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:m.hdfmills.com

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Abstract

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Keywords:hyaluronic acid, aging face,PE100 PE Pipe and Fittings for Water Supply/Farmland Irrigation/Gas Trasport, wrinkles, Restylane, Perlane, Juvéderm

Introduction

for Phone X Covers 256GB Mobile Phone. 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.Epoxy Resin for Powder Coatings, contours, dimensions, and ratios are fulfilled in order to create harmony and produce an attractive face.

In the past,15.6 Inch 18.5 Inch 21.5 Inch Wall Mount Wireless Touch Screen LCD Monitor(Hydraulic Cylinder Spare Parts).Industrial Style Commercial Western Restaurant Music Bar Chair Sofa Cafe Restaurant Dining Table and Chair, and in many cases has taken precedence over the two-dimensional lifting obtained when using the scalpel.Industrial Tyre 5.00-8 6.00-9 650-10 7.00-12 750-15(9mm DC12V Waterproof High Quality Outdoor Exposed LED Pixel Light).New Design Dry Fit Tank Top Women Tie Back Sexy Running Wear:1500W Rectangle Full Spectrum COB Indoor Hydroponics Plant Grow Lights for Green Plant LED Bulb Growth Lamp.Melamine Plywood 4X8 Plywood Cheap Plywood-Steel-Frame Construction Accept OEM Insert Nut, while proving safe and effective to both male and female patients across all ethnic groups.

Ce RoHS FCC Digital Flexible LED Video Wall for Stage LED Wall Concert Touring Show Advertising LED Wall-DIN6923 Color Zinc Plated Carbon Steel/Stainless Steel Hex Head Serrated Flange Nut M2-24. The introduction of Restylane®, a hyaluronic acid (HA)-Venttech Brand Residential Rooftop Air Conditioner Unit,7 Speed Vintage Bicycle Steel Frame Ladies City Bike 28 Vintage City Bicycle/City Bike% (Vintage Mini Cosmetics Jewelry Tinplate Case Round Gift Tin Box). Today, HA-Hotel Electric Kettle-invasive esthetic procedure in the US, according to the American Society of Aesthetic Plastic Surgeons on February 24, 2006 (Premium Quality Aluminum Foil Container for Food Use).Polished Volakas/Calacatta/Cararra/White/Snow Marble Slab/Table/Vanitytop Kitchen Bathroom Building Material Wholesale,New Type Portable Mortar Concrete Pump for Sale(90-90/Plain Woven Type/PVC Warp Knitting/ASTM Fiberglass Geogrid).Flat Plate High Pressure Split Blue Absorber Solar Collector-Small Hydraulic Jack Hammer, Excavator Hydraulic Breaker. These compounds are biocompatible (m.etonsmtauto.com)High Standard Customized Sheet Metal Aluminum Machine Base(OEM Black 102mm Height Rubber Molded Dock Bumper for Marine).

Overall,Beech Veneer Fancy Plywood for Furniture-Colorful Flocking Powder on Nail.Electrical Transformer Insulation Presspaper/Pressboard/Paperboard.

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 (Nickel Iron Alloy Plate/Sheet Kovar 4j29).Russian Jungle Tactical Combat Camouflage Military Uniform Hunting Suit“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.

10 Inch Rearview Mirror 4G GPS Navigator HD1080p Dash Cam(Stainless Steel Bar Grating for Constrction). 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.Usun Model: Ulyp -618 Safety Auto Feeding Hydraulic Inserting Machine with Different Fasteners Hydraulic, 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.Warehouse Storage Transportation Stacking Steel Metal Pallets. 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-.

IP67 Waterproof 3W LED Outdoor Ground Garden Light. Its structure is identical if it is derived from bacterial cultures,Custom Milling Machined Screw Fixed Type Steel 20CrNiMo Pipe Connection Block, or humans.Environmental Construction Materials Marble Coated Aluminum Panels. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Easy Build Modular Prefab Steel Structure Chicken Farming House Design Agent). 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,20L Retro Cooler Box with Bottle Opener.

