“Nobody likes to see the signs of aging on their face and with the high quality of injectable products available today, I can help to eliminate or soften some of those unwanted lines with a 10 to 30 minute appointment,” says an enthusiastic Dr. Moss, of his Juvederm and Botox® Boston treatments.

The facial injectable market has been steadily growing, and the statistics from the American Society of Plastic Surgeons provide proof that the American public wants to stay young looking, especially when there is little or no down time involved in the treatment.

Botox® still reins “King” in the facial injectable category. There was an estimated 4,625,192 Botox® injections performed by board certified plastic surgeons in 2007. This was a 13% increase over 2006. There are a number of reasons why Botox® is so popular.

Botox® produces results that are unique and often cannot be duplicated in any other way, including surgery. By injecting Botox® directly into a facial muscle, a physician can weaken the muscle and the contractions associated with this muscle. These facial contractions which can cause the unwanted wrinkles are therefore eliminated or softened for periods up to four months. The areas that have traditionally been treated are the frown lines between the eyes, the horizontal forehead creases, and crow’s feet around the eyes.

“Patients will often tell me that friends and co-workers will comment that they look like they are scowling or are angry when they are not,” comments Dr. Moss, Boston cosmetic surgeon. Frequently the offending muscle is the “corrugator” muscle causing the unconscious scowl.

“Patients love how a 5 minute injection with little discomfort eliminates or softens this unwanted facial expression,” Dr. Moss continues. “In addition, there usually is no bruising or swelling associated with this treatment and patients can return to work or go home with no one knowing they just had a Botox® injection.”

Patients should expect to see the effects of Botox® in about 4 days, although in some instances it can take up to 14 days for the full effect of Botox® to be seen. In addition, patients need to be aware that there can be bruising at the site of any Botox® injection.

Although bruising does not usually result from a Botox® injection, patients should be aware of its possibility, especially if they are having their treatment in preparation of a special occasion.

“My wife Carla has a tendency to bruise more than most patients, so she has purchased a concealer product from the Medical Aesthetician, Kathy Antonowicz R.E., R.I. (888-806-4844), who performs her laser skin treatments. “Carla is always happy to share any helpful hints with any of our patients, as she is aware that this can often make a patient’s treatment much easier and more pleasant,” relates Dr. Moss.

If Botox® reins “King” of the facial injectable market then Juvederm™ is the “Queen” of the facial injectables. It is important to understand that Botox® and Juvederm™ work by completely different methods. While Botox® paralyses muscles; Juvederm™ fills in valleys in the skin.

Juvederm™ is the newest of the hyaluronic acid formulations to reach the cosmetic marketplace. Restylane® and Perlane® are two other popular hyaluronic acid products that have been available for some time.

Boston cosmetic surgeon Dr. Moss has been injecting Restylane® and Perlane® since their availability and has extensive experience with the injection techniques for all of these facial fillers.

“Until the introduction of Juvederm™, I would choose a filler product that best addressed a patient’s individual needs,” states Dr. Moss. “However, with the availability of Juvederm™, I am now finding that this product has the benefits of all of the other products combined and I expect it to soon be the market leader in the facial filler category” he adds.

“What makes Juvederm™ so unique is the combination of longevity and versatility. Juvederm™ is the first hyaluronic acid that the FDA has allowed to be labeled “the effects may last up to one year.” The other available hyaluronic acids, Restylane® and Perlane® have labeling that states “the effects may last up until six months.” Radiesse® which is calcium-based microspheres suspended in a water based gel does have labeling that states “the effects may last up until one year,” however, Radiesse® cannot be injected into the lips or vermillion border.

“Having a product that lasts longer and can be injected into the lips is a big advantage for a number of reasons,” Dr. Moss continues. “Patients need to be aware that when a product is labeled “lasts on average one year” means that a patient should expect that 50% of the correction is gone at six months. This meant that any product we had for injections in the lips before the introduction of Juvederm™ would lose 50% of the correction at three months. Patients really appreciate a correction that lasts for a longer period of time.”

“Another factor concerning facial fillers that patients need to be aware of is that the more animated the area of injection, the quicker the filler is absorbed and the correction diminished. The area around the mouth has the most activity and therefore fillers are absorbed at a faster rate in this area. For example, it would not be unusual for the correction to be lost sooner in the lips than in the nasolabial folds (the lines that run from the nose to the mouth, also called the parentheses) because the lips are much more animated than the nasolabial folds. Therefore the availability of a product such as Juvederm™, which lasts longer and can be injected in the lips is big advantage,” Dr. Moss further elaborates.

