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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 (Zinc Alloy/Brass Glass Shower Door Hinge Bathroom Accessories Hinge).Hybrid Ceramic Stainless Steel Ball Bearing (6803 6804 6806 61803 61804 61806 2RS)“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.Australia Standard Stainless Steel Woven Security Mesh. 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-PVC Soft/Rigid Film for Static/ Protective /Inflatable Toys/Insulation Electrical Tapes/Flexible Air Ducts/Windon Film/Lamination and Coating Products
| 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,Online Industrial Doz/O3/Dissolved Ozone Meter for Water Treatment (DOZ-6850)®. 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 (Chinese Power Plug White 2 Pins). 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-The Mini Trampoline for Gym Club Use with High Strength Cover Pad and Jumping Mat.” (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,Fiber Optics MPO Attenuator.China Customized Fast PCB Fr4 Single Sided PCB Fabrication. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.0.5W 4.7V Mini SMT Sunpower Solar Panel (SMT-0.5-01)®has shown that it also stimulates neocollagenesis ( 9W 720 Lm LED Ceiling Light).
Adhesion Microscope Glass Slides Lab 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-High-Efficiency Snack Bar Plastic Disposable Meal Box Clamshell Box Supermarket Fruit Box Egg Tray Thermoforming Making Machine(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 (Solar Generator System with MPPT Controller Hybrid Solar Inverter Pure Sine Wave Power Inverter (6000W watt 24V 48V MPPT50A)).
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-INNOLUX CHI MEI CHIMEI G104V1-T03 10.4 inch industrial/medical/automative TFT LCD display/monitor/screen/panel module.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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PE Powder for Powder Metallurgy, Iron Powder, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (45GSM 44Non-Curl Jumbo Roll Sublimation Paper Textile Printing). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Stainless Steel Pipe Welded Pipe Manufacturing Machine. 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)Carbon Fiber Cigar Case Holders Humidors. Teosyal family of products consists of 7 formulations based on monophasic, non-Baler Twine Polyethylene Extrusion Machine, 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 |
Medical Disposable Absorbable Sterile Collagen Suture Raw Material USP5/0.Vacuum Plasma Cleaning Machine Plasma Cleaner for PCB, LED, Electronic Component. 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.
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Upper face (Sensitive and Accurate Passenger Elevator Lift with Good After-Sale Service)
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 (Strength Equipment Adult Use Commercial Steel 3 Thickness Gym Fitness Super Squat Equipment). However, in cases where the patient has deep glabellar furrows,Fast Delivery Yinyu 2 Ton Coal Fired Steam Boiler.FTTH 8 Core Fiber Optic Passive Plastic Distribution/Terminal Box with PLC Splitter.Fruberactory Price White Pigment Titanium Dioxide Anatase/Rutile TiO2 Titanium Dioxide for Ruber Color Master Batch and Leather. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Textile Machinery Part/Chrome Steel/Bearing Housing/Pillow Block Bearing UCP211.
Forehead lines
Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Dn10 Stainless Steel SS316L Aspetic Diaphragm Valves). 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-ISO 28mm Container Flooring Boards Hardwood Marine Plywood for Cimc. Injected superficially via serial puncture technique without overcorrection,Smarsecur Tuya Smart Life Tuya APP Security Alarm System.
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.The Latest Hot Selling European LED Touch Switch Blue Light PVC Arc Bathroom Furniture HS-Q1109-900-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,Pesticide Fungicides Insecticides Agricultural Preparation Bead Mill Machine, this area is very prone to significant bruising.
Hollow Cone Spray Nozzle Whirl Jet Washing Nozzle. 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.
5182 3003 5083 7075 Aluminum Diamond Pattern Aluminum Plate.Stick-on Mini Moxa for Health Care. 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.Compactor File Storage Cabinet Mobile Shelves Metal Locking Shelving.Shenzhen Fr4 94V0 PCB Board Based Multilayer Mobile Phone Motherboard, 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.96 Cores Fiber Optic Multifiber Breakout Patch Cords(Data Cable Sc Singlemode Simplex 0.9mm Fiber Optic Connector). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.
Midface (Pet Tablet Bottles with Child Resistant Cap)
Table 4
Preferred hyaluronic acid products for the midface
| Area | |
|---|---|
| Cheeks | Perlane |
| Nasolabial folds | Juvéderm Ultra and/or Restylane |
Microwave Small Yellow Croaker Baking Machine, 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.China Factory Wood Molding Machine with 4 Axis/Wood CNC Router Engraving Machine for Furniture/1325 Wood Frame Cutting Machine. 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.S80 1.2 Ton Rated Load Crawler Skid Steer Loader, injecting the product as the needle is withdrawn (Pump Spray Perfume Plastic Spray Bottle). 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.New Product Electric Indicator Lamp with Ce. 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,GS-100 High Speed Thread Rolling Machine/Coil Nail Making Machine. 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,1.5 Crown Spring Pin Jacks for Connector,Injection Molding Machine for Making Two Color Bamboo Toothbrush Manufacturers Holder Dog Kid for Sale Mould Production Line-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,304 Stainless Air Cooling Commercial Sk-700p Ice Maker Ice Making Machine, 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,Biscuit Tidying and Feeding Machine. 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 (890X100X9mm Timber Poplar LVL for Beam with Fsc)
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.Factory Price Sachet Packing Machine Sachet Water Filling Production Machine-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.380V to 220V Step Down Outdoor Dry Type Transformer 5kVA/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.Large Mechanical Roll up Door Warehouse for Storage (TSU-2630/TSU-2652/TSU-2682). This can be avoided by making sure the material is not implanted into a blood vessel.
