Joe Niamtu III, DMD – Cosmetic Facial Surgery

Domestic Violence, Ray Rice, and the NFL

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Sometimes it takes a tragic or unfortunate situation to shed light on very important topics such as Robin Williams’s untimely death which brought attention to depression and suicide.  The recent video that showed NFL star Ray Rice knock out his girlfriend, as horrific as it was, will no doubt bring much needed attention to the topic of domestic violence.  Something positive will come out of something negative.

First and foremost, there is never, ever any reason to physically or mentally abuse women and all men must get this message early on in childhood.  A man’s job is to protect women, for most men this is a natural response, almost inbred, but for many, they have grown up in a household or culture where spousal abuse is common.  They don’t grow up with this message of female respect and the perpetuation of physical violence is passed down generationally.

The biggest drawback of discussing domestic violence is the fact that the average (and intelligent) person does not fully understand the cycle.  My wife and I have been active supporters of Safe Harbor Shelter (April served on the board and we have both served as spokespersons and fund raisers) and until this I have to say that I did not fully appreciate the depth of the complex cycle of captivity.  Listening to the personal stories of violence victims makes it all crystal clear.

I describe this as captivity because the aggressor wants to “own” the victim and uses physical violence, mental punishment, jealousy, sexual and financial control and numerous other manipulating factors to maintain control of their spouse. Substance abuse is also a frequent common denominator.  Although we most often think of females as being the victims, domestic violence can flow in either direction.

The biggest misunderstanding concerns the simple statement “she deserves it, because she did not leave after the first time it happened”.  We are also seeing this in the Ray Rice incident where people are saying “she married him after that, I can’t believe it”.  What the average person may not realize is that many of these women are trapped.  They have been manipulated, controlled, beaten and robbed of all self-esteem so that they are 100% reliant on their spouse for existence.   “You are worthless, you are ugly, you are a loser, you cannot survive without me”, these are the frequent words of an abuser.  They have been made to feel worthless, they are given money or sex in a manner to further exhibit control and are intentionally made to feel that they cannot survive without their aggressor.  They are afraid of harm to themselves or their children or family if they don’t comply with their “captor”.  Their spouse may even defend the abuser because it keeps the abuser happy and may prevent another beating.  Unfortunately, many domestic abuse victims ultimately are murdered by their aggressor in the final act of ultimate control.  It is not uncommon to see a local newspaper article where a domestic violence victim took out a restraining order on their abuser and were murdered shortly after that.  Our courts and law enforcement needs to be more involved when someone identifies a spouse as a threat.

Friends and family also need to be acutely aware of the signs of domestic violence because the victims will frequently deny it out of fear.  Having treated facial trauma in local emergency departments over the last 30 years, I have seen many circumstances of domestic violence.  It is remarkable that after suturing of a facial laceration from being punched by her husband the victim leaves with the aggressor as he is her only ride home.  She has nowhere else to go, to one to turn to, she has no job, no money, no protection, no self-esteem and fears for her children’s safety.  She has to go back home.

I promise you that anyone reading this blog knows someone that is or has been a domestic violence victim.  You may not realize it, but if you think it is possible, you need to offer them help.  Safe Harbor provides emergency services for domestic violence victims and can be reached at

Don’t wait, help them now, it may save their life.


Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

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Cosmetic Eyelid Surgery: Plain and Simple

Aging changes occur at an earlier age in the upper face and hence I am performing cosmetic eyelid surgery  (blepharoplasty)  from the mid fourth decade on.  Aging changes in the eyelids include excess sagging skin, fat bags and wrinkly skin. With aging, the upper eyelid can skin hang below the lashes and can decrease vision and prevent women from wearing eye makeup.

Laser technology has greatly simplified cosmetic eyelid surgery and procedures that once took 90 minutes and produced a lot of bleeding, can now be completed in 20 minutes with no blood loss.  In addition, with laser technology, there is no need to excise skin on the lower eyelids.  The means no visible suture line, no stitches and brand  new youthful skin in the place of the sun damaged and wrinkled skin.  More information on the actual laser procedures can be seen  here.  Recovery for cosmetic eyelid surgery varies from 7-10 days, although the average patient could wear sunglasses and return to light activity much earlier.

The case shown below required less than 30 minutes of surgery time with light IV sedation in our accredited in office surgery center.   The patient took one week off of work for recovery.