Juvederm™ is available in two formulations. While both the formulations are interchangeable, the Juvederm™ Ultra Plus is more robust and used more frequently in areas such as the nasolabial folds, while the Juvederm™ Ultra, which is less viscous, is used primarily in areas such as the lips where a softer result might be more desirable.

Like Botox® injections, facial filler injections also continue to increase in popularity. The total combination of facial filler injections performed by plastic surgeons in 2007 was around 1,250,000, making facial fillers by far the second most popular procedure in the field of cosmetic surgery and procedures. Dr. Moss attributes this to both the efficacy of injections and the ease of having the treatments.

Another new trend that is appearing in the facial injectable arena is the concept of “full correction” or sometimes simply called the “Wow effect.” This is where the physician injects sufficient filler into the areas of the face needing correction in amounts that greatly diminish the wrinkles rather than softening the wrinkles.

In conjunction with fillers, Botox® is also injected in areas of concern to the patient to reduce or eliminate the dynamic wrinkles. While this is more costly to the patient the effect that can be produced will often justify the added expense. In addition, the subsequent maintenance injections are often far less than the initial injections. Achieving a “full correction” can be more difficult than simply injecting one syringe of filler or one site of Botox®. Therefore, patients considering having injections to achieve “full correction” should choose a competent physician for their treatment.

“Plastic surgeons are some of the best trained physicians for administering facial injections,” states Dr. Moss. “We fully understand the muscular and neurological anatomy of the face. It is part of the core training in a plastic surgical residency program. You cannot perform facelifts, brow lifts and eye lid surgery without fully understanding the anatomy and the perils that lie beneath the facial skin. There is no other specialty that is better trained for facial injections than the specialties of plastic surgery and facial plastic surgery. I sometimes wonder why any patient would want to choose a provider from a website that does not clearly state who the physician in charge is at the facility, his/her training, and what specific board this physician is certified by.”

In order to stay current on all of the popular facial injectable techniques, Dr. Moss frequently attends courses.

In February of 2008 Dr. Moss attended the “Baker Gordon” Cosmetic Symposium in Miami, Florida. In May Dr. Moss attended an advanced course on Botox®, Juvederm™, Restylane®, and Perlane®. He is also scheduled to attend another full day course in June devoted to the more advanced techniques on the injection of Botox® and many of the facial fillers including Juvederm Ultra™ and Juvederm™ Ultra Plus.

“Patients who come to me do so because they are looking for the expertise of a Board Certified Plastic Surgeon. Whether it’s breast augmentation, tummy tucks, or Botox®, I pride myself on staying abreast of all of the latest techniques as well as continually evaluating the results my patients receive. I always offer my patients the opportunity to return and have 2 week to 1 month post injection pictures taken and to compare them to their pre-injection pictures. We can discuss if any further treatments are necessary or if the patient is happy with his/her result. I find that most are happy but occasionally someone wants more of a correction or even another area treated. My goal is always to have a satisfied patient.”

Boston Botox patient brow at rest before	Boston Botox patient brow raised before
Boston Botox patient brow at rest after	Boston Botox patient brow raised after

Most patients have the full benefit of BOTOX® about four days from their BOTOX® injections. Allergan Inc. the corporation that markets BOTOX® states that all patients should wait up until 2 weeks before determining whether or not their result is satisfactory or whether they want additional BOTOX® injected to improve their result. Most patients find that their initial injections with Dr. Moss are satisfactory and do not require additional material to be injected.

The results from BOTOX® injections last on average for four months, at which point patients should expect to be re-injected in order to maintain their result.

So if you don’t like the New England weather, wait a few days. It will change. If you don’t like the wrinkles on your face, don’t wait. Call Dr. Moss at 508-747-1322 and schedule an appointment for BOTOX® injections.

Not enough kisses under the mistletoe this year?

Boston facial filler expert, Richard A. Moss M.D. has the perfect solution. Restylane® injections to fill out and plump up your lips! “Restylane® is one of the most popular ‘fillers’ currently being used to plump up thin lips,” states Dr. Moss. “It is an ideal filler in that it fills out the lips while still leaving them with a natural feel. It can also be used to improve the appearance of nasolabial folds (those pesky vertical lines that run from the nose to the side of the mouth).

