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									            RHINOPLASTY




Model

    RICHARD A. MOSS,   MD


  The focus is
        You
                  Model




 RICHARD A. MOSS, MD

Exemplary
   Care
                                                                       CONTENTS


Welcome ............................................................................................................... 3

Goals of the Surgery ........................................................................................ 5

Computer Morphing ......................................................................................... 9

Before & After ...................................................................................................11

Anesthesia and Pain Control .......................................................................13

Consultation .......................................................................................................15

Costs & Payment Options ............................................................................17

Preoperative Visit .............................................................................................19

Your Surger y ......................................................................................................21

Your Recovery ...................................................................................................23

Beautiful Results ...............................................................................................24

About Dr. Moss ................................................................................ back cover


All before and after photos are actual patients of Dr. Moss.




                                                                                                                       1
                 Model

 RICHARD A. MOSS, MD

Enhanced
Beauty
                                          WELCOME

Rhinoplasty (surgery of the nose) is one of the most popular
cosmetic procedures. Small changes in the appearance of the
nose can make a big difference in facial attractiveness and
self-esteem. We often find that after surgery, patients will pay
more attention to their appearance and spend more time on
hair styling, facial makeup and clothing because of increased
self-confidence.

When considering whether you need a rhinoplasty, it is
important to realize that other people see you from the side
as much as from the front. You may find that you only look
at yourself straight on because this is the only view that you
find attractive. But if your nose is large or has a bump or hook
when viewed from the side, that is all people might see.

The goal of a successful rhinoplasty is that no longer does
everyone just see your nose when they look at your face. We
often find the eyes and mouth become more complimentary
to the nose after rhinoplasty. Some patients may even choose
to enhance their other features after rhinoplasty with products
such as Latisse® for eyelash enhancement or even have their
lips plumped with a filler like Juvederm®.

Many of our rhinoplasty patients are young women. Before
surgery they will express concern about their appearance and
will often be self-conscious about their nose. Dr. Moss and
staff frequently find that these patients smile more and have
more self-confidence after surgery.

Rhinoplasty is also popular with older patients who may
have thought about changing the shape of their nose for
years. Sometimes finances have held them back, sometimes
uncertainty. It’s not too late for renewed self-esteem.

Men as well as women can benefit from rhinoplasty. The goals
of the surgery are always tailored to make the appearance of
the patient’s nose fit the patient’s face, so the desired effect
for a man will be different than that for a woman.

If you are unhappy with the appearance of your nose,
this brochure will provide you with some information on
rhinoplasty surgery. A consultation with Dr. Moss will further
educate you with his suggestion for realistic and desirable
goals of the surgery.
                                                                   3
                  Model




 RICHARD A. MOSS, MD

Your
 Choice
GOALS OF THE SURGERY


By far the most common goal for a patient who wishes
to have a change in the appearance of their nose is to
reduce the “bump” seen in profile. The bump can be
relatively small in which case simple rasping or shaving
down the car tilage is usually adequate. If however, the
bump is quite large, cutting off the bump is required.
Then breaking the nasal bones would also be necessar y
in order to smooth over the edges. In both cases, power
tools are used to polish the bone’s edges to make it as
smooth as possible.




When the goals of the surger y are primarily confined
to the bump, then usually no external nasal incisions are
required. All incisions are made within the nostrils and
are not visible.




                  Model

                                                        5
         GOALS OF THE SURGERY




  Another common goal of patients seeking nose surger y is
  to have the tip of their nose refined. This usually involves
  making it smaller, narrower, lifted, or more refined in
  shape. Sometimes this is the entire goal of the surger y,
  and patients refer to this as having their nose “bobbed.”
  Whether this is done alone or in conjunction with other
  surgeries of the nose, it is best accomplished through
  an open rhinoplasty approach. An open rhinoplasty uses
  an external incision across the base of the columella or
  dividing structure of the nose. This provides much better
  exposure of the underlying anatomy and allows the
  surgeon to be more accurate in addressing the changes he
  wishes to make. Although this does produce a scar, it is, in
  the vast majority of cases, not a concern for the patient.
Before




                             After




  6
                    One month after surgery. Scar will fade with time.
  Sometimes the goal may require narrowing of the
  nostrils. Within limits, this can be accomplished with
  external incisions, known as Weir excisions, along the
  base of the nose. The scars are well hidden in the
  natural creases of the nose. If this is the only goal of
  the surger y it could be done in the office with local
  anesthesia (you’re awake).

