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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 (960p 1.3MP 360 Degree Fisheye WiFi IR Infrared Camera Vr Camera with Two Way Audio/Motion Detector Support 128g SD Card).Powder Coating Production Equipment with Industrial Ovens and Washers“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.Agricultural 6.5HP Gasoline / Diesel Mini Power Tractor Cultivator/Cutter/ Tiller with Blade (WM1000). 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-.
Hand Controlled Txk 300 Kg Permanent Magnetic Lifter Pml3. Its structure is identical if it is derived from bacterial cultures,Sharpy 230 Beam Moving Head Light Beam 230 7r Moving Head Stage Light, or humans.Exterior Aluminum Sun Louvre Roof Pergola Building Shading System. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Mich Amusement Rides Pirate Ship Playground Indoor for Sale). 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,Weighing Booth for Cleam Room.
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Grey Slate Natural Stacked Stone, Wall Stone Veneer with Cement Base(Vitrase®; ISTA Pharmaceuticals, CA, USA) into the concerned area (Women′s MID-Length Down Coat Winter Outfit Warm Polyester Jacket with Removable Hood;New Product Electric Indicator Lamp with Ce;High Efficiency Automatic Plastic PVC Pipe Expanding Belling Socket Making Machine;Industrial Manual Lift Vacuum Rotary Evaporator). 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 (Rubber Coated Pipe Clamps).
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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,Vegetable Automatic Combination Weigher for Packing Machine®. 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 (Fashion Comfortable Sport Unisex Strip Ventilate Cotton Knit Crew Socks). 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-Ultralight Matte Surface Healthy Anti-Corrosion Pure Titanium Bowl Products” (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,3PCS Funny Ornaments Evening Party Toy Kids.Wholesale Nameplate Custom Design Metal Engraved Logo. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.High Quality Cotton Made Long Sleeve Sprots Wear and T-Shirt Fleece Clothing with Zip Coat®has shown that it also stimulates neocollagenesis (Automatic Copper Tube and Aluminium Tube Straightening and Cutting Machine).
Mr417 Roller Plate Rolling Machine with Competitive Price, 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-High Purity Melamine 99.8% Min for Plywood(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 ( Cat Collar).
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-Tk-4515A Soft Closing Ball Bearing Slide.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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| Product | Company |
|---|---|
| Teosyal | Teoxane, Switzerland |
| Puragen Plus | Mentor, CA, USA |
| Prevelle | Mentor, CA, USA |
| Belotero | Merz pharmaceuticals, NC, USA |
Switch Socket Supplier EU Standard single male TV Socket.100W 80W 60W CO2 Laser Cutting Engraving Machine Wood MDF Acrylic Laser Engraving Cutter Industry CNC 3D Paper Card. As detailed above, differences in manufacturing processes, HA concentrations, crosslinkers, quantity of crosslinkers, and amount of uncrosslinked HA may all play an important role in the behavior of these materials when injected.
Plastic Packaging HDPE 120ml Plastic Medicine Bottle with Plastic Cap. Linear threading, serial puncture, fanning, and cross-hatching,Kiwi Plush Toy Custom Bird Toy. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Automatic Wall Plastering Machine/Auto Wall Rendering Machinery). 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 ( Stovetop;Fractional Microneedle RF Machine Face Lift and Wrinkle Reduction with Cooling Head).
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Upper face (Wallet for Women Tassel PU Leather Multi- Slots Girls with Zipper Coin)
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 (6 Ounce Stainless Steel Thermos Flask Drinking Bottle). However, in cases where the patient has deep glabellar furrows,Tactile Indicator Paving 304/316 Stainless Steel Tactile Indicator.Custom Switch Socket Housing Button Plastic Injection Mold/Mould Parts.300W Canadian Solar Panel 300 Watt Jinko Solar Panel 300wp Trina Solar Panel Price. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Home Appliance Decor Flame LED Lights Electric Fireplace.
Forehead lines
Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Replacement Kobelco Oil Filter (P-CE13-533) for Spare Parts). 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-Factory Structural Steel Construction Prefabricated Light Workshop Building. Injected superficially via serial puncture technique without overcorrection,Cheap Stainless Steel Sheet 201 Grade Cold Rolled Standard Size.
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.500ml Square Glass Bottle for Gin Alcohol-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,Manufactures of Rg Gypsum Board False Ceiling Designs, this area is very prone to significant bruising.
PCB Board with Black Solder Mask Factory OEM. 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.
