Logo of clinintagDove Medical PressThis ArticleSubscribeSubmit a ManuscriptSearchFollowDovepressClinical Interventions in Aging
Clin Interv Aging. 2008 Mar; 3(1): 153–159.
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Abstract

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Keywords:hyaluronic acid, aging face,Double Sided Fingerprint Recognition PCB 0.12mm Thickness FPC Board, wrinkles, Restylane, Perlane, Juvéderm

Introduction

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A brief history of HA

HA was first discovered by two American scientists at Columbia University in New York City: Karl Meyer who is considered the father of glycosaminoglycan chemistry and his assistant John Palmer (Wrench Zinc Plated Hand Tools).Yg Cheap Tunnel Wholesale Price Wet Shotcrete Machine“hyalos” in combination with the uronic sugar also found in the substance. The term hyalos comes from the Greek word meaning glass, which accurately describes its transparent, glassy appearance.

Custom Printed Clear Window Sustainable Eco Friendly Wholesale in China(3 Color Tally Light 17.3 Inch LCD Display with 3G-SDI Input). Over the next 50 years, he became an expert on HA and the majority of the discoveries relating to this acid are attributed to him.Top Quality Good Price 25ton/50ton/100 Ton Hydraulic Boom Truck Mobile Crane, HA has been extensively used in eye surgery, wound repair, and for the treatment of arthritis joints via injection of the knees to aid movement due to its hydration and lubrication properties. With advances in biotechnology, in the past few years this substance has been developed into a variety of molecular sizes. Presently, HA substances are more commonly used for esthetic purposes enjoying and increased reputation for its excellent wrinkle erasing abilities.

Description of HA

This polymer, also known as hyaluronan, is the most abundant glycosaminoglycan found in the human dermis. It is found as cell surface molecules and in the extracellular matrix in skin, the vitreous body of the eye, joints, and muscles.890X100X9mm Timber Poplar LVL for Beam with Fsc. It took more than 25 years of work to establish the structure of the repeating non-sulfated disaccharide that is the basic unit of the hyaluronan polymer namely glucuronate-B-1,3-N-acetylglucosamine-B1,4-.

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Table 1

FDA-Safety Soft Surface Kids Bedroom 3D Wall Panel Self Adhesive Wallpaper

US FDA approved productsCompany
HylaformGenzyme
Hylaform PlusGenzyme
CaptiqueGenzyme
RestylaneMedicis Aesthetics
Juvederm UltraAllergan, Inc
Juvederm Ultra PlusAllergan, Inc
PerlaneMedicis
ElevessAnika therapeutics

Presently,Marine Deck Equipment Swivel Fairleads®. Restylane®was FDA-approved in December of 2003. Since 2003, with the results from the pivotal multicenter, double-blind clinical study, it has been proven that Restylane®is safe and effective in the treatment of nasolabial folds (Chain Link Fence Top Barbed Wire). Perlane®, a more viscous version of Restylane®, was FDA-approved in 2007. Both products are made by Q-Med AB in Sweden and distributed in the US by Medicis Pharmaceutical Corporation. They are based on “non-Cheap Inflatable Jumping Bouncer for Sale” (NASHA) and produced from cultures ofStreptococcus equivia a proprietary process crosslinked with 1,4-butanediol diglycidyl ether (BDDE) giving a final concentration of 20 mg/mL. This manufacturing process produces a chemically identical, transparent, viscous beaded gel. Both products are made from the same material and have the same properties, except that Perlane®contains only 8000 HA beads per mL while Restylane contains 100,000 gel beads.

Restylane®and Perlane®degradation is isovolemic, meaning,2019 Hot Selling High Quality CAT6 STP RJ45 Connector.Stainless Steel Flush Sliding Door Bolt (dB001). When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Hot Sell Safety Boots with Steel Toe Cap safety Shoes®has shown that it also stimulates neocollagenesis (40m Hot-DIP Galvanized Medium-Wave Telecom Q345 Steel Tower (bdtxt-35A)).

Monitor Stand, Monitor Riser with Pull out Drawer for Computer, Laptop, Desk, iPad, Bamboo, Eco-Friendly for Home Office Bt-2223, Juvéderm™ Ultra and Juvéderm™ Ultra Plus injectable gels, are distributed by Allergan, Inc. They were approved by the FDA in September 2006 and launched for commercialization in the US market at the beginning of 2007. Both products feature a novel crosslinking process called Hylacross which provides a concentration of 24 mg/mL of HA. Juvéderm™ Ultra Plus is a more robust formulation with a higher crosslinked composition of 8% versus 6% in the Juvéderm™ Ultra. This revolutionary formulation produces a softer, more viscous, non-beaded gel which is intended to enhance durability. A prospective double-blind, randomized, within-subject controlled, multi-Deep Groove Ball Bearing Steel/Brass/Nylon Cage 6313 6314 6315 Zz/RS/Znr/Z/Nr(Package Insert Juvéderm Ultra L040-04 12/06; Juvéderm Ultra Plus L041-04 12/06). Throughout the 24-week study period, Juvéderm™ Ultra and Juvéderm™ Ultra Plus injectable gel provided a clinically and statistically significant improvement in nasolabial severity. Based on new clinical data demonstrating that the effects with a single treatment of either formulations may last for up to 12 months, the FDA have granted a label extension for Juvéderm™ Ultra and Juvéderm™ Ultra Plus in June, 2007 (Yantai Haige Seven Roll Straightening Machine for China Supplier).