Richard A. Moss M.D. finds that around the holidays the number of patients interested in facial injectables sharply increases. “The number of patients scheduling appointments for BOTOX®, Restylane®, Perlane®, and Radiesse®, dramatically rises around Thanksgiving and remains at a very high level until after New Years Day. We stock a number of facial injectable products so that I can personally tailor a patient’s treatment to her individual needs and desired results”.

A Restylane expert, Dr. Moss explains that most women want to look their best around the holidays for all the family, friends and business celebrations. “Many of my patients just want a freshening up. Some are concerned that while they want to look younger they don’t want a radical change. Something that says you look ‘rested’ but not an obvious ‘overhaul’ is often what the goal is”.

Dr. Moss further explains that lips are starting to play an increasingly greater part in the rejuvenation process for many women. “No longer are they satisfied with reducing the wrinkles, they also want the lip fullness that is recognized as an important part of a youthful appearance. This is all part of the trend in the anti-aging industry of not just removing excess skin but replacing ‘lost volume.’ Even facial cosmetic surgery is trending towards the replacement or realignment of lost facial fat pad volume, not just redraping the facial skin and excising the excess.”

“Even those patients who are avid cosmetic surgery patients are supplementing their surgical results with facial fillers (Restylane®, Radiesse®, and Perlane®) for a more natural look,” explains Dr. Moss.

Another popular reason that many patients turn to Restylane® injections in their lips is that, if it is injected along the edges of the lip, (referred to as the vermilion border), there can be a reduction in the depth of lip lines around the mouth. “Women especially hate these lip lines. Lipstick bleeds into them, accentuating an already unpleasant feature of their face. And unlike men, then can’t grow a beard,” Dr. Moss further explains.

Dr. Moss has two different injection techniques for the lips. He can inject along the vermilion border of the lip to help reduce lip lines and improve definition or he can inject into the body of the lips to plump them up. He can also perform a combination of the two techniques. “One of the challenges of injecting along the vermillion border is to avoid overdoing it so that the patient still retains a natural appearance. Often times I will utilize both techniques for an optimum result. If a patient has no lip lines then I might inject just into the body of the lip as it is unnecessary to inject the vermilion border,” explains Dr. Moss. “It is so important to individually tailor the injection treatment to the patient’s specific issues and goals.”

Before	After

This Boston facial filler patient had 1 syringe of Restylane®. Dr. Moss injected part of the syringe along the vermillion border of her lips and the remainder of the syringe into the body of her lips. No other area of her face was injected.

When looking for facial injectables, patients should direct as much attention to the qualifications of the injector as they are to the material they are selecting for injection (BOTOX®, Restylane®, Perlane®, and Radiesse®). Dr. Moss is board certified in Plastic Surgery and has twenty six years of experience. All of the training that he continually receives to stay current is in the area of cosmetic surgery and facial injectables. So before the holidays are over, call 508-747-1322 or 781-337-2421 to schedule an appointment. Dr. Moss’ staff will be happy to answer any questions you might have.

Facial Injectables are a great way to refresh your appearance for the Holidays!

Dr. Moss recently performed a number of facial injectables on his wife; Lisa a new staff member photographed the entire process. Lisa also photographed the before and after pictures. Carla routinely has Radiesse® injections to lessen her nasolabial folds (lines from nose to mouth) and Restylane® injections in her lips to make them fuller. She also has BOTOX® injections to eliminate the lines on her forehead and brow as well as around her eyes to reduce the crow’s feet.

Carla Moss before her facial injectables	Carla Moss after her facial injectables

For more close up before and after pictures please scroll to the bottom of this article!

Dr. Moss first applies an internal topical numbing gel

Dr. Moss then injects a “dental block” of a Novocain like substance. This injection is identical to what a patient has in a dentist’s office.

Dr. Moss then applies an external topical numbing cream to the sites that he will inject with Radiesse® and Restylane®

Dr. Moss then marks the sites of injection for BOTOX® with a red iodine ointment. The red color is easy to identify and iodine has an antibacterial effect on the skin. He has the patient move their facial muscles to mark the sites of injection. Please note that because Dr. Moss uses a very small 32 gauge needle, Carla can barely feel the injections.

Dr. Moss then injects the BOTOX® into all of the spots that he has marked with Betadine ointment. Here he is injecting the forehead.

This picture shows Dr. Moss injecting around the eyes to eliminate some of the lines that are commonly referred to as crows feet.

Before starting the injections of facial fillers Dr. Moss has patients wipe off all of the Betadine ointment from the BOTOX® injections and also all of the numbing cream around the mouth.