  In the consultation, Dr. Moss will ask each rhinoplasty
  patient what she/he is looking to achieve. With the
  use of computer morphing he will visually demonstrate
  what might be achieved during rhinoplasty surger y.
  This way the patient can better decide whether
  she/he finds these achievable results acceptable.
Before




                                After




                                                                         7
Model

        RICHARD A. MOSS, MD

 Digital
Imaging
                  COMPUTER MORPHING

   Computer morphing (sometimes called digital imaging) is
   an invaluable tool that allows Dr. Moss to alter (morph) the
   image of a patient’s anatomy using computer software. It
   is par ticularly useful in rhinoplasty in evaluating the profile
   view. It is essential to understand that the morphed images
   do not represent a guarantee, either actual or implied, of
   what the final result will be. Rather it is best used to help
   you and Dr. Moss during your consultation, establish before
   the surger y what the goals should be.

   It is not uncommon that during the morphing process, the
   patient will change the scope or extent of the planned
   surgery because he/she can now graphically see how
   those changes would alter his/her appearance. Dr. Moss
   performs the morphing not only at the initial consultation
   but also at the preoperative visit. Dr. Moss sometimes finds
   that patients will alter the goals of their surgery at their
   preoperative visit because they have had time to think
   about their options visually. Computer morphing definitely
   improves communication between a patient and surgeon
   in establishing what a patient would like to achieve with
   rhinoplasty surgery.

   Some patients who have what is referred to as an aquiline
   (hooked) nose, also have a recessed chin. These patients
   often miss the fact that their chin is recessed. These patients
   are so focused on and unhappy with their nose, that they
   fail to see that their chin is also out of propor tion. With the
   use of computer morphing, Dr. Moss is able to demonstrate
   how a chin implant would improve their appearance. Often
   these patients then decide to add a chin implant to their
   surger y, because they like the improvement it produces.
Before Morphing




                               After Morphing




                                  Same image after computer morphing
                                                                       9
Model

        RICHARD A. MOSS, MD

  Features
Refined
         BEFORE & AFTER
Before




               After

         Patient had chin implant in addition to rhinoplasty.
Before




               After
Before




              After
Before




              After




                                                            11
Model

        RICHARD A. MOSS, MD

  Your
Comfort
  ANESTHESIA AND
           PAIN CONTROL

 Dr. Moss performs all of his rhinoplasty surgeries in
 a hospital setting and utilizes only board-cer tified
 anesthesiologists. General anesthesia (you are asleep) is used
 for all rhinoplasties to provide for patient comfor t. You will
 have either a telephone or in-hospital anesthesia consult
 prior to having your surgery. You will also meet with your
 anesthesiologist both before and after surgery.

 Anesthesia has undergone a remarkable increase in patient
 safety over the last 25 years, and new standards are
 continually being developed. These standards along with
 today’s sophisticated equipment, improved medications
 and techniques, have contributed enormously to making
 anesthesia safer than ever. In addition, Dr. Moss coordinates
 with the anesthesiologist your medications to minimize
 postoperative nausea.

 Dr. Moss provides all patients with a narcotic for
 postoperative pain. Most patients are surprised at how
 little pain they have after rhinoplasty surger y. Dr. Moss
 finds that often patients are taking only ver y small doses of
 their narcotic or just extra-strength Tylenol by the next day
 when they return for their first postoperative visit.
Before




                             After
Before




                             After




                                                            13
 RICHARD A. MOSS, MD

Desired
                            C O N S U LTAT I O N

Dr. Moss provides a very thorough and complete
consultation for those patients contemplating rhinoplasty.
During your consultation, Dr. Moss will examine you in
order to determine what might be accomplished for your
specific situation. Rhinoplasty patients often have options
concerning both goals of the surgery and surgical approach.
If this is the case, Dr. Moss will discuss what choices you
have together with their advantages and disadvantages.

