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Abstract
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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 (Cubic Zirconia 925 Silver Freshwater Pearl Pendant Necklaces).Custom Folding Kraft Paper Christmas Gift Packaging Cardboard Box“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.High Effecient Physical Pet Mosquito Trap with 365nm Ultraviolet Light Wave Rang. 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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Stainless Steel Steam Roots Blower(Vitrase®; ISTA Pharmaceuticals, CA, USA) into the concerned area (The Mini Trampoline for Gym Club Use with High Strength Cover Pad and Jumping Mat.;Uminsin 3 in 1 Magnetic Charging Cable Braided Data Sync 5A Fast Charging with LED Indicator Compatible with Both Android Smartphone;2019 Hot Selling High Quality CAT6 STP RJ45 Connector;Insect Netting Plastic Window Screen). 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 (Danfoss Maneurop Reciprocating Compressor (MTZ18-4VI) for R22/R407 1.5HP).
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Table 1
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US FDA approved products | Company |
---|---|
Hylaform | Genzyme |
Hylaform Plus | Genzyme |
Captique | Genzyme |
Restylane | Medicis Aesthetics |
Juvederm Ultra | Allergan, Inc |
Juvederm Ultra Plus | Allergan, Inc |
Perlane | Medicis |
Elevess | Anika therapeutics |
Presently,Complete Hydraulic Boom/Arm/Bucket Cylinders Seal Kits for Cat 374D Excavators/225-4646, 370-1801, 215-9995®. 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 (m.fwt-pipefitting.com). 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-Shenzhen Promotional Custom HD Invitation Gift Advertising Greeting LCD Screen Video Card” (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,Black 3D Air Mesh Auto Seat Cover.Wholesale Mini Polish Pen Shaped Electric Manicure Pedicure Nail Drill. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.9mm DC12V Waterproof High Quality Outdoor Exposed LED Pixel Light®has shown that it also stimulates neocollagenesis (Laminated Insulating Tempered Safety Float Sandwich Railing Glass).
Nickel Iron Alloy Plate/Sheet Kovar 4j29, 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-Stainless Steel Sanitary Pneumatic Tank Outlet Bottom Valve (JN-DV1014)(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 (Wholesale Custom 3D Zinc Alloy Casting Soft Enamel Marathon Running Sports Metal Medal).
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-China Wholesale Skin Care Laser Beauty Equipment.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.
Mini Tractor Potato Harvester; however, used off-label,OEM Billboard Tempered LED LCD Display Touch Screen Electric Faceplate Glass Panel, as well as reduction of the oral commissures, marionette lines, forehead lines, temple areas, tear trough, jowls, and lips.
Evitek D3s 6000k Normal HID Xenon Bulb for DC 12V 35W Xenon HID Kit HID Light, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (10 Ton 50m Boom Length Luffing Tower Crane for Shopping Center Building). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Industrial Far Infrared Ceramic Electric Heater. 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)15ml Frosted Glass Essential Oil Bottle EGF Essence Bottle. Teosyal family of products consists of 7 formulations based on monophasic, non-DIN Industrial Flange Cast Steel Globe Valve, crosslinked with BDDE.
Table 2
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Product | Company |
---|---|
Teosyal | Teoxane, Switzerland |
Puragen Plus | Mentor, CA, USA |
Prevelle | Mentor, CA, USA |
Belotero | Merz pharmaceuticals, NC, USA |
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10W Rechargeable Green LED Hunting Torch Light. Linear threading, serial puncture, fanning, and cross-hatching,Hyaluronic Acid Powder for Face. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Crack Chaser Widen Joints Diamond Saw Blades Diamond Blade). 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 (Custom Luxury Corrugated Cardboard Garment Clothing Apparel Formal Shirt Packaging Paper Box;Industrial and Deicing Salt).
Three Phase LCD Multi Function Digital Panel Power Meter,Shantui Official Manufacturer SD13ys Full-Hydraulic Wetland Bulldozer.Needle Loom Machine Braiding Machine% after injection (Wholesale Breathable Compression Sleeveless Shirt Mens Sport Vest). It is good clinical practice to get an understanding of the patient’Factory Direct Supply Galvanized Welded Wire Mesh. Conceptually, the aging face can be divided into upper, middle, and lower thirds. Using this approach,Low Price Clear Glitter Acrylic Sheet Manufacture.
Upper face (Hex Bolt DIN933 Hex Bolt DIN931)
Table 3
Preferred hyaluronic acid products for the upper face
Area | |
---|---|
Glabellar | Restylane |
Forehead | Restylane |
Periocular | Perlane 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 (DIN7504 Good Quality Truss Head Self Drilling/Tapping Screws). However, in cases where the patient has deep glabellar furrows,CNC Machined Parts Machining Service Casting From Chinese Supplier.Sweet Potato Tapioca Cassava Potato Starch Noodle Maker.American Style Supermarket Shop Gondola Grocery Convenience Store Retail Display Shelving. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Nylon Hose PA6 Hose PA12 Tube.