Please note that during Carla’s injections in the pictures shown below she can barely feel any of the needles as she has been numbed by the “dental block” and topical numbing creams.

Dr. Moss then proceeds to inject the upper lip with Restylane®. Restylane® is the product used most frequently for injections in the lips.

Dr. Moss then proceeds to inject the lower lip with Restylane®.

Dr. Moss will often ask the patient to take a look in the mirror at the result so far, during the injections. He then will ask the patient where they want more of the product injected. This way the patient has a better chance of getting the correction of wrinkles and the fullness to the lips “where they want it.” Some patients want fuller lips than others and Dr. Moss always wants to accommodate what a patient wants concerning the final result. In addition, some wrinkles bother patients more than others. It is important that Dr. Moss address those first in order to ensure that there is enough injectable material to handle a patient’s concerns.

Dr. Moss then injects Carla’s nasolabial folds with Radiesse®.

Some patients choose to have Restylane® or Perlane® injected in their nasolabial folds. Patient choice usually dictates what product the patient wants injected. Dr. Moss reviews each product and its characteristics with every patient.

Dr. Moss tries to even out the nasolabial folds. Most patients have one side that is more pronounced than the other.

This picture shows Carla immediately after all of the injections. There is very little indication of the BOTOX® injections while there is some swelling and bruising evident from the Restylane® and Radiesse® injections.

This shows Carla Moss the day after injections. There is some bruising but it can be covered with makeup.

The before and after pictures! The after pictures are taken about 1 week later.

Forehead before	Forehead after
Brow before	Brow after
Crow’s feet before	Crow’s feet after
Lips and nasolabial folds before	Lips and nasolabial folds after

Moss prides himself with the quality of service offered to his facial injectable patients. All facial injectable treatments are performed by Dr. Moss himself. He prides himself in the attention given to the details of both the injection itself and the numbing process. “Even though it takes a little longer, we have the patient wait 15 minutes after the injection of the “dental block” and the application of the numbing cream to make sure they really are anesthetized, before I inject the facial fillers,” says Dr. Moss. “All injectable material is company name branded product meant for use in the United States. I provide only the top level of service when it comes to injections of BOTOX®, Restylane®, Perlane®, and Radiesse®, Dr. Moss exclaims!

Reunion Ready! Two weeks after her injections!

In this day and age it is no longer just about losing that extra ten pounds you put on or buying a fabulous dress, or telling your spouse to be on his best behavior. It’s also about making your face as young looking as possible. And with injectables such as BOTOX®, Restylane®, Perlane®, and Radiesse®, Boston facial injectable expert, Dr. Richard A. Moss, can help most patients who want a fresher, younger appearance.

Carla Moss was delighted that their high school reunion patient had called for an appointment two weeks in advance. “This is the ideal time to be injecting a patient for an important event. BOTOX® takes four to fourteen days to take effect. And while the results of facial fillers such as Restylane®, Perlane®, and Radiesse® are apparent immediately, two weeks provides a very secure window for all bruising to disappear. Most patients find that the bruising from the facial fillers is gone within a few days, but occasionally there can be a pesky small bruise that takes its time to totally disappear. And with a very important event, we want no signs of bruising. BOTOX® does not usually cause any bruising, but again there can be that occasional patient who ends up with a small bruise from her BOTOX® injection.

Forehead Before	Forehead After
Brow Before	Brow After
Crows Feet Before	Crows Feet After
Platysma Before	Platysma After
Nasolabial Folds Before	Nasolabial Folds After

One thing patients will find when they obtain their services from a plastic surgeon who has as much expertise as Dr. Moss has is that results are not over promised and complications such as bruising are not unrealistically minimized. “We want to provide realistic expectations both in the area of results and healing. While there is virtually no down time with facial injections such as BOTOX® and Restylane® it is important that patients understand what they might have for bruising. That way they can schedule their treatments so that they fit into their busy schedule,” states Dr. Moss.

If you are interested in a fresher appearance give Dr. Moss’ office a call at 508-747-1322 or 781-337-2421 to schedule a consultation. You can have your treatment on the same day as your consultation if you so desire or come back at a later date for treatment.

The quality/condition of your skin is one of the most important factors in your appearance. If your skin looks refreshed and is not flawed by blemishes you look more beautiful. A face that is not marred by deep wrinkles and frown lines is more attractive and therefore more inviting to friends and strangers. Today’s plastic surgeons now have far more in their armamentarium to help you improve the quality of your skin and your facial appearance, than they did a decade ago.

