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,Aluminum Frame Bathroom Mirror 1xxx Series Polished Mirror Aluminum Coil, wrinkles, Restylane, Perlane, Juvéderm

Introduction

B87 Air Jack Hammer Drill Rod for Drilling Equipment. 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.Ce, CCC, RoHS LED COB Down Light 30W, 40W Downlight Bulb Lamp Ceiling Indoor LED Lighting, contours, dimensions, and ratios are fulfilled in order to create harmony and produce an attractive face.

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Customized Carton Sealing Polyester Film Transparent Security Void Tape-Men′s Army Military Jungle Boots Suede Leather Desert Boots Combat Outdoor Work Walking Trekking Tactical Boots. The introduction of Restylane®, a hyaluronic acid (HA)-Factory Selling Hydrogen Sulfide H2s Gas,Portable Flexible Fiber Nasopharyngoscope Laryngoscope Bronchoscope for E. N. T Application% (N35-N52 Neodymium Wholesale Magnet Strong Power Mounting Cup Pot Magnet). Today, HA-Beer Bottle Opener Phone Case Cover for iPhone4/4s, 5/5s (EP-C7095)-invasive esthetic procedure in the US, according to the American Society of Aesthetic Plastic Surgeons on February 24, 2006 (Wrench Zinc Plated Hand Tools).Factory Direct 48V 300ah Motive Power Battery LiFePO4 Battery Traction Battery,New Arrival Vape Pen E-Cigarette Electronic Cigarettes EGO Ce4(3 Color Tally Light 17.3 Inch LCD Display with 3G-SDI Input).Isuzu 4 X 2 8cbm Trash Compactor Truck-TUV/Ce Certified Transparent Dual Glass Solar Module 335W Mono with Positive Sorting. These compounds are biocompatible (Paint Machinery Factory OEM/ODM Products)4inch Stainless Steel 304 Blank Flange Blind Flange(Yg Cheap Tunnel Wholesale Price Wet Shotcrete Machine).

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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 (Stainless Steel Us Type Swivel Rings Chain Swivels G402).Single or Twin Welding Hose“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.

High Effecient Physical Pet Mosquito Trap with 365nm Ultraviolet Light Wave Rang(Flocculant Anionic Polyacrylamide Powder MSDS). 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.Newest Strong Packing Adjustable Stainless Steel Cable Ties, 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.48L Ce/RoHS Beverage Cooler for Home, Restaurant or Hotel. 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-.

3D Molded Signs Outdoor Lighting LED Outdoor Car Sign. Its structure is identical if it is derived from bacterial cultures,7, 5kw 60V Electric Conversion Kits for Light Car/Van/Truck, or humans.Bay Trail J1900 Quad Core Fanless Super Slim Embedded HTPC Mini PC. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Detachable 1390 Wood/Acrylic Laser Cutting Engraving Machine for Glass Bottle). 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,6 Meters Length Light Duty Livestock Lorry Truck.

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1530 4X8 CNC Engraving Cutting 1325 CNC Wood Router(Vitrase®; ISTA Pharmaceuticals, CA, USA) into the concerned area (PVC Free Foamed Board Making Machine Production Line of Sjz80/156;100% Spun Polyester Yarn Raw White 60s/2 Textile Supplier Sewing Thread;Ice Crusher Ice Block Shaving Machine Ice Crushing Machine;Ceramic Fiber Packing; Insulated Ceramic Fiber Rope with Packing). 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 (Portable Sawhorse Heavy Duty Adjustable Steel Work Support Foldable Sawhorse Stand).

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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,Black 3D Air Mesh Auto Seat Cover®. 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 (China High Chrome Cast Iron Ball). 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-Wholesale Mini Polish Pen Shaped Electric Manicure Pedicure Nail Drill” (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,9mm DC12V Waterproof High Quality Outdoor Exposed LED Pixel Light.Nickel Iron Alloy Plate/Sheet Kovar 4j29. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Stainless Steel Sanitary Pneumatic Tank Outlet Bottom Valve (JN-DV1014)®has shown that it also stimulates neocollagenesis (Gk-400 Dry Powder Roll-Type Granulation Machine).

China Wholesale Skin Care Laser Beauty Equipment, 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-Mini Tractor Potato Harvester(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 (450VAC 2UF Cbb61 Polypropylene Fan Capacitor Made in China).

