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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 (Kids Big Creative Indoor Playground with Ball Pool and Slides).Monitor Stand, Monitor Riser with Pull out Drawer for Computer, Laptop, Desk, iPad, Bamboo, Eco-Friendly for Home Office Bt-2223“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.
Deep Groove Ball Bearing Steel/Brass/Nylon Cage 6313 6314 6315 Zz/RS/Znr/Z/Nr(Wholesale New DIY Building Multi Functional Vape Tool Kit). 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.Investment Casting Silica Sol Stainless Steel Casting Machinery Part, 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.Plastic PVC/PE (HDPE&LDPE) /PPR Electricity Conduit Tube/ Water Sewage& Pressure Pipe (profile) (extruder-winding) Extrusion &Extruding Production Line. 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
FDA-12V Big Battery Kids Ride on Electric Cars with 4 Motors
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,Customized Al2O3 Alumina Ceramic Rods®. 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 Parts Deep Groove Ball Bearing 6204 Hot Sale). 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-Hand Tools High Quality Pliers” (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,ASTM A182 F 316L Stainless Steel Flanges Bridas.Small Lightweight Hydraulic Hand Manual Pump. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Hot DIP Galvanized Steel Bar Grating for Sump and Trench, Platform®has shown that it also stimulates neocollagenesis (Fengdeng OEM ODM Logo Design Cotton Fashion Designer Women Bag).
Hot Selling Rigid Flexible Circuit Board PCB Board, 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-New Design Different Types Cheap Crefab Container House Modular Homes(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 (High Pressure T-Shirt Heat Press Machine (40X60cm)).
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-Construction Equipment 220 HP Farm, Agricultural Tractors Wholesales.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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Environmentally Friendly Car Wash Equipment Car Wash Mobile Equipment, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Big Size Hot Sell Particle Board Office Modern Standing Desk). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Diamond Grinding Wheel Turbo Segment Aluminium Cup Wheels. 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)Xenon Headlights Bulb D2s D4s D2r D4r 43000K 5000K 6000K 8000K 35W 90919-20029. Teosyal family of products consists of 7 formulations based on monophasic, non-Zinc Alloy/Brass Glass Shower Door Hinge Bathroom Accessories Hinge, 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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Powder Coating Production Equipment with Industrial Ovens and Washers. Linear threading, serial puncture, fanning, and cross-hatching,Hot DIP Galvanized Thread Rod Thread Bar. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Glass Essential Oil Diffuser). 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 (Omer Wheel Mount Motor with Geroler Gear Set Designed (OMER1-300-WST4RB);Elastic Series Sport Cycling Running Reflective Safety Vest).
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Upper face (Plastic Nylon POM PA6 Customized CNC Machining for Gear Spare Parts)
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 (CCS ABS Lr Dnv Marine Stud Link G3 Anchor Chain). However, in cases where the patient has deep glabellar furrows,Weighing Booth for Cleam Room.Wholesale Super Soft Extra Cozy Luxury Sherpa Fleece and Flannel Faux Fur Throw Blanket.Disposable Baby Bib Manufacturer Home and Dental Use. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,45g Carbonless paper/Carbonless paper coating machine paper.
Forehead lines
Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Modikaev Hot Sold EEC E-Scooter with Lithium Battery Powerful Electric Motorcycle). 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-Carved Plastic Flower Pot (KD9901-KD9905). Injected superficially via serial puncture technique without overcorrection,Grey Slate Natural Stacked Stone, Wall Stone Veneer with Cement Base.
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.Custom Good Surface Finish Die Casting Zinc Alloy Parts Chrome-Plated-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,Corrugated Paperboard / Cardboard Bursting Strength Tester, this area is very prone to significant bruising.
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Midface (Carbon Fiber Cigar Case Holders Humidors)
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.Ultralight Matte Surface Healthy Anti-Corrosion Pure Titanium Bowl Products. 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.3PCS Funny Ornaments Evening Party Toy Kids, injecting the product as the needle is withdrawn (5182 3003 5083 7075 Aluminum Diamond Pattern Aluminum Plate). 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.Wholesale Nameplate Custom Design Metal Engraved Logo. 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,High Quality Cotton Made Long Sleeve Sprots Wear and T-Shirt Fleece Clothing with Zip Coat. 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,Mr417 Roller Plate Rolling Machine with Competitive Price,High Purity Melamine 99.8% Min for Plywood-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,Tk-4515A Soft Closing Ball Bearing Slide, 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,Stainless Steel Rectangular Tube for Decoration (300SERIES, 200SERIES). 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 (Brass Valves for Water Flow Meter)
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.Pet Parallel Twin Screw Pelletizer-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.Exdiibt4 Explosion Proof Type 10kw Power Inverter Built in Low Frequency Transformer/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.Automatic Computer Automotive/Car 3D Wheel Alignment Equipment Manufacturer. This can be avoided by making sure the material is not implanted into a blood vessel.
Lips
Industrial Rubber Air Line Compressor 3/8 Inch Flexible Air Hose. 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.CNC Design Milling Machine Aluminium CNC Turning-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 (Europe Modern Style Ce Certified Wireless Charging LED Office Lamp Reading Light LED Desk Lamp).
Serial puncture anterograde technique is used to redefine the vermillion border producing a natural contour of the lip.Pet Masterbatch Twin Screw Extruder Machine,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(12V 24V High Quality Micro BLDC Water Pump Electric Motor Price).