The first step in improving the quality of your skin is to determine “what bothers you about your skin” or how you feel about your facial appearance. Once you have determined what it is you want to improve about your appearance, the next step is determining what your choices are for these improvements or corrections. It is only after a patient is presented her/his choices can she/he make a reasonable informed decision to proceed with treatment.

Sometimes a prospective patient can determine what treatments are most beneficial for them, simply by surfing the web and visiting informative websites. Sometimes an e-mail to a plastic surgeon via their website can provide more specific information. Dr. Moss has tried to present all clinical information on his website: www.drmossthebeautyboss.com, in such a way that it is meaningful to viewers. His e-mails are also answered within days, usually by the next business day.

Another source of information is the doctor’s staff. At Dr. Moss’ office, the phones are staffed in such a way that in most cases there is someone who can take a few minutes to answer your questions and point you in the right direction. However, all prospective patients should realize that ultimately a consultation with an appropriate board certified physician needs to take place, before any medical/surgical treatment can be provided.

So you’re interested in improving the quality of your skin. One of the treatments that Dr. Moss offers is a “lunchtime” Vitalize Peel. This peel can improve the quality of your skin by causing it to exfoliate over a period of a few days. This is a peel that does not hurt, has little or no downtime, yet does truly exfoliate the epidermis. This peel can help with fine lines, with reduction of hyper-pigmentation (requires repeated peels), improve the texture of your skin, and provide a more youthful appearance to your skin.

The following is a description of the benefits of the Vitalize Peel, provided by SkinMedica™:

BENEFITS:
• Very superficial peel requires little to no downtime for the patient
• The only superficial peel suitable for all skin types I-VI
• Self-neutralizing formula is easy to use
• Special formulation includes a unique blend of peeling agents: alpha-hydroxy acids, beta-hydroxy acids, resorcinol, and retinoic acid (obtained by physician)
• Results are predictable and noticeable after just one peel
• Dramatic results are seen after a series of peels

Carla preparing the Vitalize Peel™ set up. There are three steps to this peel.

• Cleansing with acetone
• Application of Lactic acid, Resorcinol, Salicylic Acid, Panthenol, & Saponins
• Application of Retinoic Acid

It is also important that patients understand what a Vitalize Peel does not do. A Vitalize Peel does not erase the deep forehead or brow lines. For that you need BOTOX® treatments. It does not erase the lines between the nose and mouth, referred to as the nasolabial folds. For this you need “filler” injections of Restylane® or Radiesse™. Dr. Moss’ website and this blog have pages that provide extensive information on BOTOX®, Restylane® and Radiesse™.

Dr. Moss performs all Vitalize Peels himself. The peel itself takes between 5-10 minutes and causes the patient minimal to no discomfort at all. No pain medication (including Tylenol) should be needed. During the peel your skin may feel warm and you will be provided with a fan to cool your face.

You should avoid direct exposure to the sun for extended periods of time for the first week or two, after your peel. During the first two weeks post peel, you should also avoid other activities that would aggravate your skin such as exfoliation or waxing.

Post peel you will be instructed to use a Sensitive Skin Cleanser, a moisturizer, (Rejuvenative or Ultra Sheer, depending on your skin type) and Daily Sun Protection SPF 20, liberally on your face. Patients with a tendency towards dry skin will use the Rejuvenative Moisturizer. Patients with a leaning towards oily skin will use the Ultra Sheer Moisturizer. All of these products are provided by SkinMedica™, the manufacturer of the Vitalize Peel™. These products will help moisturize your skin, while it is exfoliating. Using these products liberally will help conceal the peeling by matting down the exfoliating skin. For the patient’s convenience, these products are stocked in Dr. Moss’ office and will be obtained on the day of your peel.

Below you will find some information from SkinMedica™ about the post peel products:

SENSITIVE SKIN CLEANSER

BENEFITS:
• Thoroughly removes makeup and excess oil as it neutralizes environmental pollutants
• Specially formulated with anti-irritants to protect highly sensitive or inflamed skin
• Cleanses gently while providing hydration for sensitive, post-procedure skin

ULTRA SHEER MOISTURIZER

BENEFITS:
• Hydrates and restores skin with antioxidants
• Protects against environmental aggressors
• Conditions and firms the skin

REJUVENATIVE MOISTURIZER

BENEFITS:
• Provides protection against environmental aggressors that contribute to aging
• Reduces the signs of aging
• Nourishes and hydrates skin

DAILY SUN PROTECTION SPF 20

BENEFITS:
• Provides full-spectrum UVA and UVB, SPF 20, anti-aging sunscreen protection
• Infuses skin with excellent moisturization in an oil-free formulation
• Contains powerful antioxidant vitamins A, C, and E for anti-aging defense

What can you expect to look like while your skin is exfoliating?