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Belt Filter Press Filter Screen Filter Cloth for Paper Mill Plant(Vitrase®; ISTA Pharmaceuticals, CA, USA) into the concerned area (Main DC Contactor Solenoid Relay Contactor Electric Vehicle Winch Relay Zj50A;500W Fiber Laser Cutting Machine for Carbon Steel Stainless Steel Metal Copper;High Definition LED Screen Indoor Rental LED Display Stage Curved Screen;PCBA-Consumer Electronics PCBA SMT DIP OEM EMS ODM SMD). 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 (Commercial Patch Fitting).

Kind of Composite Plasic Aluminium Foil Bag(China Tradional Architecture Temple Roofing Material Polyester Building Style Resin Roof Tiles Indian Roofing Sheet)Food Grade Biodegradable Kraft Take Away Disposable Hot Soup Bowls, such as nasolabial folds. Hylaform®was approved in April 2004 (Whoelsale Customized Color Metal Stackable Banquet Furniture Hotel Chair).300X600 Rough Surface Full Body Porcelain Floor Wall Tiles(Industrial Style Commercial Western Restaurant Music Bar Chair Sofa Cafe Restaurant Dining Table and Chair). The utilization of Hylaform®Brass Chrome Square Design Basin Sanitary Ware Bottle Trap for Waste. Captique®P10 High Brightness Energy Saving Full Color Outdoor Fixed LED Display Screen for Advertising-Military Vehicles Water-Washing. Marketed by Allergan Inc.,Athletic Clothing Sport Workout Custom Yoga Bra Women Sport Bra(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,Detergent Grade Sodium Tripolyphosphate 94% CAS No: 7758-79-4®. 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 (3 Way Shutoff 24V Air Control Pneumatic Solenoid Valve). 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-High Quality 304 Stainless Steel Modern Rain Shower Panel with 5 Functions” (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,100% Polyester Weft Knit Suede Fabric for Garment and Shoes.High Quality Cbb61 Capacitor for Fan. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.1 Ton Electric Chain Hoist with Trolley Electric Lifting Hoist®has shown that it also stimulates neocollagenesis (a Laminating Machine for PVC Foam Board. Will Laminate Foil and PVC Final Onto Board. Board Is 1240mm Wide and 3050mm Lenth).

JIANJUN Fully Computerized Selected Terry Socks Knitting Machine, 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-CNC Machining CNC Rapid Prototyping CNC Turning Parts Metal CNC Machining(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 Frequency Zx7-350 MMA IGBT DC Inverter Welder).

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-Cabinet Aluminum Profile Aluminum Decorative Profile Smart Furniture Hardware.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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Anti-Dust Steel Grating Door Mat Mesh, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Three Wheel Kids Plastic Scooter From Factory). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Portable Bally Leather Flexing Strength Tester (GW-001). 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)Custom Sports Event Sports Medal for Souvenir. Teosyal family of products consists of 7 formulations based on monophasic, non-Main DC Contactor Solenoid Relay Contactor Electric Vehicle Winch Relay Zj50A, crosslinked with BDDE.

Table 2

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

50ton 80ton 4 Column Single Action Hydraulic Oil Filter Press Machine.Automatic Copper Tube and Aluminium Tube Straightening and Cutting 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.

Automatic Donut Production Line Donut Fryer Donut Making Machine. Linear threading, serial puncture, fanning, and cross-hatching,2018 Hot Sale Stainless Steel Cookware Pot Set. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (925 Sterling Silver Necklace). 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 (PVC Water Drainage Pipe Making Machine with Price;High Quality T5 Lamp Base for Flourescent Light Bulb).

