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.

Boston Non-Surgical Procedures – Read about FDA approval of Radiesse® that contains tiny particles that form a scaffold around which the body is stimulated to produce new collagen.

On December 27, 2006, BioForm Medical announced that the U.S. Food and Drug Administration (FDA) approved Radiesse® for long lasting correction of moderate to severe facial wrinkles and folds such as nasolabial folds. Radiesse® is a cosmetic dermal filler that lasts longer than the current best selling filler, Restylane®.

Radiesse®, a next-generation filler, does more than just plump-up facial lines and wrinkles. Radiesse® has advanced calcium-based microsphere technology that restores volume naturally and promotes the growth of the body’s own collagen. Radiesse® treatments do not involve surgery. These treatments are performed in a doctor’s office by gently injecting the material with a very fine needle. Well trained physicians, such as Dr. Moss will also be able to provide patients with a numbing “dental block” of a Novocain like medication to eliminate most discomfort during treatment.

Radiesse® contains tiny particles that form a scaffold around which the body is stimulated to produce new collagen. Treatment provides immediate, visible improvement of folds and wrinkles. In addition, the body’s own collagen naturally restores a fuller, more youthful appearance that keeps patients looking better even longer. In clinical studies and in private practices, physician experience has shown that Radiesse® consistently lasts longer than Restylane® and collagen products.

Dr. Moss has been offering Radiesse® to his patients for over a year on an “off label” basis. “I have been very happy with the performance of Radiesse® and find that it lasts on average 1 year versus 6 months for Restylane®. Restylane® is a hylauronic acid, which has had FDA approval for a few years.” Both of these products (Restylane® and Radiesse®) last much longer than the older collagen products, which lasted on average about 3 months.

Carla Moss, Dr. Moss’s wife was one of Dr. Moss’ first patients to be injected with Radiesse®. “I had always liked the results of my Restylane® injections; however I felt that there would be a benefit if the correction could last longer.

Dr. Moss is quick to point out that Radiesse® will not eliminate the use of Restylane®. “Radiesse® cannot be injected into the lips because it forms nodules. Therefore Restylane® will still remain the preferred product for use in lip injections. What I have seen in my practice is that sometimes patients will have both Restylane® and Radiesse® injected at the same appointment. I will inject the syringe of Restylane® into the lips (primarily the vermillion border of the lips) and then inject the Radiesse® into other facial wrinkles such as nasolabial folds or marionette lines.”

Dr. Moss further commented, “Cost is sometimes a factor and we are always sensitive to a patient’s pocketbook. If a patient wants both her lips and her nasolabial folds treated from 1 syringe then it is has to be with Restylane®. However, all patients need to be aware that when you are limiting the number of syringes injected, because of cost, you may also be limiting the quality of the correction/result.”

While Radiesse® should not be injected into the lips; it can be injected into other areas of the face, that Restylane® is not traditionally used. Besides the nasolabial folds and the marionette lines, Radiesse® is an excellent “filler” to smooth out the jaw line or more clearly define a patient’s cheeks. In addition, Dr. Moss has had excellent results in using Radiesse® in the chin area, to strengthen the appearance of a weak chin.

Another area that Radiesse® works well in is the nose. Sometimes the aesthetic appearance of a patient’s nose would be better improved by filling in a defect rather than shaving down an adjoining area or structure. Radiesse® allows the surgeon to accomplish this more easily than surgery. Since it is not permanent it provides the patient the choice of not redoing it if she/he so chooses.

Dr. Moss likes to emphasize that while Radiesse® and Restylane® compete with each other to some extent, they also complement each other. “The more flexibility that I have with these products, the better the result that I can achieve. And the better the result, the happier the patient.”

Another important factor that patients should be aware of is that while Dr. Moss charges $550 for one (1ml) syringe of Restylane® and $750 for one (1.3ml) syringe of Radiesse®, in the end the Radiesse® is less expensive. This is because Radiesse® lasts longer (1 year on average for Radiesse® versus 6 months on average for Restylane®). Additionally the amount injected per syringe is greater: 1.3ml for the Radiesse® versus 1.0ml for the Restylane®.

Dr. Moss personally provides all Radiesse® and Restylane® injections himself. He is also fully trained in “filler injections” as well as the “dental blocks” required to make these treatments more comfortable. Dr. Moss has a 4 Step Process to help make treatments more comfortable.

First Dr. Moss applies a topical anesthetic gel called Benzo-gel to the gums, to numb the gums before injecting the gums with Septocaine®, a Novocain like product (This is the “Dental Block”). To make the treatment even more comfortable, Dr. Moss then applies a 5% lidocaine cream to the areas on the face that he will be injecting with either the Radiesse® or Restylane®. After any filler injection Dr. Moss provides all patients with a frozen gel pack to reduce the swelling.

Dr. Moss injecting a “dental block” before a Radiesse® injection

Having 25 years experience in the field of plastic and cosmetic surgery, Dr. Moss is extremely familiar with the facial anatomy and what lies beneath the skin. “We try to provide the optimal level of care with all the facial injectable treatments,” states an enthusiastic Dr. Moss. “Not only do I perform all treatments personally, but my highly trained staff will always do their best to schedule patients when they want to have their treatments. We even try to fit them in, the day they call, if that is what they want and my schedule can accommodate it.”

Learn More About Cosmetic Injectables in Boston

• Read Information About Radiesse
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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.

Learn More About Cosmetic Injectables in Boston

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