As you can see this peel really is effective and you do exfoliate. This picture shows Carla, Dr. Moss’ wife at 2 days after her Vitalize Peel™. To make the exfoliation more apparent photographically, Carla has not applied any moisturizer in order to demonstrate the exfoliation. You should wear liberal amounts of moisturizer to both mask the exfoliation and to help moisturize your skin.

You will not peel or exfoliate the day of the peel or the next day. However, two days after the application of the peel you will exfoliate in the lower ⅓ of your face. The day after that you will exfoliate in the center ⅓ of your face and the day after that your forehead will exfoliate. While there will be no discomfort associated with this exfoliation, you will look a little “messy” for a few days. However, most patients will not miss work during the exfoliation period. Some patients will have their peel applied so that most of the exfoliation occurs over the weekend.

Dr. Moss has received many complements on the Vitalize Peel™. He has had comments from aestheticians that this is the “best” peel that they have ever had. Others have commented on how much improvement they have received from this peel. This is an excellent alternative to micro-dermabrasion, and patients who have had glycolic peels may want to step up to a Vitalize Peel™. Many clinicians consider the Vitalize Peel™ to be a more effective peel than the glycolic peel.

Some patients will have a series of 5-6 peels, while others will have one every 3-6 months. Carla Moss, Dr. Moss’ wife will have one every 3-6 months. One of the biggest benefits that she found to having the Vitalize Peel™ is that it virtually eliminated the occasional acne breakouts. Having dry skin and pimples at 50 years of age is no fun. It is surprising how many women have this problem. The Vitalize Peel™ is very effective for reducing or eliminating this problem.

Another group of patients that love the results of the Vitalize Peel™ are the ones who sunbathe and damage their skin. This is a great refresher for these patients. The Vitalize Peel™ will also help diminish some of the brown spots that many of these patients also have.

When questioned about skin care, Dr. Moss replies, “I am looking to help my patients improve the appearance of their skin. I am a board certified plastic surgeon that practices cosmetic surgery exclusively. Many of my patients, especially my injectable patients, (BOTOX®, Restylane® and Radiesse™), are looking for treatments and products to make their skin look healthier and have a nice glow. I feel that the SkinMedica™ line, including the Vitalize Peel™ allows me to provide this service to my patients. Since I am already fully trained and credentialed to perform the much stronger phenol peels, laser treatments and dermabrasion, the Vitalize Peel™ was an easy addition to my practice.

What is the cost of a Vitalize Peel™? Dr. Moss charges $125 per peel. The products which are used post-peel and are purchased from Dr. Moss on the day of your peel, cost approximately $100. However, if you call his office, you may find that he is currently running one of his frequent in office specials.

Learn More About Non-Surgical Options in Boston

• Read About Skin Peels in Boston
• Get Information About Cosmetic Injectables in Boston

Rejuvenation of the eyes with an upper lid blepharoplasty, is a cosmetic surgery procedure that does not receive nearly as much press as BOTOX®, or injectable facial fillers. However, with an upper lid blepharoplasty, patients can achieve a significant improvement in their facial appearance and one that often does not need to be repeated.

An upper eyelid blepharoplasty will treat loose or sagging skin that creates folds or hides the natural contour of the upper eyelid. During the surgery, Dr. Moss will excise the excess skin that is causing the extra folds or sagging skin of the upper eyelid. The incision is made so that it is hidden in the crease of the upper lid and is usually barely visible after healing has taken place.

While an upper lid blepharoplasty is surgery, it is one that can be done in Dr. Moss’ office using a local anesthetic, (you’re awake). Patients can also elect to have this in a hospital setting, utilizing a general anesthesia (you’re asleep). Often times, if a patient is having some form of a facelift or even cosmetic surgery of the body, an upper lid blepharoplasty can be performed at the same time.

Dr. Moss is finding that upper lid blepharoplasty surgery is becoming more popular in his office. It is not uncommon for a BOTOX® or Restylane® patient to ask about improving the appearance of their eyes. The age group that many blepharoplasty patients are in (35 to 55) is the same age group that loves facial injectables such as BOTOX®, Restylane®, or Radiesse™.