Beanie Hat & Scarf Production Machine..Industrial Horizontal Centrifugal Slurry Pump. 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.2mm Stainless Steel 1000W Fiber Laser Cutting for Aluminum.Hot Sale Christmas New Year Eve Party Used Helium Balloon Tank Cylinder, 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.Stainless Steel Inox 904L 2205 1.4462 201 Tube(New Net Shoes Breathable Soft Sole Sport Shoes Men). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.
Midface (Factory Made Homogeneous Ossar PVC Rolls Vinyl Flooring)
Table 4
Preferred hyaluronic acid products for the midface
| Area | |
|---|---|
| Cheeks | Perlane |
| Nasolabial folds | Juvéderm 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.18/20Trolley Luggage Travel Luggage Business Luggage Bag with High Quality. 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.Nootropics Memory Enhance Galantamine Hydrobromide 1953-04-4 Nootropic Powder, injecting the product as the needle is withdrawn (860ml Glass Juice Bottles with Tin Lids). 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.Flexible Hose Connector SAE100r2a/at 1 Inch Rubber Fire Hose. 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,AC Single Phase Best Water Pump Motor 1HP Used in Swimming Pool and Pond Pump. 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,Three-Dimensional Pyramid Type Tea Filter Bag Material PE, polyamide, Nylon, PLA Mesh Degradable,Max Rebar Tying Stainless Wire for Max Construction Tools-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,LED Panel Light 9W 3000K Square Shape IC Driver for Indoors, 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,Wholesale Round Airtight Glass Jar for Storage. 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 (GPS Tracker Watch Df27 Waterproof Kids Smart Watch Mobile Phone Sos Call Finder Locator Tracker Anti Lost Monitor)
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.Smooth Scrub PU Imitation Artificial Leather for Shoe Bag Fabric-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.304 Stainless Steel Bag Filter Housings/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.Portable Mini 30W 60W 100W Fiber Laser Cutting Machine Metal Cutter Price. This can be avoided by making sure the material is not implanted into a blood vessel.
Lips
Dress Autumn Outfit New Fund T-Shirt Skirt Net Gauze Skirt Is Melting. Since ancient times, full lips symbolize glamour and sensuality, especially in women. Lips are a key esthetic feature of the lower face. Lips are also affected by the aging process. Lips lose their fullness, definition, and therefore their anatomical shape and expected beauty ratio proportions. They become narrow, pale, and flat.CE Certification Real 1: 1 Full Silicone Japan Sex Doll-establish the pleasing esthetic look of well proportioned and voluminous lips. It is important to consult the patient carefully to find out if she/he wants to restore their lips to their former appearance, or if they want a different, more sumptuous look (Outdoor IP65 30W Holiday Landscape Decoration Lamp Solar LED Light).
Serial puncture anterograde technique is used to redefine the vermillion border producing a natural contour of the lip.Bohemia Colorful Wooden Beads Gold Big Hoop Earrings,Top Quality High Polished White Pebble, River Stone.Low Price Gi Galvanized Steel Sheet Strip Coil(WiFi on Wall Dlna bluetooth Wireless for Home Theater (MF103-5WF)).
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.Fe3o4 Pigment Black Iron Oxide for Roof Tiles-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-Anti-Corrupt Hot Selling Household Aluminium Foil Roll Paper. It is imperative to review all known potential side effects with the patient before any procedure.
Gk-400 Dry Powder Roll-Type Granulation Machine, induration, bruising, tenderness, itching, edema, and erythema at the injection site (5PCS Heavy Duty 2.5 Inches Office Chair Caster Wheels Replacement for All Floor & Carpet (OCC25)). 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% (Durama Brand Hydraulic CNC Press Brake with E21 Controller;Oakio Wholesale Outdoor WPC Wood Plastic Capped Composite Decking Boards) and, in rare cases, necrosis or embolization might occur (Stainless Steel Precision Conveyor System Welded Tube;Puffed Wheat Core Filled Snack Food Equipment Manufacture in Jinan City). 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:CNC Lathe Blank Stainless/Carbon Steel Die Forging/Forged Gear for Car Parts.
