Dr. John Dr. John H. Joseph is a Facial Plastic Surgeon who has a prominent practice in Beverly Hills and is an Assistant clinical Professor at UCLA. He specializes in Aesthetic Facial Plastic Surgery but is also involved in congenital and traumatic facial reconstructive cases. Read more
Surgical Procedures

Plastic surgery is a method used to reconstruct and repair physical deformities either from birth or caused by injury or aging. Dr. Joseph uses a variety of techniques to remove or reposition tissue, augment areas with implants or resurface skin through laser surgery.

Dr. Joseph specializes in performing cosmetic and reconstructive surgery on the face, head, and neck region. As a group, facial plastic surgeons, do a major share of all facial plastic surgery performed in the United States. The most common surgical procedures performed are:

Rhytidectomy (Facelift)

As one ages, the skin of one’s face and neck loosens and, gradually, we begin to see wrinkling around the eyelids, face and neck. These changes are the result of the aging process (loss of facial volume), heredity and gravity. These changes can be accelerated by skin abuse, overexposure to sun, alcohol, smoking, and poor nutrition. Cosmetic facial surgery can minimize many of these problems. The term “facelift” is really a misnomer as the operation combines lifting of the face and neck all in one procedure. In some patients, liposuction under the chin and/or muscle tightening in the neck may be performed in conjunction with a facelift to improve the sagging fat or folds under the chin. A facelift can be combined with eyelid and forehead surgery, if needed.

The incision for the facelift operation begins in the temple hair above and infront of the ear. It extends down just infront of the ear, around the earlobe, up behind the ear, and then backward into the hair of the scalp. Through this incision, the skin is elevated out into the temples, cheeks and neck. The connective tissues are repositioned and the excess skin is removed. Sometimes fat is removed and/or the muscles under the chin are tied up so there may be a small incision under the chin to help with the correction. Then the skin edges are secured with appropriate suture material. The facelift operation usually takes between 3 to 4 hours. When completed, a bulky dressing is applied. The patient is monitored in recovery for about 1 to 2 hours. Dr. Joseph requires that the patient stay the first night after surgery in an aftercare facility or arrange for a registered nurse to monitor the patient for the first 24 hours.

The facelift operation is performed at Brighton Medical Corporation, an Accredited out-patient surgical center. Most patients are given a light intravenous sedation during surgery. If needed, general anesthesia can be administered. Surgical fees, pre-operative and post-operative instructions are given at the time of the consultation, and the patient is responsible for reading these instructions thoroughly prior to surgery.

Blepharoplasty(eyes)

Aging, heredity, skin abuse, smoking and over- exposure to the sun may eventually cause the temples, eyebrows and forehead to relax or droop. Loose skin may develop around the upper and lower eyelids as well as fatty deposits which can cause bulging or puffiness. The result is a tired, sad, and aged look. Eyelid and or forehead surgery can improve this tired, sad look and make you look refreshed and rejuvenated. Eyelid problems are corrected by an operation called blepharoplasty. A browlift alleviates the drooping brow and wrinkles of the forehead but is a separate procedure from eyelid surgery. Dr. Joseph can recommend which surgery is right for you. A blepharoplasty can be performed on the upper and/or lower eyelids to remove skin and fatty tissue. Incisions are made behind the eyelid or in the natural skin folds of the eyelids so that they are virtually unnoticeable. The incision for the browlift is usually hidden behind the hairline but the incision line can vary depending on the patient’s hairline. There are 3 types of forehead lifts: a coronal, modified coronal and endoscopic. Dr. Joseph will recommend which one is right for you. Botox or Dysport injections are recommended for lines of the forehead and around the eyes as a temporary alternative to surgery. See the Botox/Dysport section for more information.

Both the eyelid surgery and browlift surgery are performed at Brighton Medical Corporation, an Accredited out-patient surgical center. These procedures \can be done under a light intravenous sedation but may also be done under general anesthesia. The patient is required to have a responsible adult pick them up from the surgical center and stay with them the first night. Surgical fees, pre-operative and post-operative instructions are given at the time of the consultation. The patient is responsible for reading these instructions thoroughly prior to surgery.