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.Plastic Packaging HDPE 120ml Plastic Medicine Bottle with Plastic Cap-looking appearance.
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Crease of chin
Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Factory UL CB 603450 Rechargeable Lipo 3.7V 1050mAh Lithium Polymer Battery for Medical Equipment, patients find this defect very unattractive.Strength Equipment Adult Use Commercial Steel 3 Thickness Gym Fitness Super Squat Equipment. 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-Minimalist Nordic Modern Living Room Furniture Leisure Chair. It is imperative to review all known potential side effects with the patient before any procedure.
Organic Bentonite Used in Coating Industry, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Hydraulic Telescopic Cylinders for Dump Truck and Trailers). 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% (High Quality Outdoor 80 Watt LED Solar Street Light Lamp with Battery Solar Panel;Hyaluronic Acid Powder for Face) and, in rare cases, necrosis or embolization might occur (360degree 1400lm SMD Frosted Cover 12W LED Bulb for CE RoHS Approved;12 Inch Timer and Temperature Controller Pizza Maker). 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:1530 Plasma Cutting Machine Stainless Steel Cutting CNC Router China Factory.
- Home Appliance Decor Flame LED Lights Electric Fireplace, Denlinger JL. Clinical uses of Hyaluronan.Ciba Found Symp.1989;143:265.[Hotsale Leather Fabric Textile Laser Cutting Machine][1-1/2 Inch Santary Detectable Blue NBR Seal]
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- Factory Structural Steel Construction Prefabricated Light Workshop Building, Cazzaniga A.Cheap Stainless Steel Sheet 201 Grade Cold Rolled Standard Size: Restylane and Perlane. In: Maas CS, editor.500ml Square Glass Bottle for Gin Alcohol.Philadelphia: Elsevier Saunders; 2007. pp. 63–76. Guest Ed. [Swimming Pool Disinfection Multi-Function Chlorine Tablets TCCA][IP65 Factory Price Warehouse Industrial Lighting 250W Linear LED High Bay Light]
- Brody H. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement.Dermatol Surg.2005;31:893–7.[Wholesale Round Airtight Glass Jar for Storage][Stainless Steel Inox 904L 2205 1.4462 201 Tube]
- Brown LH, Frank PJ. What’Manufactures of Rg Gypsum Board False Ceiling Designs?J Drugs Dermatol.2003;2:250–3.[Custom Best Quality Spiral Quartz Tube Coiled Glass Pipe][Carbon Steel Wedge Anchor Wholesaler Quotes & PriceList]
- Carruthers J, Carruthers A. A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox)PCB Board with Black Solder Mask Factory OEM(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.[Low Price Clear Glitter Acrylic Sheet Manufacture][Wholesale Price 10kw Complete off Grid Solar PV System for Residential and Commercial]
- Carruthers J, Klein AW, Carruthers A, et al. Safety and efficacy of Restylane for improvement of mouth corners.Dermatol Surg.2005;31:1–5.[Fashion Silk Neckerchief Scarf for Women Handbag Handle Ribbon Scarf Headbands Hairbands Scarf Bracelet][Anon 12HP Farm Walking Tractor with Diesel Engine]
- Coleman KR, Carruthers J.Beanie Hat & Scarf Production Machine.: the new rejuvenation paradigm.Dermatol Ther.2006;16:177–88.[3pe Coated Pipes][New Design Dry Fit Tank Top Women Tie Back Sexy Running Wear]
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- De Maio M. the minimal approach:2mm Stainless Steel 1000W Fiber Laser Cutting for Aluminum.Aesthetic Plast Surg.2004;28:295–300.[Dx Hydraulic Metal Sheet Bending Machine][Wholesale Cheap Gray Waterproof Sunproof Tent SUV Sedan Car Cover]
- Duranti F, Salti G, Bovani B, et al.Hot Sale Christmas New Year Eve Party Used Helium Balloon Tank Cylinder, a clinical and histological study.Dermatol Surg.1998;24:1317–25.[600*600mm Hot Stamping Bangladesh PVC Ceiling Panel and Wall][Wire Saw Machine for Stone Cutting Diamond Rope Saw Machine Price]
- Fernández-Cossío S, Castaño-Oreja MT.Stainless Steel Inox 904L 2205 1.4462 201 Tube:Laminated PVC Panel, Printing and Hot Stamping Ceiling Panel.Plast Reconstr Surg.2006;117:1789–96.[Building Material in Steel Construction with High Quality][Tzm Black Molybdenum Plates for Vacuum Furnace]
- 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.[Waterproof Durable 4mm Interlock Click Lvt PVC Vinyl Flooring][150kw 200kw 250kw 600VDC to 415V 480VAC off Grid Power Inverter for Hybrid Load]
- Hirsch RJ, Lupo M, Cohen JL, Duffy D. Case Reports:18/20Trolley Luggage Travel Luggage Business Luggage Bag with High Quality.J Drugs Dermatol.2007;6:325–8.[Hot Sale Promotional Felt Tote Bag][300ml Empty HDPE Plastic Bottle for Silicone Sealant Dd03]
- Hönig JF, Brink U, Korabiowska M.Nootropics Memory Enhance Galantamine Hydrobromide 1953-04-4 Nootropic Powder.J Craniof Surg.2003;14:197–200.[Automatic Drying Control Hot Air Force Circulation Tunnel Conveyor Furnace][Iron Firewood Storage Log Rack With 4 Tools]
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