A patient will need to take 3-5 days off from work to have an upper lid blepharoplasty. However, you will be somewhat bruised, anywhere from 1-2 weeks. Eye makeup can be applied in ten days. Other facial makeup (other than eye makeup) can be worn the day after surgery. The discomfort tends to be relatively mild after an upper lid blepharoplasty. Although Dr. Moss provides all blepharoplasty patients with prescription pain medication, many find that they only need Tylenol after this surgery, to manage any discomfort.

An upper lid blepharoplasty with Dr. Moss is reasonably priced. For most patients the cost of this surgery, all inclusive, is around $2500 when performed in his office. This includes Dr. Moss’ fee for surgery and all pre and post operative appointments, as well as all supplies needed for the procedure. If a patient elects to have this surgery in the hospital, the charge would be around $3200, all inclusive. This includes all of Dr. Moss’ charges as well as hospital fees and anesthesia charges.

Please call Dr. Moss’ office, (508-747-1322 or 781-337-2421), if you have any questions concerning upper lid blepharoplasty or are interested in setting up a consultation. Both Dr. Moss and his wife Carla have personally had upper lid blepharoplasty surgery, and were delighted with the results. Dr. Moss had his surgery over 25 years ago and Carla had her upper lid blepharoplasty around 20 years ago.

Learn More About Eyelid Plastic Surgery in Boston

• See Eyelid Lift Before and After Pictures
• Read Blepharoplasty Information on Our Web Site

The holidays are here and everyone wants to look their best. Now! And with all the shopping, parties, and decorating, most people don’t have a lot of spare time. So what’s the answer? If you were to ask Dr. Moss he would tell you that facial injectables: BOTOX, Restylane, and Radiesse would be excellent choices for someone who wants to look better within a few days, and doesn’t have much time to spend doing so.

This article was written by Dr. Moss’ wife, office manager, and avid fan of facial injectables. This article will provide you with some basic information about these products, treatments and the results you may achieve. It will also offer you some with some “down to earth” tips on choosing a doctor for your injections.

BOTOX® Cosmetic is a purified protein that is administered via a few tiny injections. It is used to treat the frown lines between the eyes, the horizontal forehead lines, and the crow’s feet. It can also improve a droopy eyebrow. There is very little discomfort associated with this treatment and patients usually see results within four days. BOTOX® Cosmetic is considered to be a very effective treatment by physicians and patients. It is the number one cosmetic treatment provided in the United States.

Dr. Moss provides a “gold standard of treatment” when administering BOTOX® Cosmetic. Before any patient receives their injection, Dr. Moss discusses with the patient what the goals of the treatment are. He wants to make sure that he completely understands what the patient is bothered by and what she/he wishes to achieve. In addition, he feels it is important that before he starts any treatment, that the patient has a clear understanding of what can be achieved.

Dr. Moss pays particular attention to patient comfort during all injectable treatments. He uses a very tiny 32 gauge needle, which he purchases just for BOTOX® Injections. This has considerably reduced discomfort of patients during their injections. In addition, the saline that he uses to dilute the BOTOX® (BOTOX® is shipped as a dry powder) contains a preservative. This has been reported to cause less discomfort than saline that does not have a preservative. And lastly, when he mixes the BOTOX® with saline he does so in a way to have the injectable material at its strongest solution. This results in the actual volume needed to be injected being lower, while maintaining the strength of the BOTOX® being injected.

While most patients do not need any type of an anesthetic for BOTOX® injections, Dr. Moss does have a topical anesthetic cream that he or staff members can apply, prior to injection. Dr. Moss also has cold gel packs for all patients to apply after their injections if they so wish. Patient comfort is important to Dr. Moss. It is not unusual for patients to comment on how much more comfortable their treatments are with Dr. Moss.

Another important aspect to any facial injection treatment, including BOTOX® is the effectiveness of the treatment. BOTOX® injections are considered to have a high efficacy. However, the amount of BOTOX® that is injected needs to be at a sufficient level to produce the required results. The BOTOX® product itself is very expensive and is available from only one manufacturer. Dr. Moss always injects a sufficient amount of BOTOX® (usually 25 or 35 units) to get the expected result. He does not under treat and he always purchases genuine BOTOX® Cosmetic product from the manufacturer, Allergan.

