Out of town Patients /Online Consultation

Dr. Niamtu discusses the process of having surgery out of town or out of the country


I am honored that many of our patients come from different states and different countries.  When traveling for surgical procedures it is all the more important to exchange as much information as possible before coming to Richmond, Virginia.

When I we use the term “online consultation” it is not used in the formal sense as a true doctor/patient relationship and does not imply a formal medical consultation.  Although some surgeons actual perform online consultation where they make diagnoses and treatment recommendations, this site is does not do that.

The purpose of our online “consultation” is to begin a discussion forum about what bothers the patient about their face and neck and to discuss possible contemporary surgical and non-surgical options.  See our disclaimer at the bottom of the page.

How to Send Photographs for Pre Consultation with

Dr. Niamtu

**note, any  pictures or information sent to us is confidential and no photos or identities will be revealed.

No selfies please

Please have someone take your pictures for you, selfies are difficult to take, can be inaccurate, and don’t provide the quality required for evaluation. 

Please send pictures as email attachments as opposed to embedding into body of email.

Due to security concerns we do not accept photos from download or transfer sites.  Please send pictures via email as attachments and send all pics in a single email.  

There is absolutely no substitute for face to face, hands on consultation and no “photo consultation” can suffice.  That being said, a lot of information may be exchanged by an experienced surgeon examining photos to make generalizations and begin the diagnosis and treatment process.

Dr. Niamtu sees many out of state and international patients and our office is used to dealing with and set up to assist patients from out of town. Dr. Niamtu will examine patient photos and provide a brief commentary in most situations.  This does not constitute a formal consult or doctor/patient relationship and only serves as generalized discussion as to potential future examination and surgery.

Dr. Niamtu will only examine photos that are clear, in focus, in proper orientation (not sideways) and preferable taken with a high resolution device.  Fuzzy, grainy, sideways phone pictures do not provide enough information of discussion and will not suffice.  Due to the high volume of pictures sent to Dr. Niamtu he will only comment on those that are taken as described below.  In some cases such as a mole or scar a single picture may suffice if it is clear, in focus, taken in good light and in proper orientation (not sideways)

When taking pictures for pre consultation, it is best to use a digital camera or a phone with high photo resolution such as the iPhone 4, 5 or higher.  Pictures must be clear and in focus and it is best to use the flash option.  For scars or acne scars, a picture with and without flash are helpful.  It is best to take the pictures against a solid background such as a white wall. It is also most helpful to concentrate on the area of discussion.  If you are discussing the eyes, there is no need to take a picture from the waist up, just the upper face.

Also make sure all pictures are taken in a relaxed position (brows relaxed, not smiling, normal head position and hair off of the face).  It is also best to take pictures without makeup.

For upper face procedures such as eyelid surgery or browlift the take the following poses.

Right Side ¾                 Front               Left Side ¾

For midface procedures such as cheek implants, skin condition, laser cases. the take following poses.

¾ Left Side                  Left Side                      Front                     ¾ Right Side               Right Side

For lower face procedures such as face and neck lifts or chin implants take the following poses.

¾ Left Side                  Left Side                      Front                     ¾ Right Side               Right Side

For lip procedures the following take the following poses.

diag pics 2 50

For lip lift, also send picture of mouth 1/2 open, full smile and 1/2 smile

diag pics50

For lip lift patients, make sure to measure the distance from the base of the nose to the top of the red portion of the upper lip as shown below.

normal is 1.1

For moles please send a clear close up and a picture more zoomed out to show other neighboring anatomy.

Higham, Tracy

For Otoplasty, protruding ears, earlobe repair or earlobe reduction please take the following poses.


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This and all other electronic correspondence from Dr. Niamtu or his associates does not constitute: 1) medical advice  2) an evaluation or 3) a consultation.  Nor will any such correspondence be considered as a replacement or substitute for a formal office evaluation and/or consultation by Dr. Niamtu or his associates.  Further, information and correspondence contained in this and/or subsequent email correspondence, including all replies, does not and will not create a formal doctor-patient relationship.  Prospective patients desiring a formal consultation are invited to call (804) 934-3223 for an appointment. Prospective patients should obtain prior approval from their own physician for any  change(s) pertaining to their condition, diagnosis, treatment, and/or therapy discussed at consult. Explanation of off-label services and/or products mentioned herein do not constitute endorsement and/or promotion.