Browlift (forehead lift)

Browlift (forehead lift) Coronal, Modified Coronal, Endoscopic

Aging, heredity, skin abuse, smoking and over- exposure to the sun may eventually cause the temples, eyebrows and forehead to relax or droop. Loose skin may develop around the upper and lower eyelids as well as fatty deposits which can cause bulging or puffiness. The result is a tired, sad, and aged look. Eyelid and or forehead surgery can improve this tired, sad look and make you look refreshed and rejuvenated. Eyelid problems are corrected by an operation called blepharoplasty. A browlift alleviates the drooping brow and wrinkles of the forehead but is a separate procedure from eyelid surgery. Dr. Joseph can recommend which surgery is right for you. A blepharoplasty can be performed on the upper and/or lower eyelids to remove skin and fatty tissue. Incisions are made behind the eyelid or in the natural skin folds of the eyelids so that they are virtually unnoticeable. The incision for the browlift is usually hidden behind the hairline but the incision line can vary depending on the patient’s hairline. There are 3 types of forehead lifts: a coronal, modified coronal and endoscopic. Dr. Joseph will recommend which one is right for you. Botox or Dysport injections are recommended for lines of the forehead and around the eyes as a temporary alternative to surgery. See the Botox/Dysport section for more information.

Rhinoplasty (nose)

Obstructions in the nose that cause breathing and sinus problems and deformities of the nose such as a hump on the top or a nose that is too long or too wide can be corrected by a rhinoplasty. A rhinoplasty can be performed in conjunction with reconstructive nasal-septal surgery to relieve obstructions inside the nose. This operation is known as a septorhinoplasty. Incisions are placed inside the nose so that no scarring can be seen. Rarely, a small incision may be required across the skin between the nostrils. Most patients have packing inside their nose when they leave the surgery center which may be removed by a member of Dr. Joseph's staff the following morning. There will be a small cast on the nose for approximately 7 days which will be removed on the patient's post-operative visit.

Rhinoplasty surgery is performed at Brighton Medical Corporation, a certified out-patient surgical center . These procedures can be done under a light intravenous sedation but may be done under general anesthesia. The patient is required to have a competent adult pick them up from the surgical center and stay with them the first night. Surgical fees, pre-operative and post-operative instructions are given at the time of the consultation and the patient is responsible for reading these instructions thoroughly prior to surgery.

Before and After

Mentoplasty (chin)

Chin augmentation is an operation that can change a person's profile by bringing out the chin or can give a more balanced look to the overall face. Dr. Joseph can choose a specific type and shape of implant to achieve the best possible result. If the problem is reducing the chin which involves removing excess bone or adjusting a severe overbite or underbite than a consultation with a oral or maxillofacial surgeon may be necessary.

Following chin augmentation surgery the patient returns in approximately 7 days for suture removal. The surgery is performed at Brighton Medical Corporation, a certified out-patient surgical center . This procedure can be done under a light intravenous sedation but may be done under general anesthesia. The patient is required to have a competent adult pick them up from the surgical center and stay with them the first night. Surgical fees, pre-operative and post-operative instructions are given at the time of the consultation and the patient is responsible for reading these instructions thoroughly prior to surgery.

Before and After

Otoplasty (ears)

The most common cosmetic complaint that people have with their ears is that they protrude out from the head. An otoplasty is an operation that "pins back" the ears to keep them flat against the head. The surgery can be performed on a patient of any age after 5 years old. The incisions are placed along the back of the ear and the patient is required to wear a bulky dressing around the head for approximately 2 to 3 days. The sutures are usually the dissolvable kind but Dr. Joseph requires that the patient come in the day after surgery for a post-operative check-up appointment and then again 5 to 7 days later.

Otoplasty surgery is performed at Brighton Medical Corporation, a certified out-patient surgical center. This procedure can be done under a light intravenous sedation but may be done under general anesthesia. The patient is required to have a competent adult pick them up from the surgical center and stay with them the first night. Surgical fees, pre-operative and post-operative instructions are given at the time of the consultation and the patient is responsible for reading these instructions thoroughly prior to surgery.

