisticated camera that is easy to  use.  It is not hard to spend thousand of dollars on a clinical camera.  You can purchase very sophisticated cameras, with complex lenses and settings.  The problem is that the average staff person cannot use it!  Although I take most of my clinical pictures, when I am in surgery, it is my staff that use the camera.  Having to change lenses and adjust settings on a big bulky camera with flash settings, etc. is simply difficult and inefficient.  Due to this, many docs have awesome cameras but don’t take many pictures because the complexity and hassle.

I bought my first clinical camera from Lester Dine a company that led the field.  This was way before digital cameras.  The company has ridden the wave of technology and kept their doctors up to date with the latest improvements.  I have their latest portable clinical camera “The Dine Digital Solution”.  This camera is about the size of a deck of cards and resembles a typical “vacation” camera.  The engineers at Dine perform software modifications to make clinical photography point and shoot.  The camera is shock proof, water proof, fits in your pocket and takes stunning high resolution digital photos.  This is a 16 megapixel work horse that has 4 simple options.  One setting takes awesome close up macro pictures.  I use this a lot for eye and facelift surgery for my books and lectures.  The second setting (with a spin of the wheel) is for portrait photography and this is what I use for before and after pictures.  The camera also takes really nice video and we  have recorded a number of our YouTube videos with it.  Finally, for those that just can’t stand not to fool with settings, the camera can be used in a manual or programmed mode giving the photographer full control of F stops, etc.  But  wait, there’s more!  The camera will automatically download images to computers and mobile devices as it has an onboard GPS.

For doctors that are searching for an affordable (around $700), portable, versatile clinical camera visit   See the attaced video.

For more information about cosmetic facial surgery visit


Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

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New Makeup Trends to Make You Glow When Pregnant

My blogging has been quiet for much of the past 6 months as I had to finish the second edition of my text book Cosmetic Facial Surgery.  I have completed the preliminary writing and time to get back to my website and blog.
I have never has a guest blogger before but I am proud to post a blog by well known health and beauty consultant Gweneve Lewis.  We rarely think about beauty and pregnancy but it is a hot topic of interest for  many mommies to be.  I thank Gwen for her writing.


Contact Gwen by email,


When you’re pregnant, the cliché is that you’re going to glow. But unfortunately this isn’t always the case. Pregnancy can bring a variety of skin problems, such as dryness or discoloration, but the good news is that some of the latest makeup trends can help to turn those problems into prettiness.













image courtesy of Shutterstock


Illuminate with Eye Cream

A lack of sleep when you’re pregnant can cause the skin around your eyes to suffer from puffiness or dark circles. Start by using a light eye cream under your eyes to nourish the area. Applying an eye cream before makeup also helps to fill in lines and wrinkles. Then, gently dab on a concealer product with a makeup brush to the area of skin that needs remedying. Avoid using your fingers as this can cause you to apply too much product. Less product is better coverage!


Cover up Discoloration  
Pregnancy can make your skin more sensitive due to the change in hormones, so you don’t want to apply too much product to your face. But if your skin is patchy or discolored, again thanks to hormones, you need tinted moisturizer or a CC cream to correct your skin without packing on the heavy products.

Of course, going one step beyond foundation by nourishing your skin with skin brightening products will help your complexion be vibrant and gorgeous at a base level. Be sure to check with your doctor about using skin lightening creams when pregnant before you go ahead and always use natural skin brightening products that don’t contain harmful chemicals.a2gwen

Image courtesy of Shutterstock


Be Lovely in Lavender

If your skin is looking fantastic with a natural radiance that sometimes comes during pregnancy, you should be making the most of it! Wear as little makeup as possible, and if you simply have to wear it, make use of one of the hottest makeup trends that bloomed in spring: soft lavender. This color will look very striking on naturally-radiant skin and it’s only needed in small amounts on your eyelids and lips for a gorgeous and illuminating appearance.


Make it Creamy

Powder formulations tend to be too heavy during the warmer months, especially since you don’t want anything that feels like it’s clogging up your skin. Since pregnancy skin can also be prone to breakouts, the last thing you want is to clog your pores. It’s therefore a good idea to switch powder products for lighter cream consistencies. These not only feel lighter, but they look softer too, which is especially good if you’re pregnant because you don’t want to look too made up. The idea is to be fresh and radiant!

A clever makeup trend is to multi-task with your cream makeup items, which is both convenient and saves you time in the mornings. So, for instance a lip product could double-up as blush for your cheeks, or vice versa, and you can easily touch up during the day to maintain the fresh, luminous look.


Use a Nourishing Primer

Dry skin is a common problem during pregnancy, but you don’t have to be stuck with it or make it prevent you from wearing makeup. Facial primers are becoming even more beneficial for skin by being infused with nourishing ingredients such as coconut water. These elixirs refresh your skin and keep it smooth, while doing what traditional primers are meant to do: make your foundation. last longer as well as fill in any lines and wrinkles so that your complexion is flawless


Image courtesy of Shutterstock

There are exciting new makeup trends that every woman should try for a more glowing complexion, especially when you’re pregnant and want to look your most radiant self. Follow these makeup tips and tricks so you can maximize your glow in a flash!


For more information about cosmetic facial surgery visit


Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia




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Facelift Richmond, Virginia: Dr. Niamtu interviewed on ABC about face and neck lift options

Joe Niamtu, III DMD discusses face and neck lift options with TV 8 anchor Matt DiNardo.

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The Best of Richmond

The Best

Dr. Joe and his staff have been nominated as a finalist for “Best Plastic Surgeon” by the Richmond-Times Dispatch newspaper.  Although we asked you to vote in another contest earlier this year, winning this type of awards is a huge accolade for me and my staff.

I feel that I have the best and most compassionate staff in the world and with them we have developed an international reputation for excellence in cosmetic facial surgery.  Displaying these awards on our wall serves as a continual reminder of our commitment to excellence.

We would like to ask you to vote in the Richmond Times-Dispatch contest “The Best”.

I promise we won’t bug you again until next year!


Voting Directions

Please click this link:

Scroll down to the middle of the webpage

Then click on “Register/Login”

Then enter your email and register then click continue

Go to your inbox and click on the link to confirm your email (this will take you back to the ballot to cast your vote!)

Click on “Health and Beauty” (on left side of page)

Click on “The Best Plastic Surgeon”

Click the word “Vote” beside “Joseph Niamtu, Cosmetic Facial Surgery”


Dr. Niamtu & Staff

Kybella is Here; the first non-surgical treatment for double chins

I have never reposted a post but am doing it today.  With the coverage of Kybella on the many of the morning and news shows this AM, I have received many inquiries about this new treatment.

This video tells the entire story.  I am one of the few certified Kybella trainers in Virginia and have been training other doctors to use Kybella.  I think the new FDA treatment will make an impact on selected patients with double chin or fat under their chin.

For more information about Kybella or cosmetic facial surgery visit


Joe Niamtu, III DMD

Cosmetic Facial Surgery

804-934-FACE (3223)

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