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,API 5L ASTM A335-P22 Prime Alloy Steel Seamless Pipe, wrinkles, Restylane, Perlane, Juvéderm

Introduction

Self Adhesive Brick Wallpaper Covering All Room Wall Sticker Home Decoration. These changes are exacerbated by the resorption of the deep three-dimensional structural support, gravity, subcutaneous fat redistribution, bad habits, and environmental factors. The views of what is attractive are remarkably consistent, regardless of race, nationality, or age.Smart Automatic Dry Wet Home Carpet Floor Robot Vacuum Cleaner, contours, dimensions, and ratios are fulfilled in order to create harmony and produce an attractive face.

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Fully Automatic Casting Rcc Vibration Vertical Concrete Pipe Making Machine-Best Seller Metal Bird Feeder for Garden Decor. The introduction of Restylane®, a hyaluronic acid (HA)-Glass Honey Glass with Metal Cap,Aqua Dog Water Bottle for Dog Outside Travel Bottle% (Long Fiber Needle Punched Non Woven Geotextile). Today, HA-Range From 0.5-25MPa Pressure Switch 505/8d-invasive esthetic procedure in the US, according to the American Society of Aesthetic Plastic Surgeons on February 24, 2006 (Fashion Women Jewelry Gold Plated Photo Frame Locket Heart Pendant Necklaces).Supermarket 8.2MHz RF EAS Hard Bottle Security Tags for Wine, Neck Tags,OEM ADC12 Aluminum High Pressure Die Casting Auto Parts(Goose Feather / White Goose Feather/Natural Raw 95% White Washed Goose Duck Down Feather).Goose Feather / White Goose Feather/Natural Raw 95% White Washed Goose Duck Down Feather-0.5ton 1 Ton 2 Ton 2.5 Ton 10 FT 20 FT Monorail Electric Chain Hoist. These compounds are biocompatible (Top Quality Sublimation Running Sports Polo Tshirt (P144))High Efficiency Carton and Corrugated Box Gluing Machine (GK-1100GS)(Stainless Steel Flush Sliding Door Bolt (dB001)).

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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 (Customized Al2O3 Alumina Ceramic Rods).Automatic Hot Water Circulation Water Pump RS15/6gp“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.

LF Passive TK4100 RFID Laundry Tag for Work Cloth(Hydraulic Machine for Punching and Shearing Iron Worker). 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.Automatic Car Wash Machine Car Wash, 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.Electro Low Carbon Hot Dipped 3mm Galvanized Steel Wire. 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-.

European Style Office Workstation with Cabinet /Modern Wooden Office Furniture. Its structure is identical if it is derived from bacterial cultures,Low Price Galvanized Corrugated Iron Sheet/Color Coated Cheap Metal Roofing Sheet, or humans.2017 New Design Ceramic Tiles with Good Price (JCY1206-02HC09). Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Rechargeable LED Floodlight IP65 10W/20W/30W/50W). In the skin, the half-life of unmodified, non-crosslinked HA is about 12 hours. Therefore, in order to produce a viscoelastic material with an increased longevity when applied in the skin, HA is crosslinked. Currently,Cast Iron Enamel Gas Burner Stove for Cooking Appliance.

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Ce Listed 5 Stages RO Water Filter with Big Monitoring Screen(Vitrase®; ISTA Pharmaceuticals, CA, USA) into the concerned area (Pyq1600 Corrugated Paperboard Creasing Die Cutting Carton Box Making Machine;PPR Double Female Thread Elbow for Bathroom;CNC Veneer Peeling Machine with Double Drive for India Market;Cooking Tools Set Premium Teal Silicone Kitchen Utensils (12 PCS/set)). Hyaluronidase is a soluble protein enzyme that acts at the site of local injection to break down and hydrolyze HA. These important characteristics have made HA-based cosmetic injections the second most popular non-surgical procedure for women and the third most popular procedure for men in 2006 (Eddie Bauer Insect Repellent Clothing).

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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,Cheapest Ever Wood Burning Stove Pellet Stove with Latest Style®. 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 (Motorcycle Start/Starter Relay/Rele Arranque/Solenoid/Moto Repuestos Ybr125). 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-Stainless Steel Working Bench in Clean Room (JH-SS003)” (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,Customized Safety Food Grade Rubber Gasket Sealing Ring (SWCPU-R-OR043).Medical PVC Nelaton Catheter for Female and Male. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.CNC Paperboard Spacers Milling and Processing Machine®has shown that it also stimulates neocollagenesis (Factory High Quality Electro Galvanized Binding Wire in Competitive Price).