Before and After

Laser Skin Resurfacing

Sun exposure, natural aging and facial expressions all contribute to wrinkles that appear on your face. Laser skin resurfacing with a CO2 laser is the latest technique to reduce wrinkles and the signs of aging without any incisions. The laser works by removing the outer layers of skin and after the healing process the result is a smoother, firmer appearance to the skin. There is minimal discomfort and in some cases can be done under local anesthesia. Dr. Joseph will recommend at the time of the consultation which procedure, laser skin resurfacing or chemical peeling, is right for you. With some types of skin you may be required to start on preparatory creams several weeks prior to surgery. Most of the healing takes approximately 1 week, although the skin may look pink for several weeks after surgery. In most cases makeup can be applied approximately 7 to 10 days after surgery.

Laser skin resurfacing is performed at Brighton Medical Corporation, a certified out-patient surgical center. This procedure can be done under a light intravenous sedation but may be done under local anesthesia. The patient is required to have a competent adult pick them up from the surgical center and stay with them the first night. Surgical fees, pre-operative and post-operative instructions are given at the time of the consultation and the patient is responsible for reading these instructions thoroughly prior to surgery.

Fractionated Laser Skin resurfacing

Fractionated Laser Skin resurfacing (Face, Neck, Chest)

We are pleased to offer a new technological advancement in skin rejuvenation called Fractionated Carbon Dioxide Laser Skin Resurfacing (FLSR). It represents the next advancement in the treatment of skin since Intense Pulsed Light (IPL) or “Fotofacial”. Not only will FLSR improve pigment problems in the skin, such as IPL, but also significantly improve other problems in the skin including fine lines. FLRS produces thousands of tiny localized treatment area called Micro thermal Zones. These zones cover only a “Fraction” of the total surface area of the skin that is being treated. Unlike traditional Carbon Dioxide Laser Skin Resurfacing, which treats 100% of the skin surface, only 20-30% of the total skin surface is actually “Resurfaced” This allows for a much faster recovery and eliminates the need for anesthesia in order to undergo the procedure. Prior technologies, including Thermage and Fraxel, tried to obtain dramatic results with little or no down time and fell short of the claims the companies that manufactured them made.

The advantages of FLSR include fast recovery, use of only topical anesthesia and the ability to treat almost every part of the body including neck, chest and hands. The disadvantages are the need for 5-7 days of mild down time when compared the guaranteed 10 -14 days associated with traditional Carbon Dioxide Skin Resurfacing. There is also a mild pinkness of the skin for up to 14 days more, which looks like a sunburn and can be covered with make-up. In exchange for this temporary redness, one will obtain a noticeable and significant improvement in the skin. Although not providing as dramatic an improvement as deep peels and full Carbon Dioxide Lasers, this treatment represent middle ground between IPL, and other aggressive procedures. The adage of “No Pain No Gain” still holds true but now the pain can be chosen for the amount of gain obtained by choosing between IPL, FLSR and traditional Carbon Dioxide Skin Resurfacing technologies. We have also seen some skin tightening with this procedure but as of yet we are unable to provide more exact information regarding this potential outcome.

Liposuction Face and / or body

Excess fatty tissue can accumulate in isolated areas of the face and/or body. Sometimes this is not just a problem of being overweight. Some people find it hard to lose inches in certain areas of the face and body, no matter how much they work-out or diet. Such are ideal situations for liposuction surgery. Liposuction is performed by inserting a special instrument, or cannula, through a tiny incision in the skin and removing most of the unwanted fat cells in the area. Patient will have a more natural contour to their shape. The micro cannulas which are used are less that 1/4 of an inch wide. The most common areas for liposuction are underneath the chin, the abdomen, hips (for women), flanks or “love handles” (for men), arms, inner and outer thighs, and knees. A compressive garment is required during the healing process to obtain a better result.

Liposuction surgery is performed at Brighton Medical Corporation, an accredited out-patient surgical center. The procedure is usually preformed under a light intravenous sedation but may be done under general anesthesia, depending on the number of areas to be liposuctioned. For the patient with a few small areas of fat, liposuction can be done without any sedation at all. For those patients having sedation, a responsible adult is required to pick up the patient from the surgical center and remain with them for the next 24- 48 hours. Surgical fees, pre-operative and post-operative instructions are given at the time of the consultation and the patient is responsible for reading these instructions thorough prior to surgery.

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