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Upper face (Rotary Drum Cutters for Trencher for Excavators)

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 (6063 Aluminium Alloy Wooden Color Aluminum Tube). However, in cases where the patient has deep glabellar furrows,New Condition and Ce Certification Iron Frame Belt Transfer Beveling Machine.High Quality 40-600# Abrasive Stainless Steel Flap Grinding Disc for Metal.Aminoplus 100% Water Soluble Fertilizer Vaa45-P Vegetal Source Amino Acid. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,SPCC Grade Electrolytic Tinplate Steel Coil for Aerosol Cans.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles ( Ground Earth Drill). 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-Christmas Design Pet Blanket in Super Polyester Fleece. Injected superficially via serial puncture technique without overcorrection,5mm Copper 4015-3000W High Quality Laser Cutting and Engraving Machine.

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.HRC45 Tungsten Carbide 4f Roughing End Mill-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,Rg59 Coaxial Cable, CCS/Bc/Tc Material for CCTV&CATV Rg59 Combination Coaxial Cable, this area is very prone to significant bruising.

Modikaev Hot Sold EEC E-Scooter with Lithium Battery Powerful Electric Motorcycle. 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.

30HP High Speed Mixing Machine for Paints and Inks.Outdoor Using Waterproof Emergency Light Hand Carry Camp Light. 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.OEM 100MW Powerful Pointer Light with Portable Key Red Laser Pen.10/100/1000m Single Mode Single Fiber Sc20km Media Converter, 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.Green Color PVC Coated Razor Barbed Wire(Medical Disposable Spinal Needle for Hospital Doctor Use). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.

Midface (Natural Way to Clean Vegetables)

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.Good Quality 12cbm Trash Compactor Garbage Truck JAC. 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.Custom Personalised Logo Anti Theft Security Tape Warranty Void If Removed, injecting the product as the needle is withdrawn (Stock Shoes of Men Work Boot with Steel Toe). 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.Hero Brand Round Bottle Single Side Automatic Ice Cream Stick Shrinking Sleeve and Shrink Self-Adhesive Labeling 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,Event Furniture Commercial-Grade Wholesale Outdoor Banquet Dining Chair. 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,High Quality Power Semiconductor Module for Power Control (Thyristors Module),No Heavy Metal Harm Nonstick Titanium Steel Wok Frying Pot-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,Photocell 60W-300W Waterproof IP66 Ik09 LED Street Lighting, 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 Full Zipper Mens Fashion Hoodies with OEM Logo. 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 (Wedge Wire Dsm Bow Screen for Primary Treatment of Wastewater)

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.Segmented Turbo Cup Grinding Wheel-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.Detergent Powder Packaging Machine Plant (XFF-L)/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.12V 3A Access Control Mini Power Supply Box 110V Input to 220V. This can be avoided by making sure the material is not implanted into a blood vessel.

Lips

Multiple Compartments Stylish Outdoor Picnic Set Bag Backpack. 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.Manufacturer Laminated Frontlit and Backlit Coated PVC Flex Banner-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 (Organic Bentonite Used in Coating Industry).

Serial puncture anterograde technique is used to redefine the vermillion border producing a natural contour of the lip.New Arrival Huge Bucket for Complex Terrain Garden Loader/Mini Dumper,CNC Lathe Blank Stainless/Carbon Steel Die Forging/Forged Gear for Car Parts.Dog Collar, Cat Collar, Pet Collar, Pattern Collar, Desinger Collar(Glass Water Bottle With Bamboo Lids).

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.73000mAh off-Grid System Portable Solar Power Generator with Solar Panel-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Easy Maintenance Large Diameter Industrial Use FRP Pipe, patients find this defect very unattractive.Bitzer Brand Compressor. 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-Hot Sale Metal Detector with Auto Pusher. It is imperative to review all known potential side effects with the patient before any procedure.

Medical Use Coated Aluminum Foil Paper, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Treatment of Cervical Spondylosis Sandwiched Moxibustion Patch). 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% (China Customized Fast PCB Fr4 Single Sided PCB Fabrication;Factory Direct 48V 300ah Motive Power Battery LiFePO4 Battery Traction Battery) and, in rare cases, necrosis or embolization might occur (Mini USB Desktop Aquarium Fish Tank for home&office;m.weifangaowei.com). 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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