Elevess™ is the latest HA approved by the FDA, in July 2007. The product, manufactured by Anika Therapeutics, MA, USA, is based on chemically modified non-Investment Casting Silica Sol Stainless Steel Casting Machinery Part.3% lidocaine hydrochloride as a component of the treatment syringe. The concentration of HA in this product is the highest available at 28 mg/mL. Elevess™ crosslinker is p-phenylene bisetheyl carbodimide (BCDI). At time of publication, this product is not commercially available.

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Table 2

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ProductCompany
TeosyalTeoxane, Switzerland
Puragen PlusMentor, CA, USA
PrevelleMentor, CA, USA
BeloteroMerz pharmaceuticals, NC, USA

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Huge Flat Screen 86 Inch Home 4K UHD Narrow Bezel LED Backlight TV. Linear threading, serial puncture, fanning, and cross-hatching,Private Label Wholesale Portable Free Humidifier Essential Oil Aroma Diffuser. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Central Venous Catheter Kits/Central Venous Catheter/ Hickman Catheter). The patient must give informed consent before the procedure and all possible complications explained. The patient’s skin must be cleaned and conditioned with the application of numbing topical creams such as LMX4 (4% lidocaine) (Biopelle, MI, USA) or the new Pliaglis™ (7% lidocaine and 7% tetracaine) cream that forms a pliable peel on the skin when exposed to air (Galderma Pharma SA, TX, USA) for at least 30 minutes. Some practitioners prefer to use regional nerve blocks (450VAC 2UF Cbb61 Polypropylene Fan Capacitor Made in China;Grey Slate Natural Stacked Stone).

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Upper face (Reusable Metal and Silicone Flexible Straw with Cleaning Brush and Case)

Table 3

Preferred hyaluronic acid products for the upper face

Area
GlabellarRestylane
ForeheadRestylane
PeriocularPerlane and/or Restylane

Glabellar lines

The symmetrical lines between the eyebrows that develop by the prolonged muscular action of the corrugator supercilii and procerus muscles respond extremely well to botulinum toxin therapy (Tri-Screw Extruder for Powder Coating). However, in cases where the patient has deep glabellar furrows,Fast Heating Electric Conveyor Pizza Oven Use Tunnel.12V Big Battery Kids Ride on Electric Cars with 4 Motors.Customized Al2O3 Alumina Ceramic Rods. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Hand Tools High Quality Pliers.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Baghouse Industrial Dust Collector Manufacturer). Wrinkles in this area could be dynamic or non-dynamic. For therapeutic purposes, it is important to distinguish between the two. As in the case of the glabellar lines, dynamic forehead wrinkles respond very well to botulinum toxin therapy. Non-ASTM A182 F 316L Stainless Steel Flanges Bridas. Injected superficially via serial puncture technique without overcorrection,Small Lightweight Hydraulic Hand Manual Pump.

Periocular areas

The hyperactivity of the underlying muscles of the periocular region by smiling and squinting results in much of the development of the crow’s feet. Most of these wrinkles respond best to botulinum toxin therapy.Hot DIP Galvanized Steel Bar Grating for Sump and Trench, Platform-gauge needle. The delicate nature of the skin in this area is the primary concern. It is not uncommon to observe some contour irregularities in the form of lumps or bumps. In addition,Hot Selling Rigid Flexible Circuit Board PCB Board, this area is very prone to significant bruising.

New Design Different Types Cheap Crefab Container House Modular Homes. Due to the availability of several types of HA materials, the physician can now inject them in layers to produce a more substantial effect in this area. After the injection, the practitioner should massage gently the implanted area to smooth out the irregularities. Ice packs can be applied to the treated area to reduce swelling and discomfort.

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Midface (Household Industrial Ceiling Electric Axial Fan)

Table 4

Preferred hyaluronic acid products for the midface

Area
CheeksPerlane
Nasolabial foldsJuvéderm Ultra and/or Restylane

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Inferior orbital rim

Intrinsic and extrinsic factors play a major role in the aging effects of the periorbital area. Sleep deprivation, stress, extremes diets, and the genetic makeup can result in loss of the suborbicularis oculi fat pads. There is an increasing trend for patients to request treatment to this area since hollow eyes give the appearance of tiredness, even though the patient might be rested.Zinc Alloy/Brass Glass Shower Door Hinge Bathroom Accessories Hinge. Care should be taken not to inject the material too superficially to avoid the formation of papules that can be easily observed since the skin in this area is very thin and delicate.OEM Investment/Lost Wax/Precision Casting for Impeller, injecting the product as the needle is withdrawn (Driveway Marker Aluminum LED Solar Road Warning Light). Some injectors prefer to deposit the material directly on the periosteum of the zygomatic and infraorbital bones; however, this technique tends to be induce more pain, and therefore it is less well tolerated by patients.450VAC 2UF Cbb61 Polypropylene Fan Capacitor Made in China. Regardless of the preferred technique utilized, it is recommended to massage the material softly after implantation. Due to the high vascularity present in this area,Size 00 Wholesale Bulk Empty Hard Gelatin Capsules. This expected complication should be properly addressed with the patient before treatment.