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For more information about eyelid rejuvenation or cosmetic facial surgery by Dr. Niamtu visit


Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

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Angel Faces

Several years ago I was invited to speak in New York City at a major laser meeting and part of my lecture involved my treatment of burn injuries.  Other surgeons also reported their experiences and it was a great meeting.  Between all the doctor lectures I had an opportunity to hear a talk by Lesia Cartelli.  This was one of the most inspirational and emotional presentations I have ever heard in my life.  Lisa sustained burns of 50% of her body and details her emotional struggle and challenges and how she dedicated her life to helping other girls with burns.  Her book has just been released and I was extremely honored to be quoted on the inside cover (along with Sanjay Gupta, Dr. Phil and Barbara Walters, none the less).  Lisa is making a difference in the lives of many young women.  Her story is touching and her work truly is angelic.  It has been my honor to call her a friend.



Lesia Cartelli, Founder and Director of Angel Faces<sup>®</sup>


Lesia Cartelli endured a serious burn injury over 50% of her face and body from a natural gas explosion at her grandparents’ at the age of nine. The home was completely destroyed yet her spirit survived. Not wasting her pain, Lesia is the founder and director of Angel Faces®, the first and only national nonprofit organization whose mission is to provide healing retreats and aftercare support designed to inspire adolescent girls with severe facial disfigurements to achieve their optimum potential and develop meaningful relationships for themselves, their families and their communities.





Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

Helping A Beautiful Little Girl

From time to time I like to discuss touching cases that impact my life and practice.  Earlier this year I received a pleading and heartfelt letter from a low income single mother in Atlanta whose daughter has

dprotruding ears and was being taunted and bullied by her peers.  The mother could not afford the surgery and we agreed to treat her daughter free of charge.  Obviously, it is impossible to treat all requests free of charge, but we do our best to help disadvantaged patients, especially children as often as we can.  I love my profession and it is so gratifying to posses the ability to help patients who have no where else to go.




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To learn more about cosmetic Facial Surgery visit


Joe Niamtu, III DMD

Cosmetic Facial Surgery


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Treating Small Birthmarks with the Iridex 940 Laser by Joe Niamtu, III DMD

Dr. Niamtu discusses and shows a video of the treatment of a small port wine stain birthmark using the 940 wavelength laser.

For more information about lasers or cosmetic facial surgery by Dr. Niamtu, visit

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Football Hall of Fame 2014

Having grown up in Canton, Ohio I have always been a fan of the NFL Hall of Fame which opened during my childhood.  I don’t go every year, but have been to the annual enshrinement many times including for my buddies from the Buffalo Bills, Jim Kelly, Thurman Thomas, Bruce Smith and this year Andre Reed.  This is football’s greatest weekend and Canton becomes shrine to all of the games best.  The entire weekend is filled with festivals, parades, banquets, the actual enshrinement, the after parties and of course the first NFL game of the season.

This year was notable for not only Andre Reed, but also because now TV celebrity Michael Strahan was enshrined, so it upped the ante for attendees and coverage.  All of this was great, but for me personally, the best part of the weekend was being able to hang out with my buddy Jim Kelly.  I visited Jim in the hospital in NYC in February and although we talk frequently, I had not seen him personally until last week.  Jim is staging a courageous battle with cancer and is showing all of us what “Kelly Tough” is.  Jim looked good, considering what he has been through and other than having a little less energy, he is same old Jim.

April and I had the pleasure to visit with our old football friends and families and to meet many legends, some celebrities and generally enjoy the weekend.  The following are pictures from the weekend.



Hall of Famer and buddy Jim Kelly and 2014 HOF inductee Michael Strahan

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2014 HOF inductees Andre Reed and  Punter Ray Guy.

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Some legends, celebrities, coaches, politicians and others at the 2014 Hall of Fame in Canton, Ohio.

Hard core football fans will recognize most of the pics. If you want to identify any of the people in the pictures you can view the names at   and mousing over the pictures.

Joe Niamtu, III DMD

Cosmetic Facial Surgery

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Technology Review: AccuVein imaging device to view veins

I love new technology and regularly perform technology reviews.  The AccuVein device is a neat little hand held bundle of technology that shows superficial veins.  The device uses visible and invisible laser light to show the veins under the skin.  It has a big “cool factor” as it looks magic that the veins seem to appear from under the skin like bones in an X ray.  There are numerous uses for this device to enhance patient safety during filler injection, avoiding veins during Botox injection and decrease complication such as bruising with fillers or missed IV’s.  It is also helpful to identify and treat leg veins and to identify IV sights on patients that are difficult to obtain IV access or in infants and children.  The attached video shows my review of this device.  This video contains actual surgical footage so viewer discretion is advised.


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Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

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Laser Treatment of Acne Scars

Acne can be a devastating condition for numerous reasons.  Not only are there physical lesions and scars, but there is also a large emotional component as well.  To add insult to injury, it all happens in the years after puberty when we begin dating and relationships.

