Monthly Archives: February 2012

I just found out about this study being conducted by nationally renowned facial plastic surgeon Dr. John Joseph here in Beverly Hills. If you have deep acne scars that you would like to get rid of, see below:

Has acne left scars on your cheeks? If you have moderate to severe acne scars on your cheeks, you may be eligible to take part in a voluntary research study lasting up to twenty months for the treatment of your acne scars with an FDA-approved dermal filler or placebo. Participants must be at least eighteen years of age, in good health, and have at least four individual scars on the cheeks.

Qualified participants may be compensated for time and travel.

For more information, please contact:

Irma Garcia

Dr. John H. Joseph, M.D.

9400 Brighton Way, Suite 403

Beverly Hills, CA 90210


Have a great weekend!



You asked and we answered! See below:

The latest and greatest Fraxel machine is called the Fraxel Restore.  It is a fractionalized resurfacing laser that has two wavelengths (1550 nm and 1927 nm).  The 1550 penetrates deeper then the 1927, which means it is good for fine lines, wrinkles, acne and surgical scars.  The 1927 wavelength has more superficial penetration and is great for any hyperpigmentation spots (sun spots) as well as Actinic Keratoses (pre-cancerous lesions).  The laser puts microscopic pinpoint holes into the skin called microscopic treatment zones (MTZs), which in turn spares the surrounding area from injury compared to traditional CO2 laser resurfacing where the entire area is injured.  This also allows for less healing time and less risk than traditional CO2.  These small wounds trigger your body’s healing response system to produce collagen and elastin in the treated areas. There is about 5 days of redness and swelling after Fraxel before one starts to see the results. Even though results start to take effect within the first week, Read More

Okay girls, here’s some eye candy for you. My friend John Schneider has allowed me to pimp him out to make a point. First of all, for the record–no, he’s not single. He’s just a great example of someone who has allowed himself to age and looks even better than he would have if he’d started having his face puffed, pulled and frozen to get rid of all the lines. The informal poll taken of everyone that came into my office this week has led to the general consensus that he looks even better now than he did during his “hunky” days on Dukes of Hazzard:

John Schneider then…

Although, I’ve had to be honest with him, I never really watched Dukes of Hazzard—back in those days I was too busy keeping up with Family Ties and The Facts of Life. But I think I might have stirred up a little John Schneider fan club here right in my office…:)

Actually, John still has a huge fan base and if you’re interested you can check out what he’s been up to at

And even though we hear about him every day, I don’t think anyone will be opposed to being forced to look at pictures of George Clooney, another great example of someone who keeps getting better with age:

In comparison, I think it’s safe to say that Mickey Rourke’s aging process hasn’t gone quite as well:

Young Mickey Rourke

Now, ageless in appearance

And yes, I’ve heard the story about how he was a boxer and had to have plastic surgery to fix his injuries, but did they have to blow out all the wrinkles in his face? It looks like his lips are still swollen from getting punched at his last boxing match.

I know, I know, it’s not fair to just show pictures of men, because they’re so much better at aging than we are. So here are some analogous female comparisons:

Helen Mirren as a doe-eyed young beauty–doesn’t she look a little like Gwyneth Paltrow here?

…and now, no longer “young” but still beautiful 

Compared to:

And now…she doesn’t look old, but the expression is gone, and she doesn’t look like herself anymore.

So in addition to trying to drive traffic to my blog with posting pictures of celebrities, what’s the point I’m trying to make?

John certainly could be having little tweaks done to his face. So could George Clooney and Helen Mirren. But even if they are…they are doing it the right way. I think the key here to not “crossing over” is to maintain at least some character in your face. Don’t get me wrong–there are certain parts of your face that do fine without any character whatsoever. Like the center of your brow, for instance. Being able to frown is completely overrated. For this, Botox® has been an amazing discovery and I also highly recommend it for softening (though not obliterating) the creases that go across your forehead.

For those of you who have never had Botox® because you’re afraid you’ll wind up looking frozen, just trust me. I do mine myself, and it wears off so gradually that when it’s gone I look in the mirror and think, “Oh, I look okay, I don’t need it.” And then one day I stop being lazy and just do it and after a few days I start thinking, “Wow, I look a lot better than I feel,” and then I remember it’s the Botox®, and I promise myself I’m never going to let it go that long again.

But one area I try to go light on in my patients–and I never do on myself—is the crow’s feet(lateral area next to your eye.)  Crow’s feet have never bothered me. When I first started practicing I used the “standard” recommended dose of twenty to twenty-five units on each side for everyone, but now I usually use only three to five. I think that when you have no lines there, it causes a disconnect between your eyes and your mouth when you smile. And have you noticed that completely getting rid of your crow’s feet can make the crinkling under your eyes even worse? That’s because the muscle being targeted–the orbicularis oculiis circular around your eye. When you paralyze it laterally, it will increase its movement inferiorly. If you’re having that problem, and you don’t want to decrease your crow’s feet Botox® dose, you can ask your doctor about adding a unit of Botox® to your lower eyelid, just below the lash line.

