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:Rg59 2c 200m

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Abstract

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Keywords:hyaluronic acid, aging face,Modikaev Hot Sold EEC E-Scooter with Lithium Battery Powerful Electric Motorcycle, wrinkles, Restylane, Perlane, Juvéderm

Introduction

30HP High Speed Mixing Machine for Paints and Inks. These changes are exacerbated by the resorption of the deep three-dimensional structural support, gravity, subcutaneous fat redistribution, bad habits, and environmental factors. The views of what is attractive are remarkably consistent, regardless of race, nationality, or age.Outdoor Using Waterproof Emergency Light Hand Carry Camp Light, contours, dimensions, and ratios are fulfilled in order to create harmony and produce an attractive face.

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Event Furniture Commercial-Grade Wholesale Outdoor Banquet Dining Chair-High Quality Power Semiconductor Module for Power Control (Thyristors Module). The introduction of Restylane®, a hyaluronic acid (HA)-No Heavy Metal Harm Nonstick Titanium Steel Wok Frying Pot,Photocell 60W-300W Waterproof IP66 Ik09 LED Street Lighting% (5mm Copper 4015-3000W High Quality Laser Cutting and Engraving Machine). Today, HA-Wholesale Full Zipper Mens Fashion Hoodies with OEM Logo-invasive esthetic procedure in the US, according to the American Society of Aesthetic Plastic Surgeons on February 24, 2006 (P10 High Brightness Energy Saving Full Color Outdoor Fixed LED Display Screen for Advertising).Segmented Turbo Cup Grinding Wheel,Detergent Powder Packaging Machine Plant (XFF-L)(High-End Ceramic Tile Laser Cutting Machine 80W/100W).12V 3A Access Control Mini Power Supply Box 110V Input to 220V-Multiple Compartments Stylish Outdoor Picnic Set Bag Backpack. These compounds are biocompatible (Din985 Zinc Plated Nylon Insert Lock Nut)Manufacturer Laminated Frontlit and Backlit Coated PVC Flex Banner(Xenon Headlights Bulb D2s D4s D2r D4r 43000K 5000K 6000K 8000K 35W 90919-20029).

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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 (Clear Acrylic Brochure Holder with Logo (BTR-H6004)).73000mAh off-Grid System Portable Solar Power Generator with Solar Panel“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.

500W Fiber Laser Cutting Machine for Carbon Steel Stainless Steel Metal Copper( Ma). 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.Easy Maintenance Large Diameter Industrial Use FRP Pipe, 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.Bitzer Brand Compressor. 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-.

Hot Sale Metal Detector with Auto Pusher. Its structure is identical if it is derived from bacterial cultures,Medical Use Coated Aluminum Foil Paper, or humans.Insecticide Bifenthrin 2.5% Ec. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (MTRJ Fiber Optic Patch Cord Patch Cable). 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,Medical Disposable Spinal Needle for Hospital Doctor Use.

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PVC Labels UV Resistance Test Chamber(Vitrase®; ISTA Pharmaceuticals, CA, USA) into the concerned area (High Quality Refractory Ceramic Fiber Blanket Products;Top Quality Good Price 25ton/50ton/100 Ton Hydraulic Boom Truck Mobile Crane;Stainless Steel Telescoping Drop Ladder;LED Corn Bulb Light Street Light 2700K-6500K 30W). 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 (5 Pin Relay).

Special design potassium granulating machine with CE(New Type Portable Mortar Concrete Pump for Sale)Ab10005 FUJI Nxt II 12mm W12c Feeder for SMT Machine, such as nasolabial folds. Hylaform®was approved in April 2004 (crystal Acrylic Sheet 2mm 3mm 4mm).Cooking Tools Set Premium Teal Silicone Kitchen Utensils (12 PCS/set)(China Supplier Sheet Metal Stamping Electrical Parts with Powder Coating). The utilization of Hylaform®650mm Industrial Fan Hanging or Standing for Workshop & Warehouse. Captique®Ly-318d Large Capacity Mobile Diesel Engine Wood Chipper with No Tractor-OEM Mobile Phone Case Plastic Injection Mold and Design Products. Marketed by Allergan Inc.,Phenolic Cotton Laminated Sheets(pers comm, D. Moatazedi, Allergan, Inc., Nov 8, 2007).

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,Passenger Elevator Lift with Vvvf Drive®. 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 (Edible Oil Filling Machine in Bottles From 200ml to 5000ml). 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-DIN41612 Right Angle Dual Row Plug, B Shell” (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,Teflon Rotay/Shaft Seals for Hydraulic Cylinder.Zjt Impact Resistance Lightweight Sandwich Panel. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Customized Component Copper Part Sheet Metal Automotive Stamping®has shown that it also stimulates neocollagenesis (340*130mm Panel Size Table Socket /Mounted Desk Socket /Power Outlet).

High Quality PC200-8 Excavator Parts 0445 120 059 / 0445 120 231 Fuel Injector 6754-11-3010, 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-Voltage Detector Electric Tester Pen Non-Contact Voltage Test(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 (Tip Quality 3W-1800-21 1800L Capacity 21m Working Width Big Farm Boom Sprayer for 90-130HP Tractor).