Acne is basically a bacterial disease where the bacteria live deep in the pores and oil glands in the skin.  Many myths exist about causes and treatments of acne.  Good hygiene and antibiotics that attack the bacteria (called P. Acnes) are mainstays of treatment along with topical preparations.  Severe cases of acne require a dermatologist prescribing Accutane which suppresses the sebaceous (oil) glands. The early diagnosis and treatment of acne is imperative to prevent scarring which can last for a lifetime.  Unfortunately, many children do not ever receive treatment for acne and regret the scars forever.

There are numerous options for treating acne scars including scar release (subcision), filler injection, surgical excision and laser skin resurfacing.  Of all the treatments, laser skin resurfacing has proven to be the gold standard since the 1990’s.  Laser treatment can mean different things to different doctors.  I still perform “old school” (full coverage ablative laser) CO2 laser, which again has not been surpassed by any other type of laser for acne, scar and wrinkle treatment.  This type of “heavy” laser requires IV sedation and the recovery is not a picnic. It is not very painful, but the patient is swollen.  It takes about 10 days for primary healing and the patient will be pink for several weeks after that.  Most patients take 10-12 days off for full coverage ablative laser.

There are newer less invasive lasers called fractional lasers.  These lasers have become very popular because they can be done on awake patients and have shorter recovery.  Unfortunately, they don’t have the same result as the full coverage ablative CO2 laser.  With laser result, you get what you pay for.  Not in terms of money, but it terms of recovery.  Lasers that heal in several days provide very little result, lasers that heal in two weeks provide maximum results.

Most patients with acne scars will require multiple treatments for maximal results.  The patient shown below underwent full face full coverage ablative CO2 laser.  There is an obvious improvement in the patient’s acne scars after a single treatment.  The patient will undergo at least one additional laser treatment and some patients continue treating after that.  Although the skin will never be perfect, the annoying scars are usually greatly improved.


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For more information about laser surgery or cosmetic facial surgery in general visit

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

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“Saving” Frank Sinatra

Recently, Open Source RVA posted a story by David Brumfield on entertainers that were injured in Richmond over the years.  Sort of a recap of mayhem that befell star performers that graced our city.

One of the items was Frank Sinatra collapsing on stage at the Mosque on March 6th, 1994 and being attended by  several Richmond doctors including me,  and then taken to MCV (now VCU) Hospitals.  This brought back some memories and chuckles and demands a blog recapping the events of that evening.

I had the chance to see Elvis while in school in Cleveland and did not go because he was a bit out of touch by then, but when he died I lamented on missing that chance to see a legend.  When I heard that Frank Sinatra was coming to Richmond to perform at the Mosque (now the Altria) I remembered old Elvis and bought 4 tickets.

I forgot that the concert was on the same day as my semiannual Advanced Cardiac Life Support recertification and I was also on call for facial trauma at the local hospitals.  Despite these two obligations, I managed to finish my certification in time and took a friend and another couple (well-known Richmond photographer Bob Jones and his wife Beth) to the Mosque.

I had good seats in the first row of the right balcony right next to the exit door.  Sinatra came on stage and was backed by his son Frank Jr.’s orchestra.  Frank was almost 80  then and although he was a little slow he cranked out many of his greatest hits.  He had a giant prompter in front of him with the words to the songs streaming across like a giant Karaoke machine and occasionally seemed to forget some lyrics, but after all, he was “old blue eyes and the chairman of the board”, so he was allowed some slack out of respect.

He sat on a plain barstool and had another stool next to him with a clear glass with brown liquid which he sipped through the performance.

About 20 minutes into his act I noticed that he was a little wobbly on his stool and I jokingly said to by friends “hey, if Frank falls off of that stool and hits his face, I am on facial trauma call for the local emergency rooms and lucky for him, I just recertified in ACLS today”  No sooner did those joking words leave my lips, when BANG, Frank collapsed like a rag doll and smacked his head on the big monitor that was in front of him.  It was a pretty big noise and we all looked at each other for a second when his son asked “if there was a doctor in the house?”  There was a policeman or guard standing at the exit that was one seat away from my chair and when I raised my hand he literally whisked my down some steps and there we were center stage with the real Frank Sinatra lying at my feet.  I was the first and only person on the stage except for his people.  Time seemed to warp into slow motion and I looked out at the sold out crowd and there was gasping followed by absolute silence.  It was a creepy and eerie feeling.

I got down on my knees and Frank was unresponsive.  His toupee was crooked and his pot belly was hanging out of his shirt that became untucked.  I lifted his arm and remember that he had a large pinky ring on his little finger.  I lifted his chin to see if he was breathing and felt for a pulse.  I remember that there were some very large men that could have been called Sal or Guido that were next to me, obviously Frank’s bodyguards.

