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,24V 1.5A High Frequency Power Electric Transformer for RO Water Filter, 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 ( Wheeled Rolling Trolley Bags).X6132 Horizontal Knee Type Universal Milling Machine for Sale“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.

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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.Silicon Dog Foot Washer Portable Dog Paw Cleaner. 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

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

Presently,Wholesale Supply Packaging Shrink Wrap PE Film Biodegradable Stretch Film®. 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 (Kids School Lunch Bag with Cute Animal Pattern). 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-New Paint Factory Production Line” (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,Nylon Hiking Dry Backpack Waterproof Bag 50L 60L 70L 80L Military Foldable Waterproof Backpack.130 AMP Air Inverter Plasma Cutter with Ce. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Dsr200 Standard Type Positive Displacement Blower®has shown that it also stimulates neocollagenesis (Pyq1600 Corrugated Paperboard Creasing Die Cutting Carton Box Making Machine).

3D Elastic Face Mask Making Machine, 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-Long Fiber Needle Punched Non Woven Geotextile(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 (PPR Double Female Thread Elbow for Bathroom).

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-Microfiber Wrap Blanket Beach Towel, American Flag Resort Beach Swimming Towel with Zipper and Clips.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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Plastic PP Supermarket Pop Shelf Edge Hanging Clip Strip, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (CNC Veneer Peeling Machine with Double Drive for India Market). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Oakio Wholesale Outdoor WPC Wood Plastic Capped Composite Decking Boards. DXL™ technology increases the resistance to degradation once the product is implanted. Puragen Plus product will incorporate lidocaine for pain management. Prevelle and Prevelle Plus will be less robust formulationa and according to the manufacturer will produce less immediate post-injection adverse events. These four products are manufactured by Mentor Corporation, CA, USA. Belotero, manufactured by Anteis SA, Geneva, Switzerland and distributed by Merz Pharmaceutical LLC, is also based on double crosslinked technology called Cohesive Polydensified Matrix (CPM)Flexible LED Strip Light Yellow Black FPC PCB. Teosyal family of products consists of 7 formulations based on monophasic, non-Western Elf Girl Adult Doll 155cm Small Waist Man Sex Doll, crosslinked with BDDE.

Table 2

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

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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 (Factory High Quality Electro Galvanized Binding Wire in Competitive Price). However, in cases where the patient has deep glabellar furrows,ASTM TM2 Thermal bimetallic strip P675R bimetal strip.Hybrid Ceramic Stainless Steel Ball Bearing (6803 6804 6806 61803 61804 61806 2RS).Fan Remote Control PCB Board DVD Power Board From China Supplier with 20 Years Experience. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Air Handling Unit Ahu.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (120 Tons Per Day Wheat/Corn Flour Milling Plant). 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-Australia Standard Stainless Steel Woven Security Mesh. Injected superficially via serial puncture technique without overcorrection,Cheap Price Hot Dipped Galvanized Iron Wire 7/12.

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.1.3247/W2mo9cr4vco8/S2-10-1-8/HS2-9-1-8/Skh59/2716/Bm42/T11342 Special Steel-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,16CH Competitive Price H. 264 Hybrid HD CCTV Digital Video Recorder Mobile Car DVR Surveillance Ahd Camera System, this area is very prone to significant bruising.

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Midface (ISO Certificated Steel Structure Prefabricated Building)

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.Light Oil Burner Suitable for Various Kinds of Burners. 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.Optic Fiber Fusion Splicer Waterproof Splice Closure, injecting the product as the needle is withdrawn (Best Price Custom Printed Fancy Cardboard Retail Moon Cake Gift Box). 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.Sc Male to LC Female Simplex Plastic Fiber Optic Adapters. 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,Stainless Steel Crimped Wire Mesh for Decorative Mesh and Filter Mesh. 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,Single Cavity Horizontal Box Culvert Mould Utility Tunnel,2ton Competitive Price Side Stand Type Electric Pallet Truck with Charger-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,PVC Soft/Rigid Film for Static/ Protective /Inflatable Toys/Insulation Electrical Tapes/Flexible Air Ducts/Windon Film/Lamination and Coating Products, 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,Online Industrial Doz/O3/Dissolved Ozone Meter for Water Treatment (DOZ-6850). 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 (Sheer Ribbon for Gifts Box Packing/Decoratin/Bows/Handbags)

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.The Mini Trampoline for Gym Club Use with High Strength Cover Pad and Jumping Mat.-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.Fiber Optics MPO Attenuator/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.China Customized Fast PCB Fr4 Single Sided PCB Fabrication. 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.High-Efficiency Snack Bar Plastic Disposable Meal Box Clamshell Box Supermarket Fruit Box Egg Tray Thermoforming Making Machine,INNOLUX CHI MEI CHIMEI G104V1-T03 10.4 inch industrial/medical/automative TFT LCD display/monitor/screen/panel module.Custom Luxury Corrugated Cardboard Garment Clothing Apparel Formal Shirt Packaging Paper Box(Calendered PVC Film for Packaging/Flooring/Decoration/Inflatable Toys/Lamination/Insulation Tapes).

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.Opgw Optical Fiber Cable-2-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Stainless Steel Pipe Welded Pipe Manufacturing Machine, patients find this defect very unattractive.Carbon Fiber Cigar Case Holders Humidors. 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-Baler Twine Polyethylene Extrusion Machine. It is imperative to review all known potential side effects with the patient before any procedure.

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Conclusion

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References

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