So I think the “take home”  (or the “take to your plastic surgeon/dermatologist/nurse practitioner”) message here is that it’s better to look older than to lose all character in your face. If there are some lines that make you look a little more “mature” but not “bad,” consider leaving them alone. Consider decreasing your Botox® dose. And this goes for men especially. The “overdone” female face is still widely accepted by society, but the male one is not.

Although, you middle-aged guys certainly could kick it up a notch when it comes to taking care of your bodies.  It’s disappointing, but even here in the glamour capital of the world, there seems to be some unspoken rule that women have to stay in shape to be attractive, but the majority of straight men think it’s totally okay to grow a beer belly. And if you don’t believe me, check out a conference room full of a bunch of “professionals” at the Century City Hyatt Regency and see for yourself. FYI—you guys might actually get more action with some abs than with a Black Card.

But we should end on a positive note, shouldn’t we?  🙂

John’s P90X addiction certainly doesn’t seem to have hurt him at all

And if you guys can’t get rid of your love handles with simply working out, don’t be shy–that’s what I’m here for!



Okay, this Fraxel® definitely worked. I noticed a difference as soon as the swelling went down when I caught a glimpse of myself in a three-way mirror. Three-way mirrors can be scary, but they keep you honest. My jawline looks smoother, and my skin texture feels better. I will say that it was swollen for two days, which was not a good look without the scarf. However, it wasn’t crazy–if you didn’t know me you would have just thought I had a fat neck. I’ve had those horizontal tree-trunk rings around my neck since I can remember so I always assumed they were genetic and never bothered to address them, but Christine says no, they probably just started at a young age on me because I sleep on my side. So that’s great.  But now I really think they’re less noticeable. My husband used to call me “ET neck,” and I haven’t heard it for days. I will need two more treatments, but I’m not afraid, because with an hour of numbing cream beforehand, it really didn’t hurt. And apparently Fraxel® is the way to go for the neck, even though you have to do it in a few treatments. My sources tell me that although the CO2 Laser is a one-shot deal, not only is there significant downtime (which isn’t practical for most of us) but there is significant risk of Read More

So Christine and her equally awesome sister Karianne–who is a nurse at Ava MD—and I had a Fraxel® party on Friday. The Fraxel® laser does skin resurfacing for wrinkles, acne scars, sun spots, and surgical scars (and it’s less harsh than the time-honored C02 laser, that works but can leave you red for weeks.) Christine was completely honest with me about how it temporarily makes you scary swollen and has about five days of downtime on the face, so I chickened out and just did my neck because I had a meeting the next day. With numbing cream on an hour before it really didn’t hurt much at all, and it got red but not outrageous. The next day it was pretty swollen but now, forty-eight hours out, it just feels a little tight (which was the point, I guess, right?) and a little rough, but not too weird. My skin definitely looks more Read More

…those who are interested in plastic surgery, and those who are interested in plastic surgery and won’t admit it.

The first group find their way into someone’s office. The closeted group is secretly searching the internet about procedures, winding up on blogs like this one. Which is why it’s here. Not only is my goal to answer questions that people are afraid to ask, but to de-stigmatize the words, “plastic surgery.”

Not that there’s a stigma here in L.A., where it’s a badge of honor to walk around Whole Foods with a splint on your nose, and everyone calls their plastic surgeon by their first name. But I think the media—especially reality television and makeover shows (The Swan, anyone?)–scared the rest of the country away.

The Extreme Makeover show was just, well…too extreme. Not only did it make everyone involved–from the patient to the producer—seem beyond ridiculously superficial, but after being redone from head to toe, those patients were almost unrecognizable, which is what frightens most people about plastic surgery.  Nip/Tuck was a brilliant show. But even though the producers consulted with plastic surgeons (and I know because I was one of them) for medical information, the storylines were purposely taken to the extreme. The writers didn’t want to know about “routine” plastic surgery. And why would they? It’s safe and boring and doesn’t make for good TV.

It doesn’t help that in entertainment, plastic surgeons are almost always depicted as egocentric, mercenary fame-whores. How could you take a plastic surgeon seriously after watching Dr. 90210? Read More

Fat Transfer from Butt to Breasts

I used to get asked this question all the time–meant as a joke. But the truth is, making your breasts bigger with your own fat can be a reality.

Fat injection is not a “new” procedure, and breast enlargement with autologous (your own, and no, you can’t use someone else’s) fat has been around for decades with good results, especially in Europe and Asia. I first heard about it a couple of years ago, at the Atlanta Breast Surgery Symposium. A plastic surgeon performed the procedure at a nearby hospital with satellite surveillance for the meeting attendees. It was the first time all day that I actually started paying close attention, as it was the first “new” thing in breast surgery that I’d heard anyone talk about yet. I was blown away—basically, the patient was getting the fat sucked out of her “problem areas” and injected back into her breasts! A dream come true!

The procedure just seemed like a natural addition to my liposuction practice. I researched it as much as possible—even spent two days in the operating room with Dr. Roger Khouri (one of the pioneers of the procedure in this country, as well as the creator of the BRAVA device) of Miami.

The first few I did on my friends, because what are friends for, right…? 🙂

Honestly, so far everyone has been thrilled. It’s truly an amazing procedure. I wish I could show before and after pics, but this is a G-rated blog.

So…What are the advantages over traditional breast implants?

Read More