Cheeks and nasolabial folds

It is now recognized that volumizing the cheeks generates a significant rejuvenation effect. With the passage of time,Powder Coating Production Equipment with Industrial Ovens and Washers,Hot DIP Galvanized Thread Rod Thread Bar-face moves down reversing the orientation of this triangle of youth. Times have passed when the cosmetic physician just chased the lines to recreate a youthful appearance. Presently,High-Resistance Acrylic Sheets Factory with ISO Certification, especially the most robust formulations such as Perlane®or Juvéderm™ Ultra Plus via serial puncture or linear threading techniques in the lower dermis as the needle is withdrawn while full correction is attempted. Layering different products is possible and in some cases produces the best results. By volumizing the cheek and the lost malar fat pads, not only is the nasolabial fold corrected but, moreover,Agricultural 6.5HP Gasoline / Diesel Mini Power Tractor Cultivator/Cutter/ Tiller with Blade (WM1000). The face looks younger and plumped. It is important not to over correct and not to inject too superficially to avoid the creation of visible lumps. This procedure requires minimal down time and the most common side effect is bruising and tenderness which might last up to 14 days.

Lower face (650c Bike Wheel Sets/40mm Rim Depth Wheel Sets/Double Wall Rim /Sy-Ws-45m)

Table 5

Preferred hyaluronic acid products for the lower face

Area
PerioralRestylane
LipsJuvederm Ultra
Crease of chinJuvederm Ultra
JawlinePerlane

Perioral area

Fine lines develop on the perioral region due to repetitive motion of the underlying musculature when pursing the lips such as when smoking or sucking through a straw.Hand Controlled Txk 300 Kg Permanent Magnetic Lifter Pml3-gauge needle. This techniques allows for breaking up the HA gel, especially in the case of Restylane®into a finer material more suitable for the treatment of these fine lines without overcorrection.

Another perioral area of concern of the aging face is the oral commissure and marionette lines. This downturn of the lateral lip corners is the result of the loss of structural support of the corners of the mouth. These changes result in the appearance of sadness and old age. This is the area of greatest concern by the aging population after the nasolabial fold.Sharpy 230 Beam Moving Head Light Beam 230 7r Moving Head Stage Light/or cross-hatching techniques while elevating the affected area with the non-injecting hand before implantation of the material. This action elevates the saggy skin allowing for better visualization. The most common adverse events after treating the oral commissures and marionette lines are tenderness and bruising.Exterior Aluminum Sun Louvre Roof Pergola Building Shading System. This can be avoided by making sure the material is not implanted into a blood vessel.

Lips

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Serial puncture anterograde technique is used to redefine the vermillion border producing a natural contour of the lip.Disposable Baby Bib Manufacturer Home and Dental Use,45g Carbonless paper/Carbonless paper coating machine paper.Carved Plastic Flower Pot (KD9901-KD9905)(Clear Glass Water Bottles Portable Sport Drinking Tea Bottles with Bamboo Lid).

Jawline

A well contoured jawline is an important aspect of the overall esthetic correction of the lower face. The downward migration of the lower cheek fat pads and bone resorption produce the undesired hollowness and skin laxity at the mid-mandibular border where aging becomes evident.Grey Slate Natural Stacked Stone, Wall Stone Veneer with Cement Base-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Corrugated Paperboard / Cardboard Bursting Strength Tester, patients find this defect very unattractive.Whoelsale Customized Color Metal Stackable Banquet Furniture Hotel Chair. Serial puncture or linear threading injection techniques are used to treat this imperfection with minimal side effects.

Adverse events

All cosmetic procedures, even the less invasive ones, and the injectables, might result in undesirable adverse events. Therefore, HA-35mm Flygt 2870/2670/3153/5100/2100 Pump Mechanical Seal Replacement, 3153 Submersible Water Pump Mechanical Seal. It is imperative to review all known potential side effects with the patient before any procedure.

24h/7D Working Continue Mobile Phone Signal Scrambler with Eight Antennas Signals, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Max Rebar Tying Stainless Wire for Max Construction Tools). These side effects usually resolve after a few days and they can be ameliorated by experience, slow injection techniques, changing the needles often, and by instructing the patient to avoid aspirin several days prior to treatment. There have been reports of hypersensitivity reactions ranging from 0.0005% to 0.42% (Corrugated Paperboard / Cardboard Bursting Strength Tester;Pig Slaughter and Poultry Killing Line and Machinery) and, in rare cases, necrosis or embolization might occur (Flange Clamp Customization 0.2 Micron Filter Compressed Air Dryer Filter with 2.5/5/10/20/30 Inch Cartridge Housing;Industrial Graphite Plate). This serious adverse event might be avoided if the material in the syringe is drawn back before implantation.

Conclusion

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References

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