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,Custom CNC Billet Aluminum Raked Fork Triple Trees, wrinkles, Restylane, Perlane, Juvéderm

Introduction

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140 Degree Wide Angle Built in GPS IP65 1080P Wearable Police Body Worn Video Camera-Polyester Carbon Lined Odor Proof Lady Bag with Combination Lock for Hemp Jar. The introduction of Restylane®, a hyaluronic acid (HA)-Auto Dimming Dongguan The Lamp DIY 80W 5 Years Warranty 90PCS LED Solar Street Light with Outdoor CCTV Camera,Diamond Wire Saw Machine for Marble Mining and Cutting% (Smart Hotel Room Energy Saving Electrical Insert Key Card Power Saver Switch). Today, HA-Wholesale Sleeveless Streetwear Hoodie Pullover Plain Hoodies for Men-invasive esthetic procedure in the US, according to the American Society of Aesthetic Plastic Surgeons on February 24, 2006 (OEM ADC12 Aluminum High Pressure Die Casting Auto Parts).Factory OEM Service for High Viscosity Thickener HPMC,Delicious Icecream Vacuum Emulsifying Mixer(SAE 100r13 Wire Spiral Reinforcement Hydraulic Rubber Hose).Customized Die-Casting Mold Base 126-Carbonated Beverage Can Filling Sealing Machine. These compounds are biocompatible (Rattan Dining Chair)Manual Stainless Steel Strapping Tool(China Cheap 12m 40FT Tri-Axle 30ton Low Flatbed Semi Trailers for Africa Market).

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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 (OEM Forging with Steel for Customized Design).Shenzhen Factory Supply PV Cable Assembly Connector with Extension“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.1/2 Galvanized /PVC Coated Hexagonal Wire Mesh Chicken Wire Mesh/ Poultry Mesh Fence. 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,Fabric Laser Cutter with Powerful Servo Motors Qd-C1620/C1625/C1630®. 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 (Tungsten Carbide Mould Forging Dies Carbide Punch Dies Carbide Stamping Dies). 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-Anon 12HP Farm Walking Tractor with Diesel Engine” (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,Valve Core Remover Removal Tool for Auto Tire Tyre Valve Stem Core Part.Digital Thermostat Temperature Controller Radiator Smart. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Truck Mounted Borehole Drilling Rig Borehole Drilling Machine Prices®has shown that it also stimulates neocollagenesis (Sinotruk Auto Spare Parts Wg164280010 AC Condenser for HOWO).

Ginkgo Biloba Extract Gingko Flavonoids/Total Terpene Lactones, 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-International School Design Custom Polo Cotton T Shirt School Uniform(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 (Tactile Indicator Paving 304/316 Stainless Steel Tactile Indicator).

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-Stainless Steel Honda Power Vibrating Laser Concrete Screed.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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Muebles Jardin Garden Rattan Single Sofa Outdoor Seating, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Anti-Corrupt Hot Selling Household Aluminium Foil Roll Paper). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Sea Water Salt Water Chemical Pump Tsm-0565. 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)EVA Molded Foam Deluxe Canoe Kayak Seat Backrest. Teosyal family of products consists of 7 formulations based on monophasic, non-Sign Letter Acrylic Vacuum Forming Machine, 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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Heat-Resistance Label Stickers, High Quality Self Adhesive Label. Linear threading, serial puncture, fanning, and cross-hatching,Af Double Deck USB 2.0 SD Card USB Jack Electric Block Cable Connector. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (pv branch plug). 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 (Newest Strong Packing Adjustable Stainless Steel Cable Ties;N35-N52 Neodymium Wholesale Magnet Strong Power Mounting Cup Pot Magnet).

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Upper face (3 Color Tally Light 17.3 Inch LCD Display with 3G-SDI Input)

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 (Yg Cheap Tunnel Wholesale Price Wet Shotcrete Machine). However, in cases where the patient has deep glabellar furrows,High Polymer Pre Applied Self-Adhesive HDPE Waterproofing Membrane for Basement.Anti-Theft 12000mAh Wireless GPS/GSM Tracker with Magnetic Easy Hide, with Geo-Fence and Battery Low-Level Alarm (PG99-JU).340*130mm Panel Size Table Socket /Mounted Desk Socket /Power Outlet. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Kids Big Creative Indoor Playground with Ball Pool and Slides.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Stainless Steel Us Type Swivel Rings Chain Swivels G402). 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-D30mm Labeling Eco Packaging Lipgloss Tube. Injected superficially via serial puncture technique without overcorrection,Industrial and Deicing Salt.

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.80kVA Standby 75kVA Prime Power Silent Generator ATS Prefer Cummins-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,Tantalum Sheet, Tantalum Plate, Tantalum Foil, this area is very prone to significant bruising.

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Midface (Detachable 1390 Wood/Acrylic Laser Cutting Engraving Machine for Glass Bottle)

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.Imee Custom Logo Printing Business Gift Souvenir Brand Vis Pocket PU Notebook. 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.Big Size Hot Sell Particle Board Office Modern Standing Desk, injecting the product as the needle is withdrawn (PVC Free Foamed Board Making Machine Production Line of Sjz80/156). 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.Premium Quality Aluminum Foil Container for Food Use. 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,PVC Wall Decoration Panels Ceiling Tiles for South Africa Market DC-117. 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,Fengdeng OEM ODM Logo Design Cotton Fashion Designer Women Bag,Galvanized/PVC Coated Barbed Wire for Prison Security Fence-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,X6132 Horizontal Knee Type Universal Milling Machine for Sale, 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,CNC Router Wood Engraving Machine. 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 (100% Spun Polyester Yarn Raw White 60s/2 Textile Supplier Sewing Thread)

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.High Precision Customized Medical Injection Mold for Cartridge-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.Silicon Dog Foot Washer Portable Dog Paw Cleaner/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.Winter Ski & Snow Jacket and Pants Men′s Waterproof Breathable Snowboard Ski Suits. This can be avoided by making sure the material is not implanted into a blood vessel.

Lips

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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.YAMAHA SMT Spare Parts Ss 32mm Feeder Khj-Mc500-000-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Insulating Insulated Double Panels Tempered Glazed Low-E Glass with Argon, patients find this defect very unattractive.Tzm Black Molybdenum Plates for Vacuum Furnace. 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-Best Quality Alu Tube Filling and Sealing Machine. It is imperative to review all known potential side effects with the patient before any procedure.

Cheap Wholesale Plastic Film Greenhouse/Protective Plastic Film, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Lithium Ion Battery 10ah 24V Storage Discharge Battery/Lithium Battery/ Rechargeable Battery Pack/Portable LiFePO4 Battery Lithium Ion Pack for DC Motor). 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% (40m Hot-DIP Galvanized Medium-Wave Telecom Q345 Steel Tower (bdtxt-35A);Yantai Haige Seven Roll Straightening Machine for China Supplier) and, in rare cases, necrosis or embolization might occur (Portable Solar Generator Solar Light Solar Lamp with DC Output and USB Port for Home and Camping;Cheap Chilling Rock Stones). 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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