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Meet Our Staff
At Alexander Cosmetic Surgery we are fortunate to have an excellent, caring, and dedicated staff, many of whom have been with the practice for decades. The longevity of our staff’s service is a testament to the commitment to quality and excellence provided by the Alexanders to our patients.

Julie Hill
Julie Hill - Patient Care Coordinator
Julie joined Alexander Cosmetic Surgery in 1997, and quickly became an indispensible member of the team. Her primary role is to provide superior patient service by understanding the needs of our patients. Julie has exceptional interpersonal ability. Her energetic and friendly personality, combined with her strong communication skills, allow her to create a successful experience for our patients. Julie is knowledgeable about every procedure offered at Alexander Cosmetic Surgery. She guides our patients through the surgical process, helping arrange pre and post-operative care.

Julie holds an A. A., Business Administration and Accounting from Southeast College, Lincoln, Nebraska. She was also educated in management, career counseling and nutrition at the University of Nebraska. Prior to joining Dr. Alexander Julie was the Program and Office Manager at Life Fitness and Weight Management, where she organized and opened a medical clinic.

Julie is married with two beautiful daughters and together they enjoy photography, softball, and camping. She volunteers at her children’s school, Girl Scouts of America, and the Three-Day Breast Cancer Walk.

“By addressing every question and concern you may have, I will help you become completely comfortable before your procedure. I will work with you to make this an enjoyable and successful experience.”

Surgery Center
Our team of Supervisors, Registered Nurses, and Medical Technicians work seamlessly together to make your surgical procedure as stress free and uneventful as possible. James Koed, our Operating Room Supervisor, has been with Dr. Alexander since 1980!

James Koed
James Koed - Surgical Center Supervisor
Jim Koed began working with Dr. Alexander 30 years ago! Jim was in the U.S. Navy during the Vietnam War. There he completed the Navy Operating Room Technician Program in Oakland, California, becoming a Corpsman. He was transferred to San Diego and served as Operating Room Technician at Balboa Naval Hospital. His years of experience include operating room management, emergency room medicine, and Surgical ICU, including the Code Blue Team in hospital settings. Jim graduated from UCSD in 1991 with a degree in Biology and Biochemistry.

Jim is an incredibly hard worker, a jack-of-all-trades, and an efficiency expert. His leadership and efficient Surgical Center management allow him to interact easily with surgeons, anesthesiologists, nurses, technicians, and patients. He ensures medical care standards are excellent at our Surgical Center, which is certified by the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF), so our patients can consistently receive optimum results in a safe environment. His dedication and commitment to our practice and to the wellbeing of our surgery patients is a testimonial to his work ethic and character.

Jim and his wife of 35 years, Penny, have three children. Jim has served as a CPR instructor for over twenty years. He has a strong commitment to his faith, his family, and our practice. In his free time he enjoys home repairs and trips to Napa.

The Alexanders are like family.
-Jim Koed-

Alexander Skin Care
Our Skin Care technicians are specialists in their field. Working under the direction of our Board Certified Plastic Surgeons they have extensive experience and provide exceptional patient care.

Joanna C. Nicholson
Joanna C. Nicholson - Physician Assistant
Joanna Nicholson is a board certified Physician Assistant, specializing in aesthetic skin and laser treatments. Having completed extensive advanced training in all arenas of aesthetics and skin care management, she offers innovative medically proven skin care treatments. After receiving her Bachelor's Degree in Science from San Diego State University, Joanna continued her education and training as a Physician Assistant at the renowned University of Southern California. She received the Ethel Gardener PEO Scholarship Award and was on the Dean’s List during both didactic and clinical phases of training.

Joining the prestigious Alexander Cosmetic Surgery practice in 2003, she has worked extensively with both Dr. Alexander Sr. and Dr. Alexander II. She is frequently asked to attend roundtable discussions regarding new products and is often invited to educate other medical professionals.

Joanna has extensive experience in all FDA approved fillers including Botox,® and Dysport.® Joanna has practical general dermatology experience and offers a variety of laser treatments such as FotoFacial™ treatments and Laser Hair Removal using the most effective and advanced systems available.

Joanna has successfully combined her passion for science and medicine with an exceptional approach to patient care, a quality that has earned the respect and admiration from both our patients and staff.
Darcy Duffin
Darcy Duffin - Physician Assistant
Darcy returned home to the San Diego area as a 2013 graduate from the George Washington University Physician Assistant Program in Washington, D.C.

Growing up in Idaho, and a collegiate tennis player at Point Loma Nazarene University, Darcy always had a passion for health, fitness, and the outdoors. After graduation at Point Loma, she worked as an exercise physiologist and specialized in sports rehabilitation, lifetime fitness, as well as nutritional counseling in the La Jolla area. Darcy has worked with several aesthetic practices. She has a keen knowledge of skin care, injectables and dermatological conditions.

LeAnne Howard
LeAnne Howard - Registered Aesthetician
LeAnne has over 17 years experience working closely with cosmetic plastic surgeons and dermatologists in the field of medical aesthetics. She completed her training as an aesthetician at Je Boutique in San Diego, and has participated in several specialty courses in acne, acne scarring, photodamage, and numerous peels. She was the west coast educator for a cosmeceutical skin care line from New York for two years. She understands that aesthetic skincare and cosmetic surgery are private and individual and helps patients feel secure with their decisions.

LeAnee has developed skin care programs integrating the care of Dr. Alexander and our Physician Assistant, Joanna, to help patients learn how a more youthful appearance can be achieved through current innovations.

She works closely with Alexander Cosmetic Surgery patients providing pre-operative and post-operative skin care treatments. Leanne’s knowledge of skin care has advanced with certifications in both medical strength products and chemical peels. She continues to broaden her knowledge with cutting edge skin care allowing Alexander Cosmetic Surgery and Alexander Skin Care to provide our patients with an assortment of effective, versatile and personalized treatments.





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