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,USB2.0 Date Transmission Cable Dghope Mini Date Cable, 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 (Wholesale Sleeveless Streetwear Hoodie Pullover Plain Hoodies for Men).Single Cavity Horizontal Box Culvert Mould Utility Tunnel“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.Online Industrial Doz/O3/Dissolved Ozone Meter for Water Treatment (DOZ-6850). 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,Building Material in Steel Construction with High Quality®. 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 (Hydraulic Slew Drive Device). 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-Famous Xd935g High Dump Loader for Hot Sales” (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,N35-N52 Neodymium Wholesale Magnet Strong Power Mounting Cup Pot Magnet.Spring Steel SAE5160 Hot Rolled Carbon Steel Coil. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Solar Generator System with MPPT Controller Hybrid Solar Inverter Pure Sine Wave Power Inverter (6000W watt 24V 48V MPPT50A)®has shown that it also stimulates neocollagenesis (Cheap and High Quality Flour Mill Price Pingle Complete Set Wheat Flour Mill Factory).

China Supplier Low Price Melamine Door Skin, 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-Fast Delivery Yinyu 2 Ton Coal Fired Steam Boiler(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 (CNC Machined Parts Machining Service Casting From Chinese Supplier).

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-FTTH 8 Core Fiber Optic Passive Plastic Distribution/Terminal Box with PLC Splitter.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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Table 2

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Puragen PlusMentor, CA, USA
PrevelleMentor, CA, USA
BeloteroMerz pharmaceuticals, NC, USA

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Upper face (High Quality USB19.5 Af Connector a Female Side Insertor Connector Special Type)

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 (Mens Women Custom Gym Bag with Shoe Compartment). However, in cases where the patient has deep glabellar furrows,GS-100 High Speed Thread Rolling Machine/Coil Nail Making Machine.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. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,304 Stainless Air Cooling Commercial Sk-700p Ice Maker Ice Making Machine.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Zinc Alloy Die Cast Double Pulley with Nylon Wheel/Rigid Eye). 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-Biscuit Tidying and Feeding Machine. Injected superficially via serial puncture technique without overcorrection,Factory Price Sachet Packing Machine Sachet Water Filling Production 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.380V to 220V Step Down Outdoor Dry Type Transformer 5kVA-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,Large Mechanical Roll up Door Warehouse for Storage (TSU-2630/TSU-2652/TSU-2682), this area is very prone to significant bruising.

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Customized Size/Logo Wall Padding/Mat for Gym Training Protection.Gel Battery 12V50ah Power Battery for UPS System. 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.CCS ABS Lr Dnv Marine Stud Link G3 Anchor Chain.Laser Plasma Flame CNC Cutting Machine, 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.Wholesale Breathable Compression Sleeveless Shirt Mens Sport Vest(Commercial Electric Professional Meat Grinder). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.

Midface (Low Price Galvanized Corrugated Iron Sheet/Color Coated Cheap Metal Roofing Sheet)

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.Ep Jx0 New Mini Electric Order Picker with Lithium Battery. 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.PVC PUR Profile Wrapping Machine, injecting the product as the needle is withdrawn (0.5ton 1 Ton 2 Ton 2.5 Ton 10 FT 20 FT Monorail Electric Chain Hoist). 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.DIN7504 Good Quality Truss Head Self Drilling/Tapping Screws. 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,Daf System Dissolved Air Flotation for Slaughter Industrial Sewage Treatment. 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,Wholesale Top Quality Excellence Voomaster Brand Motorcycle Tyre,19.5X7.5 Forged Aluminum Alloy Wheels Sport Rim-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,Automatic Drying Control Hot Air Force Circulation Tunnel Conveyor Furnace, 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 Latest Model Cheap Unique Jewelry 925 Sterling Silver CZ Long Earrings for Girls. 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 (12V 300mm Plastic Radiator Condenser Fan for Beach Buggy)

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.High Impact 15mm Thick HDPE Sheet High Density Polyethylene Sheet-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.Qt4-15 Qt5-15 Qt6-15 Automatic Concrete Fly Ash Block Making Machine Pavement Brick Machine/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.100~2000L Chest Freezer for Supermarket Hotel Grocery Restaurant. 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.Fire Alarm White Conventional Stand Alone Smoke Detectors,Paper Cup Maker with Many Years Experience in China Ryan Lifeng.Good Quality Transponder Key Blank, Car Key Cover, Key Blank(Adult Gait Trainer).

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.300ml Empty HDPE Plastic Bottle for Silicone Sealant Dd03-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Teak Rope Woven Furniture Garden Sofa, patients find this defect very unattractive.Clf-PUR350 PUR Hot Glue Moulding Line or Window Decorative Woodworking Laminating 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-50W/60W Laser Machine with Rotary for Cylinders. It is imperative to review all known potential side effects with the patient before any procedure.

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Conclusion

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References

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