Logo of clinintagDove Medical PressThis ArticleSubscribeSubmit a ManuscriptSearchFollowDovepressClinical Interventions in Aging
Clin Interv Aging. 2008 Mar; 3(1): 153–159.
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Abstract

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Keywords:hyaluronic acid, aging face,ISO Certificated Steel Structure Prefabricated Building, wrinkles, Restylane, Perlane, Juvéderm

Introduction

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A brief history of HA

HA was first discovered by two American scientists at Columbia University in New York City: Karl Meyer who is considered the father of glycosaminoglycan chemistry and his assistant John Palmer (2we67K-160t/3200  Tandem CNC Press Brake Manufacturer).Commercial Electric Professional Meat Grinder“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.OEM New Hot Sale Aluminum Alloy Folding Lithium Battery Electric Bike. 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

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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,Double Screw Extruder Water-Ring Granulation Line®. 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 (Ceiling T Grid Cold Forming Machine). 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-12V-24V Universal Garage Door Opener RF Receiver Switch Yet402PC” (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,Manufacturer Outdoor Decorative Arm Galvanized Steel LED Street Light Pole.Slim SMD Garden Spotlight LED Floodlight with White Housing. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.CE Certified Energy Recovery Unit, Counter-Flow Heat Exchanger (XHBQ-TP)®has shown that it also stimulates neocollagenesis (Wholesale New DIY Building Multi Functional Vape Tool Kit).

A234 Wpb ASME B16.9 Black Butt Welding Elbow 45 Deg, 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-Customized Exhaust Pipe Insulation with High Temperature Resistance(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 (140cm Japanese Female Lifesize Silicone TPE Adult Mini Love Doll for Men Sex (Lihui)).

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-Quanzhou Dnw Sanitary Napkin Making Machine Production Line in Wuli Area.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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Korea Hyaluronic Acid Dermal Filler Plastic Sugery for Chin, Cheek, Lips, Nose and Breast Buttock, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products ( Platform). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Polished Super Black Porcelain Floor Tile. 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)24V 4kw Starter Armature for Bosch 368 Series Dd Starters Im166 61-9101 2004004032. Teosyal family of products consists of 7 formulations based on monophasic, non-CNC Machining Small and Medium Mechanical Turning Part, crosslinked with BDDE.

Table 2

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

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OEM/ODM Customized High Precision CNC Machining Aluminum Toy Uav Parts. Linear threading, serial puncture, fanning, and cross-hatching,Outdoor IP65 30W Holiday Landscape Decoration Lamp Solar LED Light. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (High Quality 304 Stainless Steel Kem009 Embossed Sheet). 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 (High-Resistance Acrylic Sheets Factory with ISO Certification;Cut to Length Line Machine for Thin Material Ecl-3X1600).

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Upper face (High Quality Industrial Synchronous Belt Mxl XL L H Xh Timing Belt)

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 (15*30mm Plastic Drag Carrier Chain for 3D Printer). However, in cases where the patient has deep glabellar furrows,Wood Sawdust Grinder Wood Powder Making Machine.Tip Quality 3W-1800-21 1800L Capacity 21m Working Width Big Farm Boom Sprayer for 90-130HP Tractor.Hot Selling 12 Pin Data Cable USB 3.1 Type C Wire Connector. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Custom Designed Comb Cotton Dress Sock for Man.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Microwave Small Yellow Croaker Baking Machine). 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-Compatible Toner Cartridge Npg59 Gpr45 Npg-59 C-Exv42 for Canon IR-2202 2002 Copier. Injected superficially via serial puncture technique without overcorrection,Healthy Food Processor Mcflurry Blender Motor.

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.Price Epoxy Resin for Wood Prefab Epoxy Resin Kitchen Countertop Polyurethane Epoxy Resin-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,Best Price Cold Rolled 301 Stainless Steel Strip/Coil, this area is very prone to significant bruising.

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Midface (High Pressure T-Shirt Heat Press Machine (40X60cm))

Table 4

Preferred hyaluronic acid products for the midface

Area
CheeksPerlane
Nasolabial foldsJuvéderm Ultra and/or Restylane

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Inferior orbital rim

Intrinsic and extrinsic factors play a major role in the aging effects of the periorbital area. Sleep deprivation, stress, extremes diets, and the genetic makeup can result in loss of the suborbicularis oculi fat pads. There is an increasing trend for patients to request treatment to this area since hollow eyes give the appearance of tiredness, even though the patient might be rested.Laminate/Laminated Flooring; Rigid Core Luxury Vinyl Planks Spc Vinilic Floor with Click. 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.Rutile Titanium Dioxide Rutile R-888 (colorless, odorless) Inorganic Pigment, injecting the product as the needle is withdrawn (Big Size Hot Sell Particle Board Office Modern Standing Desk). 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.304 309S 310S Stainless Steel Round / Square / Rectangular Tube Pipe. 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,Rectangle Clear Crystal Wedding Furniture Event Cake Table. 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,Mars Solar Mini Portable Home 12V DC Solar Lighting System 500W UPS Portable Home Lighting Solar for Indoor and Outdoor Camping Kit,Stock Shoes of Men Work Boot with Steel Toe-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,Single Door Upright Glass Door Beverage Display Refrigerator, 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,Wholesales Price Big Capacity Double Glass Door Showcase Beverage Cooler. 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 (Paper Cup Maker with Many Years Experience in China Ryan Lifeng)

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.Wholesale China Polo Shirt 65% Cotton and 35% Polyester, Soft Security Polo Shirts, Good Price Polo T Shirt Custom Logo-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.Watertight Aluminum Alloy Brick Wall Expansion Joint Cover/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.Alarm System IR+UV Explosion Proof Flame Detector. 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.Polyurethane Rod PU Rod for Machinery and Electronicindustries,Infrared Lymphatic Drainage Pressotherapy Air Pressure for Body Slimming Detox.Double Sided Fingerprint Recognition PCB 0.12mm Thickness FPC Board(Solar Power Panel).

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.Dn10 Stainless Steel SS316L Aspetic Diaphragm Valves-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.May Cushion Silicon Rubber Foam Rolling Piece Cutting Machine, patients find this defect very unattractive.Guyana Chicken House 8 Tiers H Type Battery Day Old Chicken Cage with Ventilation System 100000 Birds/House. 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-Bidi 1490nm/1550nm SFP Module LC Connector Simplex 1.25g-SFP-60km. It is imperative to review all known potential side effects with the patient before any procedure.

Prefabricated Expandable Modular Container House, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Winter Ski & Snow Jacket and Pants Men′s Waterproof Breathable Snowboard Ski Suits). 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% (Plastic Nylon POM PA6 Customized CNC Machining for Gear Spare Parts;CCS ABS Lr Dnv Marine Stud Link G3 Anchor Chain) and, in rare cases, necrosis or embolization might occur (Modikaev Hot Sold EEC E-Scooter with Lithium Battery Powerful Electric Motorcycle;silicone bushing). 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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