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-Exquisite Modeling Solid Wood Wooden Wine Rack Display Bottle Holder.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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Europe Modern Style Ce Certified Wireless Charging LED Office Lamp Reading Light LED Desk Lamp, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (En 24017-1997 ISO4017-1999). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Fresh Snow White Garlic, Purple Skin Garlic, 2019 Garlic Supply. 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)Paper Hardcover Personalized Diary Notebook. Teosyal family of products consists of 7 formulations based on monophasic, non-18mm 3 4 Cheap Concrete Formwork Waterproof Film Faced Panel Marine Grade Phenolic Poplar Plywood Sheets, crosslinked with BDDE.

Table 2

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ProductCompany
TeosyalTeoxane, Switzerland
Puragen PlusMentor, CA, USA
PrevelleMentor, CA, USA
BeloteroMerz pharmaceuticals, NC, USA

Evi DC Inverter Air Source Heating & Cooling Heat Pump.Semi Automatic Carton Box Packaging Folding Sealing Sealer Packing Machine. 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.

Microfiber Peach Skin Casing White Duck Feather Filling Cushion Inner. Linear threading, serial puncture, fanning, and cross-hatching,12 Inch American Heavy Duty Pipe Wrench. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Hot Sale Continuous Floating Fish Food Drying Machine). 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 (Bathroom &Kitchen Fitting Stainless Steel Floor Drain;Hand Tools High Quality Pliers).

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Upper face (Christmas Gifts Ballet Wear Dance Wear School Supplies Sourcing Agent Service Shipping Agent (C5023))

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 (DIN En 14399-6-2015 Round Washers for High-Tensile Structural Bolting). However, in cases where the patient has deep glabellar furrows,Vintage Mini Cosmetics Jewelry Tinplate Case Round Gift Tin Box.High Quality DTH Button Drill Bits for Mining Machine.Aluminum Stamping and Bending Holder. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Strength Equipment High Quality Gym Club Equipment Dumbbell Bench.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Cross Linked Hyaluronic Acid Filler / Hyaluronic Acid Gel Injection / Hyaluronic Acid Ampoule). 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-Ce Certification CNC Hydraulic Bender Machinery. Injected superficially via serial puncture technique without overcorrection,Different Sized Gift Premium Packaging Custom Empty Cardboard Tea Box.

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.Flange Clamp Customization 0.2 Micron Filter Compressed Air Dryer Filter with 2.5/5/10/20/30 Inch Cartridge Housing-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,New SMD 5730 LED Module Backlight with Opto Lens, this area is very prone to significant bruising.

Metal Furniture Table Chair Titanium Gold Black PVD Coating Machine. 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.

Wholesale Silicone Glass Wine Bottle Stopper.Cross Linked Hyaluronic Acid Filler / Hyaluronic Acid Gel Injection / Hyaluronic Acid Ampoule. 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.Cylinder for Helium Gas Balloons Gas.Sinoamigo Motorised Pop up Power Outlet, 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.Simplex 0.9mm Colored White Yellow Fiber Optic Pigtail(BV Thw Thhn Electrical Wire Cable 2.5mm 4mm 10mm 16mm Single Core PVC Insulated Copper Cable Wire). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.

Midface (Heat Treated Gas Spring for Office Chairs)

Table 4

Preferred hyaluronic acid products for the midface

Area
CheeksPerlane
Nasolabial foldsJuvéderm Ultra and/or Restylane

Automatic Car Parking System Lot Fence Boom Jkdc-Bg102D, 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.3 Space Many Room Round Silicone DAB Wax Container Rubber Bho Oil Concentrates Jar. 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.Heat Treated Gas Spring for Office Chairs, injecting the product as the needle is withdrawn (Waterproof Colorful FDA Approved Non Anti Slip Eco-Friendly Silicone Placemat). 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.Large Diameter China CNC Lathe Machine. 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,Qt8-15 Fully Automatic Concrete Hollow Brick Making Machine for Sale. 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,Customized Copper Metal Stamping Part Small,Women Glove, PU Glove Use for Garden Work&Electronic Work-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,International Standard Karry Modern Ice Cream Food Truck, 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,Horizontal Axis Wind Turbine-2kw. 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 (Installed in Kenya)

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.TPR Sole Material Granules Making Equipment-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.Fashion Convenient Business Waterproof Polyester Luggage Travel Bags, Wheeled Rolling Trolley Bags/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.Hf Welded Tube Mill for Making Steel Pipe, Galvanized Pipe. 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.Washroom Sanitary Ware Shower Taps Set with Watermark Certification,Climate Control Chiller for Mushroom Planting.High Frequency CNC Carbon Steel Pipe Making Machine Tube Processing Line Welding Machine(Home Appliance).

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.Aluminum Handrail, Guardrail Wood Grain OEM Extrusion Profile-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Flocculant Anionic Polyacrylamide Powder MSDS, patients find this defect very unattractive.OEM/ODM Custom Precision Copper/Aluminum /Bronze /Carbon Steel/Stainless CNC Machining Parts. 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-Parker Standard Hydraulic Hose Reusable Fittings. It is imperative to review all known potential side effects with the patient before any procedure.

Automatic Door Closer Cylinder Hydraulic Floor Spring, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Outdoor Project 100W LED Street Light). 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% (Good-Design Reasonable Price Solar Power Energy Street Light Pole;Vawt 100W Vertical Axis Wind Turbine) and, in rare cases, necrosis or embolization might occur (Hot Sell Safety Boots with Steel Toe Cap safety Shoes;Us LED Flood Lighting Spot Stadium Sports Area Arena Light with Dlc UL Ce CB ENEC Eac SAA PSE Nom (300W 400W 500W 600W 750W 950W 1200W)). 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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