Dr. Moss will take the time to answer any questions and
address your specific goals. Dr. Moss will also explain the
details of the surgical procedure. He will discuss how the
surgery is performed and what you can expect if you go
forward with surgery. He will also show you many examples
of patients using before and after pictures.

A large par t of the rhinoplasty consultation involves
computer morphing. Dr. Moss will first take your
photograph digitally and transfer it to his computer.
With special cosmetic surgery software, he will be able
to make various changes in the shape of your nose in the
photograph. This way you will be able to realistically see
what Dr. Moss is suggesting to help establish the goals
of the surgery. Morphing is best used as a method of
establishing the goals of the surgery and should NOT be
viewed as a guarantee of the final result.

We find that many patients are very excited about the
anticipation of improving the appearance of their nose. We
also find that some patients may be nervous because “it is
surger y” or “it’s my face.” Rest assured that Dr. Moss will try
to put you at ease and give you the information you need.

You will be given the oppor tunity to star t the scheduling
process after your consultation. Carla and staff will review
what surgical dates are available and discuss what hospital
might best suit your needs. You are also welcome to go
home and think about your procedure, before making
your decision. Whatever choice you make, you will have
the necessar y information to make the decision that is
right for you.

                                                             15
Model

        RICHARD A. MOSS, MD

  Personalized
C O S T S & PAY M E N T O P T I O N S


 Dr. Moss provides flexibility on how you would like to
 pay for your surgery. He accepts all major credit cards
 (American Express, Discover, MasterCard, and Visa) as well
 as personal checks, bank checks and cash. You may also
 finance all or par t of your surgery through CareCredit®.
 Patients who choose the finance plan must be approved by
 CareCredit®. The approval process is very simple and can
 be accomplished online at www.carecredit.com.

 Dr. Moss has very attractive pricing for his rhinoplasty
 patients. His staff will be happy to discuss pricing over
 the phone. Dr. Moss provides approximate pricing for all
 surgeries on his website www.drmossthebeautyboss.com.
 Once Dr. Moss has examined you at your consultation, a
 written quote will be provided. Dr. Moss’ rhinoplasty
 pricing includes the following:

 • Dr. Moss’ surgical fee (includes all preoperative and
   postoperative visits)
 • Operating room and recovery room fee
 • Anesthesia fee

 You will be required to make a $250 (non-refundable)
 deposit to schedule surgery. The $250 deposit is included
 in the overall price that you have been quoted. The deposit
 for this surgery is required before Dr. Moss’ time for
 surgery can be reserved. The balance is collected at the
 preoperative visit two weeks before the surgery. Dr. Moss’
 staff will also collect fees for the hospital and anesthesia at
 the preoperative visit. Dr. Moss has found that this is the
 most convenient way for patients to make their payments.
Before




                              After




                                                             17
                 Model


 RICHARD A. MOSS, MD

Thorough

  Care
              PREOPERATIVE VISIT


 Dr. Moss provides all patients with a very thorough
 preoperative visit. This visit usually takes one to two hours.
 It is intended to ensure that you have an understanding
 about all instructions concerning your upcoming surgery.
 The following will take place:

 • Goals of the surgery reviewed
 • A final computer morphing session
 • Any and all remaining patient questions answered
 • Prescriptions and instructions provided
 • Pre- and postoperative instructions reviewed
 • Hospital arrival time discussed
 • Directions to hospital provided
 • Postoperative appointment scheduled
 • Preoperative pictures taken
 • Consent forms signed
 • All remaining monies collected (including hospital
   and anesthesia)
Before




                               After
Before




                               After




                                                             19
 RICHARD A. MOSS, MD

Compassionate
                              YOUR SURGERY


 The big day has arrived. If you feel a little nervous, this is
 normal. Dr. Moss can even provide you with a mild tranquilizer
 for anxiety at your preoperative visit for the night before
 surgery if you feel it is necessary. However, you can feel
 confident that you have chosen a plastic surgeon with over 27
 years of experience who has performed many rhinoplasties. In
 addition to being board certified in Plastic Surgery, Dr. Moss is
 also board certified in Ear, Nose and Throat.

