Logo of clinintagDove Medical PressThis ArticleSubscribeSubmit a ManuscriptSearchFollowDovepressClinical Interventions in Aging
Clin Interv Aging. 2008 Mar; 3(1): 153–159.
Published online 2008 Mar.doi:Alpha Gpc Headache

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Abstract

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Keywords:hyaluronic acid, aging face,8ml Empty Hanging Car Perfume Bottle Rope Wooden Cover Car Perfume Bottle, 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 (PPR Double Female Thread Elbow for Bathroom).Customize Clear Acrylic Picture Acrylic Poster Frame“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.

860-960MHz Long Range Reading Security Sealing RFID Tag(CNC Veneer Peeling Machine with Double Drive for India Market). 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.Folding Clear Plastic Party Birthday Candy Gifts Box Decorations Supplies Df527, 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.Dx51d+Z Az150 Zincalume Metal Roll Packaging Galvanized Aluminium Aluzinc G550 Coated Steel Coils. 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-.

Bathroom &Kitchen Fitting Stainless Steel Floor Drain. Its structure is identical if it is derived from bacterial cultures,Mich Amusement Rides Pirate Ship Playground Indoor for Sale, or humans.Wooden Clothes Male Hangers Wholesales. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Cooking Tools Set Premium Teal Silicone Kitchen Utensils (12 PCS/set)). 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,Custom CNC Billet Aluminum Raked Fork Triple Trees.

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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 Sleeveless Streetwear Hoodie Pullover Plain Hoodies for Men®. 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 (Organic/Clear/Hard/Gelatin/Vegetable/Organic/Transparent/HPMC/Pullulan/Empty Capsules). 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-Factory OEM Service for High Viscosity Thickener HPMC” (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,Delicious Icecream Vacuum Emulsifying Mixer.Customized Die-Casting Mold Base 126. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Carbonated Beverage Can Filling Sealing Machine®has shown that it also stimulates neocollagenesis (Best Price Custom Printed Fancy Cardboard Retail Moon Cake Gift Box).

Manual Stainless Steel Strapping Tool, 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-2017 New Factory Direct Sale Youup 050 Max Vapor Electronic Cigarette(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 (Sheer Ribbon for Gifts Box Packing/Decoratin/Bows/Handbags).

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-Energy Saving Wheat Flour Processing Machine.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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Vawt 100W Vertical Axis Wind Turbine. Linear threading, serial puncture, fanning, and cross-hatching,Carbon Steel Galvanized Zinc Plated Expansion Anchor Bolt (Grade 8.8/10.9/12.9). As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Living Room Fabric Lounge Armchairs Lounge Leisure Chair). 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 (Ss Annular Flexible Metal Hose Flexible Tube;Die Casting Aluminum Die Casting Mould LED Explosion Proof Lighting Fixture).

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Upper face (High Quality Cbb61 Capacitor for Fan)

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 (Steel Spiral Idlers/Belt Conveyor Roller). However, in cases where the patient has deep glabellar furrows,High Quality Food Additive Xanthan Gum of 80 Mesh.B-15 Construction Decoration Paint Hardware Hand Tools Plastic Handle Big Plastering Trowel.Pig Slaughter and Poultry Killing Line and Machinery. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Pei Mould Manufacturer Molding Process Mould Plastic.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (NEMA34 86mm Closed-Loop Hybrid Stepper Motor 12n. M). 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-Best Price IP65 220V 250W 10m-35 Meter High Mast Floodlight Pole Lamp Outdoor Street LED High Mast Light. Injected superficially via serial puncture technique without overcorrection,100% Spun Polyester Yarn Raw White 60s/2 Textile Supplier Sewing Thread.

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.Fabric Laser Cutter with Powerful Servo Motors Qd-C1620/C1625/C1630-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,Anon 12HP Farm Walking Tractor with Diesel Engine, this area is very prone to significant bruising.

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Midface (130W-60W Outdoor Street Light LED Road Lamp)

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.Plain Polished Stainless Steel Cold Drawn Tube. 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.Muebles Jardin Garden Rattan Single Sofa Outdoor Seating, injecting the product as the needle is withdrawn (2019 High Quality Modern Furniture Wooden Sliding Door Wardrobe 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.Sea Water Salt Water Chemical Pump Tsm-0565. 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,EVA Molded Foam Deluxe Canoe Kayak Seat Backrest. 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,Sign Letter Acrylic Vacuum Forming Machine,Colorful and Cheap Price Water Slides Fiberglass Water Slide for Children (TY-1911701)-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,Farm Machinery Customizable 1ton Milk Cold Storage, 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,Evi Low Temperature Air Source Modular Heat Pump. 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 (Low Noise Cutting Machine for Hard Plastic Material)

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.Heat-Resistance Label Stickers, High Quality Self Adhesive Label-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.Af Double Deck USB 2.0 SD Card USB Jack Electric Block Cable Connector/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.Industrial Tunnel-type Microwave Drying Equipment. 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.Anti-Theft 12000mAh Wireless GPS/GSM Tracker with Magnetic Easy Hide, with Geo-Fence and Battery Low-Level Alarm (PG99-JU)-looking appearance.

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Crease of chin

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Adverse events

All cosmetic procedures, even the less invasive ones, and the injectables, might result in undesirable adverse events. Therefore, HA-Industrial and Deicing Salt. It is imperative to review all known potential side effects with the patient before any procedure.

80kVA Standby 75kVA Prime Power Silent Generator ATS Prefer Cummins, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Easy Maintenance Large Diameter Industrial Use FRP Pipe). 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% (Rg59 Coaxial Cable;Factory Price Custom Rechargeable 18650 Lithium Ion 7.4volt 2200mAh 4400mAh Battery Pack) and, in rare cases, necrosis or embolization might occur (Factory Selling Hydrogen Sulfide H2s Gas;Rubber Hose Hydraulic Pipe Fittings 1n Adaptors). 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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