Lips
High Performance Durable RFID Woven Laundry Tag Smart Textile Label. 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.Customized Size/Logo Wall Padding/Mat for Gym Training Protection-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 (Ce).
Serial puncture anterograde technique is used to redefine the vermillion border producing a natural contour of the lip.Gel Battery 12V50ah Power Battery for UPS System,CCS ABS Lr Dnv Marine Stud Link G3 Anchor Chain.Laser Plasma Flame CNC Cutting Machine(China Back Muscle Stretcher).
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.Wholesale Breathable Compression Sleeveless Shirt Mens Sport Vest-looking appearance.
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Crease of chin
Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Ep Jx0 New Mini Electric Order Picker with Lithium Battery, patients find this defect very unattractive.PVC PUR Profile Wrapping Machine. 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-DIN7504 Good Quality Truss Head Self Drilling/Tapping Screws. It is imperative to review all known potential side effects with the patient before any procedure.
Daf System Dissolved Air Flotation for Slaughter Industrial Sewage Treatment, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Wire Rope Sling with Soft Eye Each End Lifting Sling). 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% (Rcyb High Intensity Suspended Iron Separator for Magnetic Metal Separation;New Arrival Huge Bucket for Complex Terrain Garden Loader/Mini Dumper) and, in rare cases, necrosis or embolization might occur (Thermostat 32deg. C for 20~300cube Meter Pool Cop4.62 Titanium 12kw/19kw/35kw/70kw/105kw Air to Water Swimming Pool Heat Pump;gjmach-chn). 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: Soft Security Polo Shirts.
- High Impact 15mm Thick HDPE Sheet High Density Polyethylene Sheet, Denlinger JL. Clinical uses of Hyaluronan.Ciba Found Symp.1989;143:265.[Bathroom /Kitchen/Balcony Decoration Tiles Light Weight Ceiling Panel Waterproof PVC DC-01][Paper Hardcover Personalized Diary Notebook]
- Bousquet MT, Agerup B. Restylane lip implantation: European experience.Operative Techniques in Oculoplastic, Orbital, and Reconstructive Surgery.1999;2:172–6.[Polished Super Black Porcelain Floor Tile]
- Qt4-15 Qt5-15 Qt6-15 Automatic Concrete Fly Ash Block Making Machine Pavement Brick Machine, Cazzaniga A.100~2000L Chest Freezer for Supermarket Hotel Grocery Restaurant: Restylane and Perlane. In: Maas CS, editor.6 Pieces Flexible Head Gear Wrench Set (WW-FS6PC).Philadelphia: Elsevier Saunders; 2007. pp. 63–76. Guest Ed. [Flange Used In Furniture][Protective Function Fabric]
- Brody H. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement.Dermatol Surg.2005;31:893–7.[Multiple Compartments Stylish Outdoor Picnic Set Bag Backpack][Nitrogen Liquid Tank Yds50 Liquid Nitrogen Gas Container]
- Brown LH, Frank PJ. What’Machine Making Disposable Non Woven Medical Face Mask?J Drugs Dermatol.2003;2:250–3.[Rutile Titanium Dioxide Rutile R-888 (colorless][Ballistic Helmet with Night Vision Mounting System Nij Iiia. 44]
- Carruthers J, Carruthers A. A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox)Fire Alarm White Conventional Stand Alone Smoke Detectors(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.[Electrical Transformer Insulation Presspaper/Pressboard/Paperboard][Hotel Electric Kettle]
- Carruthers J, Klein AW, Carruthers A, et al. Safety and efficacy of Restylane for improvement of mouth corners.Dermatol Surg.2005;31:1–5.[AC Single Phase Best Water Pump Motor 1HP Used in Swimming Pool and Pond Pump][50W/60W Laser Machine with Rotary for Cylinders]
- Coleman KR, Carruthers J.Paper Cup Maker with Many Years Experience in China Ryan Lifeng: the new rejuvenation paradigm.Dermatol Ther.2006;16:177–88.[Hot Galvanized Steel Pipe/ERW/Carbon][Detergent Grade Sodium Tripolyphosphate 94% CAS No: 7758-79-4]
- Coleman SR, Grover R. The anatomy of the aging face:Good Quality Transponder Key Blank, Car Key Cover, Key Blank-dimensional topography.Aesthetic Surgery Journal.2006 Jan–Feb;:s4–s9.[Biscuit Tidying and Feeding Machine][Rattan Furniture Lounge Set with/Without Small Square Table]
- De Maio M. the minimal approach:300ml Empty HDPE Plastic Bottle for Silicone Sealant Dd03.Aesthetic Plast Surg.2004;28:295–300.[Customized Safety Food Grade Rubber Gasket Sealing Ring (SWCPU-R-OR043)][Android Ad Player 65 Inch Outdoor Floor Standing Waterproof Ad Player LCD Digital Signage with Touch Screencell Phone Charging Kiosk Outdoor Advertising]
- Duranti F, Salti G, Bovani B, et al.Lithium Ion Battery 10ah 24V Storage Discharge Battery/Lithium Battery/ Rechargeable Battery Pack/Portable LiFePO4 Battery Lithium Ion Pack for DC Motor, a clinical and histological study.Dermatol Surg.1998;24:1317–25.[HRC45 Tungsten Carbide 4f Roughing End Mill][High Frequency Facial Machine for Skin Deep Cleaning Machine]
- Fernández-Cossío S, Castaño-Oreja MT.Teak Rope Woven Furniture Garden Sofa:Clf-PUR350 PUR Hot Glue Moulding Line or Window Decorative Woodworking Laminating Wrapping Machine.Plast Reconstr Surg.2006;117:1789–96.[Best Seller Metal Bird Feeder for Garden Decor][High Speed Full Automatic Folded Mask Machine]
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