The skill and training of the person providing your BOTOX® injections is critical to a good result. Dr. Moss is fully trained in BOTOX® injections and he is also a board certified plastic surgeon. This means that he has one of the highest levels of understanding of the facial anatomy of any of the specialties that provide BOTOX® injections to patients. Plastic surgeons are one of the two specialties trained to perform facelifts. (The other specialty is facial plastic surgeons.) This means that Dr. Moss understands the anatomy including the muscles and nerves underneath your facial skin. And that is what BOTOX® Cosmetic actually treats. Again, Dr. Moss provides the “Gold Standard of Care.”

Cost is another issue for patients receiving BOTOX® injections. BOTOX® lasts on average for 4 months. Therefore cost can be important, especially on a long-term basis. A patient can choose to not be retreated with BOTOX®, however they should expect their facial wrinkles to return. A complete listing of Dr. Moss’ pricing for BOTOX® is provided on his website: www.drmossthebeautyboss.com. A standard injection of BOTOX® for 1 site costs $375.00. Dr. Moss’ staff will review all costs over the phone with you and you will always be provided with an actual cost before you receive your injections. Dr. Moss wants you to be completely informed of the prices and costs at all times.

Dr. Moss’ wife has had BOTOX® injections many times in all three sites, (forehead, frown lines between eyes, and crow’s feet). Feel free to call her if you have any questions and are considering BOTOX®.

The other category of facial injections is referred to as “facial fillers.” The two products that Dr. Moss uses in this category are Restylane® and Radiesse™. These two products do not compete with BOTOX® but rather can be used to complement the results achieved with BOTOX®. A patient can also receive Restylane® or Radiesse™ without receiving BOTOX®.

Dr. Moss uses Restylane® or Radiesse™ to treat the wrinkles and lines in the lower part of the face. Both Restylane® and Radiesse™ can be used to soften the nasolabial lines that run from the nose to the mouth or the marionette lines that run down from the mouth. In addition, Restylane® can also be used to plump up the lips. Radiesse™ is not used to plump up the lips because it tends to form nodules when used in this location.

Dr. Moss is very experienced in the technique of facial filler injections. He has been providing this service for approximately 20 years. The original fillers that were used back then were the collagen products. Because Restylane® and Radiesse™, newer products to the market, last considerably longer, most patients no longer request collagen injections. Restylane® lasts on average 6 months while Radiesse™ lasts on average 1 year.

An important factor in the treatment with “facial fillers” is the local anesthetic that is provided at the time of treatment. Unlike BOTOX®, which requires no anesthetic for treatment, facial filler injections do require some type of local anesthetic in most patients. Dr. Moss is well trained in providing a “dental block” with a Novocain-like product to patients prior to their facial injections. He first uses a topical anesthetic on the gums to make the “dental block” itself as easy as possible for patients. Then after the numbing injections, he will have all patients wait at least 15 minutes before injecting with any filler. He has found that patients feel very little discomfort if he provides enough time for the “dental block” to take effect.

In addition to the dental block, Dr. Moss also applies a topical numbing cream to the facial sites that are to be injected with Restylane® or Radiesse™. Again, he finds this little bit of extra attention reduces treatment discomfort to the absolute minimum. Occasionally, Dr. Moss has a patient who wishes to forgo the “dental block” when receiving Restylane® or Radiesse™. Dr. Moss will perform “facial filler” injections without “dental blocks” if that is the patient’s choice. All patients receive a cold gel pack at the end of their injections to help minimize bruising. There is no additional charge for any of the local anesthetic services provided with the facial filler injections.

Dr. Moss provides the same high level of service with all facial filler injections. He will sit down with the patient in the examination room and ask what areas of her face she would like to see the wrinkles reduced and softened. He always tries to correct the areas that bother the patient. In addition, Dr. Moss will provide guidance to the patient so that she/he receives the best possible result.

Dr. Moss prices Restylane® and Radiesse™ treatments by the syringe. While these products are very expensive, he does offer them at attractive pricing. Dr. Moss charges $550 for one, 1.0ml syringe of Restylane®. He charges $1000 for two syringes of Restylane®, when injected at the same visit. He charges $750 for one 1.3ml syringe of Radiesse™. Patients can choose to have treatment with multiple syringes if they feel that the correction they want warrants more than one syringe. Patients can also elect to come back for additional syringes at a later date if they feel they want to further improvement. Carla Moss, Dr. Moss’ wife has had multiple injections of both Restylane® and Radiesse™, and is happy to discuss these treatments with interested callers.

If you feel that facial rejuvenation is something you would like to have Dr. Moss perform for you, please call 508-747-1322 or 781-337-2421, to set up an appointment.

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