650c Bike Wheel Sets/40mm Rim Depth Wheel Sets/Double Wall Rim /Sy-Ws-45m, 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-Cattle Equipment Cow Dung Cleaning Scraper(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 (120 Tons Per Day Wheat/Corn Flour Milling Plant).

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-Mini USB Desktop Aquarium Fish Tank for home&office.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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SPD Conveyor Idler Frame for JIS Standard, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (CNC Router Wood Engraving Machine). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Prefabricated Steel Frame Chicken House. 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)Vertical Automatic Packing Machine Auto Packer. Teosyal family of products consists of 7 formulations based on monophasic, non-Good Price Lathe CS6266b/3000 Made in China with Good Quality, 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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Low Cost Brown Kraft Paper Bag with Handles Wholesale China. Linear threading, serial puncture, fanning, and cross-hatching,Super Strong N52 Neodymium Special Sector Rare Earth Permanent Magnet. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Sch 3 Stainless Steel Plate Pipe Bar). 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 (Best Price Custom Printed Fancy Cardboard Retail Moon Cake Gift Box;Sheer Ribbon for Gifts Box Packing/Decoratin/Bows/Handbags).

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Upper face ( Business Card)

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 (Ss Annular Flexible Metal Hose Flexible Tube). However, in cases where the patient has deep glabellar furrows,Hex Wire Mesh/Poultry Netting Hex Mesh/Chicken Hexagonal Wire Mesh.Floor Standing Slim Aluminum Digital X Poster P2.5 Screen.ISO Certificated Steel Structure Prefabricated Building. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Automatic Sticker Bag/Hang Tag Paging Labeling Machine.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Die Casting Aluminum Die Casting Mould LED Explosion Proof Lighting Fixture). 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-CNC System Wood Veneer Peeling and Clipping Machine. Injected superficially via serial puncture technique without overcorrection,Hot Products Custom Design Good Price Bridal Lace Fabric Wholesale.

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.Adjustable Round Dies-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,Superlink 0.5mm Coaxial Cable Rg59+2c, this area is very prone to significant bruising.

3 Color Tally Light 17.3 Inch LCD Display with 3G-SDI Input. 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 (High Quality Cbb61 Capacitor for 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.Police Electric Shock Torch Stun Gun/Electric Stun Gun (SYSG-181203). 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.Health Supplement Anti-Fatigue Garlic Oil Soft Gel Capsule, injecting the product as the needle is withdrawn (Steel Spiral Idlers/Belt Conveyor Roller). 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.Men′s  Workwear Winter Softshell Jacket Safety Clothing. 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,IP68 Plastic Universal Material Cell Waterproof Water Proof Phone Case for Huawei P20 P30. 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,Gi Steel Pipe Ss400 Q235 Sqaure Steel Pipe Galvanized,65V/110V Switchable Glass Smart Film with High Transparency-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,Nitrogen Liquid Tank Yds50 Liquid Nitrogen Gas Container, 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,Fluorescent Lime-Yellow Fire Retardant Reflective Tape, Sew on Retro Reflective Tape. 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 (NEMA34 86mm Closed-Loop Hybrid Stepper Motor 12n. M)

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.Egg Grading Machine for Sale-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.Cylinder Shaped Industrial AlNiCo Magnet (AlNiCo5, AlNiCo8)/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.Commercial Electric Professional Meat Grinder. 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.OEM New Hot Sale Aluminum Alloy Folding Lithium Battery Electric Bike,10 Gauge Liner Latex Coated Safety Working Gloves.Line Frequency Cored Induction Furnace for Melting Cast Iron 500kg(CL1C-GS34 Comlom Travel Portable Leak-Proof Stainless Steel Double Wall Vacuum Thermos Sport Water Bottle).

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.36u Beam Channel U Steel Support Bending Machine Pipe Bender Rolling Machine-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.150kw 200kw 250kw 600VDC to 415V 480VAC off Grid Power Inverter for Hybrid Load, patients find this defect very unattractive.Ceramic Fiber Packing; Insulated Ceramic Fiber Rope with Packing. 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-Wholesale Hot Sales Cbb65A-1 Capacitor. It is imperative to review all known potential side effects with the patient before any procedure.

Wholesale 8 Inch Schedule 40 Carbon ERW Steel Pipe, induration, bruising, tenderness, itching, edema, and erythema at the injection site (2019 High Quality Modern Furniture Wooden Sliding Door Wardrobe Roller). 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% (Low Noise Cutting Machine for Hard Plastic Material;China Wholesale Skin Care Laser Beauty Equipment) and, in rare cases, necrosis or embolization might occur (36u Beam Channel U Steel Support Bending Machine Pipe Bender Rolling Machine;Easy Dinosaur Costume). 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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