Although this seemed like an eternity, it was probably only 60 seconds and then the conversation from the crowed began to increase and you could hear people crying.  By now a large crowd with several local doctors began to gather at the front of the stage and several jumped up on the stage.  From stage right came the paramedics and the late well-known cardiologist Tommy Thompson.  He and I helped the paramedics set up the EKG and Frank began to arouse and mumble.  I also noticed that there was a table stage left with a bottle of whiskey, ice and glasses.

I think by now the Mosque closed the red velvet stage curtains as concert goers wandered aimlessly contemplating his fate.  The EKG was normal and Frank regained his facilities and he or someone with him wanted the crowd to see that he was alright.  They now transferred him to wheel chair and the curtains opened and Franked waved goodbye to the fine people of Richmond.  At his point, someone took a picture.  This picture (shown below) made it to people magazine in the 3-21-94 issue.  My bald head can be seen behind Frank under the yellow arrow.

Frank was then transferred to a yellow stretcher to be transported to the MCV emergency room.  I think Tommy Thompson was in contact with them telling them that Frank Sinatra was on his way.  His EKG continued to be normal and I still have part of his actual EKG.  I tore off a piece and gave it to Tommy Thompson as a souvenir of that evening.  Guess I will put it on Ebay someday.

By this point, the paramedics told Frank and his handlers that he was going to be taken to MCV and he pretty much wigged out!  He said, with many expletives, that he was not going anywhere but home.  He said something like “I want to get out of this dump” or something similar.  He was pissed and most probably “pissed” in the British sense of the word, i.e. intoxicated.

At this point there was a circus as they were loading him into the ambulance and someone was contacting the hospital administrator at MCV to alert them of the whirlwind that was en route.

I went back to find my friends and by now people were leaving and a lot of folks came up to me asking what happened.

As the ambulance drove away the event was over and the story was that Frank did not want to go to MCV and they had to really persuade him to do a head CT scan.  Although they wanted him to stay overnight he refused and the story goes that he was transported to the airport with some MCV people in vehicle and he was mad as a hornet and the car pulled over and his people asked them to exit the vehicle.  Not quite sure how they got back.

I did not get home till about 11:30 and then got a call from Channel 12 and they came over after midnight for an interview and I did an interview and other local stations followed the next day.  My phone rang all night with media outlets as far as Australia wanting an interview on the events of the night.  Pretty soon, I quit answering the phone as I had surgery in the morning.

The actual People Magazine article is still online but does not have the original pictures.




Dr. J under yellow arrow




Warning:Do not view this video if you are going to laugh at my then, hair :)


Actual People Magazine Article from 3-21-94


Guess that was my 15 minutes of fame.


Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia




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In Memory of Dr. Richard E. Fitzpatrick

On the Shoulders of Giants


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Dr. Rox Anderson on left and Fitz on the right in March of 2014 and at the ASLMS laser meeting several years ago.

I was extremely saddened to see the passing of Dermatology and Human icon Richard E. Fitzpatrick. In every profession, you can sift through the total membership over decades and find thousands of names. In that pile of names lay a small group of truly special and talented individuals that have made exceptional contributions to the specialty and to life. “Fitz” is at the top of that heap in Dermatology. Not only was he truly a pioneering individual but he was truly an exceptional individual. Dick was the type of person that this world needs. As famous and well-known as he was, he always had time for the little person or the student. You could stop him cold walking down the hall at a major meeting to ask for advice and he would treat you like you were related. He always made time for everyone and the reward for that time was his impish smile as well as his wisdom.
When laser technology hit the market there were not “user manuals” and the learning curve was exponential. Dick and several other colleagues led the charge to “figure out” this science and make it predictable. He was the Thomas Edison of lasers.
Anyone who knew Dick was well aware that along with any dispensed wisdom would come a joke or funny story. I shared a podium and social evening with him in early March and he appeared quite healthy. He showed me a picture of him in a hot pink and outlandish outfit the he wore to a Halloween party one year. He told me one of his patients lent it to him he liked it so much that the patient gave it to him. What made the story special was that his friend and patient was Ike Turner who along with Tina Turner strutted that suit on stage in the 70’s and 80’s. Typical Fitz story!
They say that leaders see so well because they stand on the shoulders of the giants that preceded them. We have lost one of the biggest giants ever and anyone whomever shared knowledge or laughs with Fitz will feel void in their life.
Thanks for all you did Dick. We will never forget you.

Joe Niamtu, III DMD
Richmond, Virginia

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