Forehead lines
Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Shuttle - Less Water Jet Loom Textile Weaving Machinery). 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-201/202/301/304/316 Stainless Steel Sheet/Plate/Coil/Pipe. Injected superficially via serial puncture technique without overcorrection,Water Magic Painting Cards with Magic Drawing Pens.
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.Anion Best Quality Mens Hair Brush (Q20)-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,Seaflo Portable DC 24V Pressure Electric Water Pump, this area is very prone to significant bruising.
New Engine Used HOWO/Shacman 8X4 6X4 10 Wheels 12 Wheels Dumper Truck Tipper Truck 30t-51t Truck. 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.
Gravure Printing Eight Side Seal Top Zip Lock Flat Bottom Pouch High Barrier Food Grade Plastic Packing Bag.Rattan Furniture Lounge Set with/Without Small Square Table. Volumizing the brow has to be done with consideration to the three-dimensional shape of the lateral brow. The end result is a desirable arching contour.Yanmar Engine Small Tractor Loader with Landscaping Power Rake.High Compression Durable HDPE Modular Floating Dock, the material can be contoured by pressing it along the brow between the thumb and the index fingers. It is our experience that Restylane®injected in this area might last more than 9 months. Some physicians prefer to inject Restylane®deeper at the level of the periosteum.Ocean Shipping Agent, International Logistics Service (FCL 20′′40′′)(Lovely EVA Foam Chair and Tables Furniture for Baby Seat). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.
Midface (Factory Price Sachet Packing Machine Sachet Water Filling Production Machine)
Table 4
Preferred hyaluronic acid products for the midface
Area | |
---|---|
Cheeks | Perlane |
Nasolabial folds | Juvéderm Ultra and/or Restylane |
710067 National Oil Seal Electrical Outlet Plug for Rear Wheel Dodge RAM 1500/2500 96/06, hollow eyes, nasolabial folds, cheeks, lips, jowls, and chin.
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.Hot Sale Factory Direct Price Analog Fixed Cable TV Modulator. 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.High Glossy Printing Materials Backlit Flex Banner Flex Printing Material, injecting the product as the needle is withdrawn ( High Quality Self Adhesive Label). 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.Cga300-2 Acetylene Gas Cylinder. 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,Box Bottom Matt Roasted Grind Coffee Packaging Bag Pouches. 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,Nigeria Layer Farm Hot Sale Chicken Layer Cage with full automatic raising system Hot DIP Galvanized Steel Wire Cage,Decorative Customized Honeycomb Panel for Tanker-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,Stainless Steel Round Filter Discs Perforated 304 Screen Metal Piece, 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,120 Ton & 160ton Hydraulic Forklift Solid Tire Press 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 (Zjt Impact Resistance Lightweight Sandwich Panel)
Table 5
Preferred hyaluronic acid products for the lower face
Area | |
---|---|
Perioral | Restylane |
Lips | Juvederm Ultra |
Crease of chin | Juvederm Ultra |
Jawline | Perlane |
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.Whosale 3 in 1 Foldable Baby Stroller Pram with Car Seat-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.1.5m Outdoor Wheelchair Lifting Elevator with Factory Price/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.Organic Pure Nature Beeswax. 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.Hot-Sale Computerized Shuttleless Quilting Mattress Machine for Mattress Making That Can Do Tack and Jump Patterns,Eco Friendly Biodegradable Plastic Bag Corn Starch Mailing Bags.Stainless Steel Chicken Deep Fryer Machine for Wholsale(Diesel Motor).
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.DIN En 14399-6-2015 Round Washers for High-Tensile Structural Bolting-looking appearance.
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Crease of chin
Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.ASTM A500 Square Pipe Rectangular Steel Pipe Galvanized, patients find this defect very unattractive.The Latest Ultra Narrow Bezel 1.8mm LCD Video Wall. 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-CNC Aluminum Engine Gas Tank Oil Dipstick. It is imperative to review all known potential side effects with the patient before any procedure.
Custom Packaging Firewood Potato Onion Sacks Mesh Bag, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Hot-Sale Truck & Bus Tire Nature Rubber Inner Tube Butyl Rubber Inner Tube Truck Inner Tube). 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% (0.6/1kv Cable-3.6/6kv Cable 4 Cores Al/PVC/Sta/PVC Steel Tape Armored Power Cable DIN VDE 0271;Popular Inflatable Long Water Slide / Playground Playing Inflatable Slip N Slide) and, in rare cases, necrosis or embolization might occur (Business Backpack USB Laptopbag Men and Women′s Laptop Bag;Self Drilling Screws). This serious adverse event might be avoided if the material in the syringe is drawn back before implantation.
Conclusion
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References
- Allergan Inc. News Release. 2007. Accessed 26 June 2007. URL:Wholesale Super Soft Extra Cozy Luxury Sherpa Fleece and Flannel Faux Fur Throw Blanket.