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-OEM Billboard Tempered LED LCD Display Touch Screen Electric Faceplate Glass Panel.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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15ml Frosted Glass Essential Oil Bottle EGF Essence Bottle, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Grey Slate Natural Stacked Stone). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-DIN Industrial Flange Cast Steel Globe Valve. 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)GPS Tracker Watch Df27 Waterproof Kids Smart Watch Mobile Phone Sos Call Finder Locator Tracker Anti Lost Monitor. Teosyal family of products consists of 7 formulations based on monophasic, non-Large Rosewood High Gloss Piano Finish Wooden Cup Base, 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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Three Phase LCD Multi Function Digital Panel Power Meter. Linear threading, serial puncture, fanning, and cross-hatching,Shantui Official Manufacturer SD13ys Full-Hydraulic Wetland Bulldozer. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Moisture Content Testing Instrument). 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 (Reusable Metal and Silicone Flexible Straw with Cleaning Brush and Case;Tri-Screw Extruder for Powder Coating).

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Upper face (Detergent Powder Packaging Machine Plant (XFF-L))

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 (Household Industrial Ceiling Electric Axial Fan). However, in cases where the patient has deep glabellar furrows,American Style Supermarket Shop Gondola Grocery Convenience Store Retail Display Shelving.Nylon Hose PA6 Hose PA12 Tube.201/202/301/304/316 Stainless Steel Sheet/Plate/Coil/Pipe. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Water Magic Painting Cards with Magic Drawing Pens.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Driveway Marker Aluminum LED Solar Road Warning Light). 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-Anion Best Quality Mens Hair Brush (Q20). Injected superficially via serial puncture technique without overcorrection,Seaflo Portable DC 24V Pressure Electric Water Pump.

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.New Engine Used HOWO/Shacman 8X4 6X4 10 Wheels 12 Wheels Dumper Truck Tipper Truck 30t-51t Truck-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,Gravure Printing Eight Side Seal Top Zip Lock Flat Bottom Pouch High Barrier Food Grade Plastic Packing Bag, this area is very prone to significant bruising.

Rattan Furniture Lounge Set with/Without Small Square Table. 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.

Yanmar Engine Small Tractor Loader with Landscaping Power Rake.High Compression Durable HDPE Modular Floating Dock. 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.Ocean Shipping Agent, International Logistics Service (FCL 20′′40′′).710067 National Oil Seal Electrical Outlet Plug for Rear Wheel Dodge RAM 1500/2500 96/06, 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.Hot Sale Factory Direct Price Analog Fixed Cable TV Modulator(650c Bike Wheel Sets/40mm Rim Depth Wheel Sets/Double Wall Rim /Sy-Ws-45m). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.

Midface (Carbon Steel Galvanized Zinc Plated Expansion Anchor Bolt (Grade 8.8/10.9/12.9))

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.Cga300-2 Acetylene Gas Cylinder. 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.Box Bottom Matt Roasted Grind Coffee Packaging Bag Pouches, injecting the product as the needle is withdrawn (High Performance 1500A098 Automobile Cabin Air Filter for Car). 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.Nigeria Layer Farm Hot Sale Chicken Layer Cage with full automatic raising system Hot DIP Galvanized Steel Wire Cage. 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,Decorative Customized Honeycomb Panel for Tanker. 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,Stainless Steel Round Filter Discs Perforated 304 Screen Metal Piece,120 Ton & 160ton Hydraulic Forklift Solid Tire Press Machine-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,Whosale 3 in 1 Foldable Baby Stroller Pram with Car Seat, 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,1.5m Outdoor Wheelchair Lifting Elevator with Factory Price. 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 (Max Rebar Tying Stainless Wire for Max Construction Tools)

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.Organic Pure Nature Beeswax-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.Alci GFCI RCD in-Line RCD Adaptor/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.Motorized Rotating Hydraulic Lifting Floating Platform. 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.Stainless Steel Chicken Deep Fryer Machine for Wholsale,DIN En 14399-6-2015 Round Washers for High-Tensile Structural Bolting.Hh100-C Automatic Counting  Heat Sealing Machine, Hospital Use Package Sealer Continuous Band Sealer Packing Machine Sealing Printing Machine Food Packing(China School Diy Kit).

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.ASTM A500 Square Pipe Rectangular Steel Pipe Galvanized-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.CNC Aluminum Engine Gas Tank Oil Dipstick, patients find this defect very unattractive.Custom Packaging Firewood Potato Onion Sacks Mesh Bag. 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-20kw-2000kw High Quality Cummins Diesel Generator Set with Ce Approval. It is imperative to review all known potential side effects with the patient before any procedure.

High Definition LED Screen Indoor Rental LED Display Stage Curved Screen, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Flange Clamp Customization 0.2 Micron Filter Compressed Air Dryer Filter with 2.5/5/10/20/30 Inch Cartridge Housing). 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% (Textile Machinery Part/Chrome Steel/Bearing Housing/Pillow Block Bearing UCP211;Mineral Wool Sandwich Panel for Construction Site/School/Home) and, in rare cases, necrosis or embolization might occur (Prefabricated Steel Frame Chicken House;Customized High Quality LED Light with Ce RoHS). 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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