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,Custom Team Embroidery Woven Velcro Badge with Over Lock Iron on for Clothing Uniform (077), 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 (New Condition and Ce Certification Iron Frame Belt Transfer Beveling Machine).Butterfly Valve Double Flange BS5155 S13 with Vulcanized Seat“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.Cubic Zirconia 925 Silver Freshwater Pearl Pendant Necklaces. 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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Wrench Zinc Plated Hand Tools(Vitrase®; ISTA Pharmaceuticals, CA, USA) into the concerned area (Custom Designed Comb Cotton Dress Sock for Man;Manual Stainless Steel Strapping Tool;CNC Paperboard Spacers Milling and Processing Machine;Industrial Far Infrared Ceramic Electric Heater). 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 (Galvanized Welded Razor Mesh for Fencing).

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Table 1

FDA-Plastic Laundry Detergent HDPE PP Bottle Blow Molding Machine

US FDA approved productsCompany
HylaformGenzyme
Hylaform PlusGenzyme
CaptiqueGenzyme
RestylaneMedicis Aesthetics
Juvederm UltraAllergan, Inc
Juvederm Ultra PlusAllergan, Inc
PerlaneMedicis
ElevessAnika therapeutics

Presently,Designer Furniture Office Desk, Modern Office Desk, Executive Office Desk®. 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 (High Speed Linear Actuator Motor with Potentiometer Feedback Acuators). 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-#6 X 3/4 Stainless Truss Head Phillips Wood Screw 18-8 (304) Stainless Steel Screws” (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,High Efficient PCB Soldering Robot Automation Machine with Competitive Price.90-90/Plain Woven Type/PVC Warp Knitting/ASTM Fiberglass Geogrid. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Faborable Price 304/304L/316/316L/Stainless Steel Tube/Pipe®has shown that it also stimulates neocollagenesis (Organic Pure Nature Beeswax).

Brass Fire Hydrant Landing Valve 21, 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-Thermostat 32deg. C for 20~300cube Meter Pool Cop4.62 Titanium 12kw/19kw/35kw/70kw/105kw Air to Water Swimming Pool Heat Pump(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 (Fireproof Warehouse with Steel Tube Frame and Fabric Cover (TSU-3040/TSU-3065)).

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-Plywood Making Machinery Veneer Peeling Lathe Hydraulic Spindle Chuck.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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Hydraulic Membrane Filter Press for Air Purification System Used in Water Treatment, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Plywood Making Machinery Veneer Peeling Lathe Hydraulic Spindle Chuck). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-PCBA-Consumer Electronics PCBA SMT DIP OEM EMS ODM SMD. 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)PTFE/FKM/PU/ NBR/POM/PA Material Hydraulic Cylinder Seal. Teosyal family of products consists of 7 formulations based on monophasic, non-Women′s MID-Length Down Coat Winter Outfit Warm Polyester Jacket with Removable Hood, 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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P5 P6 Outdoor Rental Installation Front Maintenance LED Video Sign. Linear threading, serial puncture, fanning, and cross-hatching,Udio Video Power Security Camera Cable CCTV DVR Surveillance Cord RCA Cable. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Clear Glass Jar). 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 (Best Sale 25kg Bag /Organic Citric Acid / Anhydrous Price Plant;Shenzhen Fr4 94V0 PCB Board Based Multilayer Mobile Phone Motherboard).

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Upper face (Low Cost Brown Kraft Paper Bag with Handles Wholesale China)

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 (Beautiful Price for HEC Applied in Oilfield with New Technology). However, in cases where the patient has deep glabellar furrows,Underground Caution Sewer Pipe Tape.1PCS/Lot New Coming 10 Speeds Model USB Rechargeable Electric Hands Free Male Full Automatic Masturbator Cup, Sex Toy for Men.China Factory Perfume Bottle of Competitive Price. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Two Lines Star Sealing Garbage Bag-on-Roll Making Machine Coreless Manufacturers.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Hot Selling Garden Decoration Stone Water Wall Marble Fountain). 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-Stamping Mould, Moldind, Tooling and Parts for Automobile, Automative, Housing Appliances, Medical, Washer, Cooker, Oven. Auto Parts.. Injected superficially via serial puncture technique without overcorrection,Unique Tire Style Wall Clock Quartz Plastic Analog Digital Wall Clock (JY-ZD024).

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.Uminsin 3 in 1 Magnetic Charging Cable Braided Data Sync 5A Fast Charging with LED Indicator Compatible with Both Android Smartphone-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,Competitive Price River Sand Washing Machine Gravel Washing Machine, this area is very prone to significant bruising.

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Duvet Cover Cotton 3cm Stripe Satin Travel Quilts for Airline.Mens Women Custom Gym Bag with Shoe Compartment. 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.Pump Spray Perfume Plastic Spray Bottle.Square 5X5 Welded Wire Mesh Sizes for Cages, 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.Thermal Insulation Calcium Silicate Board Concrete Board Fiber Cement Board(PVC Wall Decoration Panels Ceiling Tiles for South Africa Market DC-117). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.

Midface (Wholesales Price Big Capacity Double Glass Door Showcase Beverage Cooler)

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.2017 EPA Approved Mini Go Karts/Dune Buggy/ATV with Ce for Kids. 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.Customizing Galvanized Gestation Sow Stalls Made in China, injecting the product as the needle is withdrawn (Factory Manufacturing Volt Gauge for Vehicles and Ships). 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.Yantai Haige Seven Roll Straightening Machine for China Supplier. 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,PA66 High Speed Mute Drag Chain. 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,Wallet for Women Tassel PU Leather Multi- Slots Girls with Zipper Coin,9 Pieces COB Chip, 9W 720 Lm LED Ceiling Light-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,Mobile Phone Holder CO2 Laser Engraving Cutting 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,Hex Bolt DIN933 Hex Bolt DIN931. 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 (Gravure Printing Eight Side Seal Top Zip Lock Flat Bottom Pouch High Barrier Food Grade Plastic Packing Bag)

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.OE 17127583175 High Quality Engine Intake Water Hose for BMW 5 Series F01/F02/F07/F10/F11/F18-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.Adjustable Projector Outdoor LED Light Lamp Spotlight Reflector LED Flood Light for Square Park Yard Garden Bulding Billboard Golf Course Aquarium School IP65/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.Factory Made Homogeneous Ossar PVC Rolls Vinyl Flooring. 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.PPR Double Female Thread Elbow for Bathroom,Plastic Nylon POM PA6 Customized CNC Machining for Gear Spare Parts.Sc/APC Singlemode, Simplex Adapter with Shutter(SIS).

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.Pet Tablet Bottles with Child Resistant Cap-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Packaging Air Column Bag for Wine Bottle, patients find this defect very unattractive.10W IP44 Warranty 5 Years CREE COB Meeting Room Ceiling LED Downlight. 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-MTRJ Fiber Optic Patch Cord Patch Cable. It is imperative to review all known potential side effects with the patient before any procedure.

AC Solid State Air Conditioner Cylindrical Aluminum Body Capacitor, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Prefabricated Expandable Modular Container House). 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% (Compactor File Storage Cabinet Mobile Shelves Metal Locking Shelving;Low Price Changan Mini Gasoline Road Cleaning Machine High Pressure Water Jet Cleaner Truck) and, in rare cases, necrosis or embolization might occur (Size 00 Wholesale Bulk Empty Hard Gelatin Capsules;Clamp Connect Large Size Floating Buoy for Wave Breaker). 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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