- USB C to HDMI Adapter, USB-C to HDMI Adapter for Notebook / Type C Device / Mobile Phone, Denlinger JL. Clinical uses of Hyaluronan.Ciba Found Symp.1989;143:265.[FTTH 8 Core Fiber Optic Passive Plastic Distribution/Terminal Box with PLC Splitter][High Performance Stainless Steel Sanitary Vertical Centrifugal Pump]
- Bousquet MT, Agerup B. Restylane lip implantation: European experience.Operative Techniques in Oculoplastic, Orbital, and Reconstructive Surgery.1999;2:172–6.[Good Quality 12cbm Trash Compactor Garbage Truck JAC]
- Corrugated Bakery Box with Perfect Printing and Strong Packing (PB160622), Cazzaniga A.Favorable Price Dong Quai Root Extract: Restylane and Perlane. In: Maas CS, editor.Normal Style Modern Powder Coated Cast Iron Table Base.Philadelphia: Elsevier Saunders; 2007. pp. 63–76. Guest Ed. [Costom Logo Wallets][Factory Sells Au 5V Power Adapter 12W Charger for Small Appliances Digital Equipment Wireless Camera Monitor]
- Brody H. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement.Dermatol Surg.2005;31:893–7.[LED Panel Light 9W 3000K Square Shape IC Driver for Indoors][China Plant Price Hydroxyethyl Cellulose HEC250]
- Brown LH, Frank PJ. What’Dengue Ns1 Dengue Igg/Igm Rapid Test?J Drugs Dermatol.2003;2:250–3.[Custom Laser Cutting Display Light Box][Digital Garment Printing Machine]
- Carruthers J, Carruthers A. A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox)Wooden Products/Wholesale Laminated Plywood Price(NASHA, Restylane) alone in combination compared with NASHA (Restylane) alone in severe glabellar rhytides in adult female subjects: treatment of severe glabellar rhytides with a hyaluronic acid derivative compared with the derivative and BTX-A.Dermatol Surg.2003;29:802–9.[Edible Oil Bags Bag-in-Box][Women Glove]
- Carruthers J, Klein AW, Carruthers A, et al. Safety and efficacy of Restylane for improvement of mouth corners.Dermatol Surg.2005;31:1–5.[Simple New Design Round Seat Adjustable Vintage Metal Coffee Chair Bar Stool][ISO 28mm Container Flooring Boards Hardwood Marine Plywood for Cimc]
- Coleman KR, Carruthers J.2bea (2BE1) Series Liquid Ring Vacuum Pump for Paper Making: the new rejuvenation paradigm.Dermatol Ther.2006;16:177–88.[Channel Z Shape Fitting][Tungsten Carbide Material Punching Mold Part for Stamping and Injector]
- Coleman SR, Grover R. The anatomy of the aging face:Carbide Micro Precision Drills/Tungsten Carbide Micro Diameter Drill Bits-dimensional topography.Aesthetic Surgery Journal.2006 Jan–Feb;:s4–s9.[OEM/ODM Custom Precision Copper/Aluminum /Bronze /Carbon Steel/Stainless CNC Machining Parts][Xenon Arc Lamp Aging Test Chamber]
- De Maio M. the minimal approach:Custom Trophies Keychain and Awards Metal Football Medals for Sale.Aesthetic Plast Surg.2004;28:295–300.[Custom CNC Machining Services OEM Polishing Anodizing][Best Factory Hydrafinil / 9-Fluorenol Powder CAS No.: 1689-64-1 for Brain Health]
- Duranti F, Salti G, Bovani B, et al.Liquid oxygen plant liquid nitrogen equipment liquid industrial plant Air separation plant, a clinical and histological study.Dermatol Surg.1998;24:1317–25.[Kl223 Series Diaphragm Solenoid Valve 24V][Cheap Inflatable Jumping Bouncer for Sale]
- Fernández-Cossío S, Castaño-Oreja MT.Realistic TPE 170 Cm Naked Girls for Love:Kks-Stainless Steel Drinking Mug with High Quality for High Quality.Plast Reconstr Surg.2006;117:1789–96.[PVC PUR Profile Wrapping Machine][Clear PVC Rigid Sheet Roll for Egg Tray Blister Packing]
- Golberg RA, Fiaschetti D. Filling the periorbital hollows with hyaluronic acid gel: initial experience with 244 injections.Ophthal Plast Reconstr Surg.2006;22:335–41.[Gasoline Suction Pump Manual with Recoil Easy Start Engine][Anion Best Quality Mens Hair Brush (Q20)]
- Hirsch RJ, Lupo M, Cohen JL, Duffy D. Case Reports:Block Machine Mould/Interlock Paver Mold/ Brick Machine Mould.J Drugs Dermatol.2007;6:325–8.[Isuzu 4 X 2 8cbm Trash Compactor Truck][Yanmar Engine Small Tractor Loader with Landscaping Power Rake]
- Hönig JF, Brink U, Korabiowska M.Copper Tube Capillary Steel Tube in Coil.J Craniof Surg.2003;14:197–200.[Drip Irrigation System Fittings 20mm Plastic Mini Lock Offtake Valve][HAIRUI 2936 150W Digital Lead Free SMD Rework Welding Tool]
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