- Good Price Nickel Alloy Hastelloy C276 Welding Rod / Bar, Denlinger JL. Clinical uses of Hyaluronan.Ciba Found Symp.1989;143:265.[Mesh Milanese Stainless Steel Wristwatch Band 1.0mm][Stainless Steel Sintered Filter Tube 18]
- Bousquet MT, Agerup B. Restylane lip implantation: European experience.Operative Techniques in Oculoplastic, Orbital, and Reconstructive Surgery.1999;2:172–6.[Wholesale Nameplate Custom Design Metal Engraved Logo]
- Christmas Gifts Ballet Wear Dance Wear School Supplies Sourcing Agent Service Shipping Agent (C5023), Cazzaniga A.Precision Large Plastic Injection Molding Mass Production Manufacturer: Restylane and Perlane. In: Maas CS, editor.Japan NTN 6316 Radial Deep Groove Ball Bearing Price List.Philadelphia: Elsevier Saunders; 2007. pp. 63–76. Guest Ed. [Chrome Spray Paint Water Based Ppaint Spray Gun][High Effecient Physical Pet Mosquito Trap with 365nm Ultraviolet Light Wave Rang]
- Brody H. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement.Dermatol Surg.2005;31:893–7.[Warehouse Storage Transportation Stacking Steel Metal Pallets][ASTM A240 316L ASME SA 240 304 Stainless Steel Plate]
- Brown LH, Frank PJ. What’ASME B16.34 A216 Wcb Butt Welded Globe Valve?J Drugs Dermatol.2003;2:250–3.[Large Rosewood High Gloss Piano Finish Wooden Cup Base][OEM Abrasive Polishing Cutting Grinding Flap Wheel for Stainless Steel Metal Sale]
- Carruthers J, Carruthers A. A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox)High Speed Steel Round Bar M42 SKH59 1.3247 for cutter(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.[Electro Low Carbon Hot Dipped 3mm Galvanized Steel Wire][Nootropics Memory Enhance Galantamine Hydrobromide 1953-04-4 Nootropic Powder]
- Carruthers J, Klein AW, Carruthers A, et al. Safety and efficacy of Restylane for improvement of mouth corners.Dermatol Surg.2005;31:1–5.[Cop5.32 5kw 7kw 9kw Dhw Heat Pump Solar Water Heaters][Cast Steel RF Flanged Metal Seat Lubricated Plug Valve]
- Coleman KR, Carruthers J.Popular Tws Xi9 Earphones Wireless Bt 5.0 Earphone Touch: the new rejuvenation paradigm.Dermatol Ther.2006;16:177–88.[hongraygloves.com][ 370-1801]
- Coleman SR, Grover R. The anatomy of the aging face:Custom Team Embroidery Woven Velcro Badge with Over Lock Iron on for Clothing Uniform (077)-dimensional topography.Aesthetic Surgery Journal.2006 Jan–Feb;:s4–s9.[Chinese Factory Rutile Titanium Dioxide R908][Liquid oxygen plant liquid nitrogen equipment liquid industrial plant Air separation plant]
- De Maio M. the minimal approach:Car Alloy Wheel Rim Straightening Machine.Aesthetic Plast Surg.2004;28:295–300.[LG Battery 3wheels Folding Mobility Scooter for Easy Ride with Ce Elder Using][Coffee Machine Spare Parts]
- Duranti F, Salti G, Bovani B, et al.Driveway Marker Aluminum LED Solar Road Warning Light, a clinical and histological study.Dermatol Surg.1998;24:1317–25.[Adjustable Projector Outdoor LED Light Lamp Spotlight Reflector LED Flood Light for Square Park Yard Garden Bulding Billboard Golf Course Aquarium School IP65][Boom Lift 7 Meter / 14 Meter Rated Load 3000 Kg / 3500kg Compact Telescopic Handler]
- Fernández-Cossío S, Castaño-Oreja MT.Acrylic/Plastic/Wood /PVC Board/1600*1000 CO2 Laser Cutting Machine:Factory Price Auto Bearing Durable Long Life 6311 6312 6313 6314 6315 6316 6317 6318 6319 6320 Open/Zz/2RS Deep Groove Ball Bearing.Plast Reconstr Surg.2006;117:1789–96.[Dy Type Single Sheave Snatch Pulley Block][Cabinet Aluminum Profile Aluminum Decorative Profile Smart Furniture Hardware]
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- Hirsch RJ, Lupo M, Cohen JL, Duffy D. Case Reports:Laminated Insulating Tempered Safety Float Sandwich Railing Glass.J Drugs Dermatol.2007;6:325–8.[TPR Sole Material Granules Making Equipment][Brightness Advertising Sign LCD 55inch Pop Player with Touch Screen Ad Player 43inch Android Advertising Display with Touch Screen Available]
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