 Dr. Moss will meet you in the morning at the hospital before
 your surgery. You will find that the doctor and hospital staff are
 very compassionate, experienced, skilled and sensitive to your
 needs. Most rhinoplasties take approximately 1-2 hours for Dr.
 Moss to perform. You will be spending another 1-2 hours in
 the recovery room before being allowed to go home.

 The person who is providing you transportation to and from
 the hospital will be allowed to wait for you at the hospital or
 they may leave and come back to pick you up when you are
 discharged. Dr. Moss will also want someone to be with you
 when you return home, as well as the next day. You should
 make arrangements so that you are not alone at these times.
Before




                               After
Before




                               After




                                                                21
Model

        RICHARD A. MOSS, MD

 What to
                           YOUR RECOVERY

 Most patients are in the hospital recovery room for about two
 hours before they are ready to be discharged home. You will
 have a cast on your nose and a small dressing beneath your
 nostrils. Once home, you will be asked to use cool compresses
 about your eyes to reduce swelling and bruising. It surprises
 most patients how little pain they have.

 All patients see Dr. Moss the day after surgery. The primary
 purpose of that visit is to ensure that everything is as it should
 be and to answer any questions you might have. If you had
 an open rhinoplasty, your next visit with Dr. Moss will be in
 about four days to remove sutures (which doesn’t hurt) and
 to remove the cast. If you had a closed rhinoplasty, then suture
 removal is not necessary, and the cast would be removed in
 about a week.

 At this point your nose will be noticeably swollen, and it usually
 takes about 10 to 14 days before the swelling and bruising have
 subsided to be almost unnoticeable. It must be emphasized
 that your nose has NOT reached its final result, as this normally
 takes one year. It is also important for you to understand that
 your nose will change in shape as you get older in the same way
 that it would even if you did not have rhinoplasty.
Before




                                After
Before




                                After




                                                                  23
                B E A U T I F U L R E S U LT S


 A young girl walks into Dr. Moss’ office with a bashful smile,
 but the impression is clear ; she is happy and confident. Her
 mother and father accompany her, and they tell us how
 pleased they are with their daughter’s surgery. The father
 reiterates how he did not understand before surgery why
 his daughter wanted the procedure, but now he does.

 Another young lady comes for a one-year follow-up
 appointment, her last. We have not seen her for 6 months
 during which time she has become more mature and
 self-confident, completing a successful year at college.
 Her mom is with her and both are ver y pleased with the
 daughter’s results.

 In both these real life situations, rhinoplasty had greatly
 improved not only the facial appearance of each patient,
 but their self-esteem as well. Both had lovely eyes and
 full lips but, on profile, all that had been noticeable
 was a large nose with a bump. Now each patient has a
 nose that compliments her face, allowing the rest of her
 beautiful features to become more apparent and her
 confidence to shine.

 Male or female, no matter your age, if you would like
 to explore your options for rhinoplasty, call us at
 508-747-1322 or 781-337-2421 to schedule an
 appointment. Consultations are available on Saturday as
 well as Monday through Friday.
Before




                             After




 24
Models

     RICHARD A. MOSS, MD

 Confident
                           ABOUT DR. MOSS


                       Dr. Richard Moss received his M.D. degree from
                       University of Miami Medical School. Prior to
                       entering medical school, Dr. Moss completed
                       his Ph.D. in Aerospace Science at Princeton
                       University and taught at M.I.T. Practicing since
                       1983, Dr. Moss is board certified in both Plastic
                       Surgery and Otolaryngology.

Currently, Dr. Moss is in private practice, specializing in cosmetic
surger y. In addition to being a former clinical instructor at
Har vard Medical School, Dr. Moss maintains memberships with
several professional societies. He is an active member of the
following organizations:

• American Society of Plastic Surgeons
• Massachusetts Medical Society
• Massachusetts Society of Plastic Surgeons



                       Dr. Moss’ wife and practice manager Carla
                       is an invaluable asset to the team, assisting
                       patients in many ways including answering
                       general patient questions and financing and
                       scheduling options.




            110 Long Pond Road, Suite 201
            Long Pond Medical Building
            Plymouth, MA 02360
            508.747.1322
            781.337.2421
            www.drmossthebeautyboss.com

								
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