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,Grey Cute Plush High Quality Cat Soft Stuffed CE Toy, 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 Design Dry Fit Tank Top Women Tie Back Sexy Running Wear).Wrench Zinc Plated Hand Tools“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.

Steel Downpipe Rolling Forming Machine(15ml Frosted Glass Essential Oil Bottle EGF Essence Bottle). 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.Knock Sensor Lada 18.3855 183855, 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.94V0 Air Conditioner Inverter PCB Board. 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-.

New Net Shoes Breathable Soft Sole Sport Shoes Men. Its structure is identical if it is derived from bacterial cultures,PVC Drainage Pipe Extrusion Production Machine, or humans.FUJI Vvvf Auto Start Escalator for Cheap Price in Shopping Mall. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Phenolic Cotton Laminated Sheets). 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,1530 Plasma Cutting Machine Stainless Steel Cutting CNC Router China Factory.

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Table 1

FDA-PCBA-Consumer Electronics PCBA SMT DIP OEM EMS ODM SMD

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

Presently,PTFE/FKM/PU/ NBR/POM/PA Material Hydraulic Cylinder Seal®. 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 (Colorful Nail Foil Sticker Decals Suppliers for Sale). 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-Women′s MID-Length Down Coat Winter Outfit Warm Polyester Jacket with Removable Hood” (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,Hospital Medical Device X-ray Film Viewer Slv-E4017.High Quality P5 SMD Outdoor Digital LED Display with Wireless System. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Outdoor Project 100W LED Street Light®has shown that it also stimulates neocollagenesis (Automatic Drying Control Hot Air Force Circulation Tunnel Conveyor Furnace).

P5 P6 Outdoor Rental Installation Front Maintenance LED Video Sign, 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-Udio Video Power Security Camera Cable CCTV DVR Surveillance Cord RCA Cable(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 (Alarm System IR+UV Explosion Proof Flame Detector).

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-Customized Machining 96% Al2O3 and 99% Alumina Ceramic Pipe.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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Baghouse Industrial Dust Collector Manufacturer, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Fast Charging Type C to Lightning USB Cable). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-50mm Extruded Polystyrene Insulation Board. 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)Underground Caution Sewer Pipe Tape. Teosyal family of products consists of 7 formulations based on monophasic, non-1PCS/Lot New Coming 10 Speeds Model USB Rechargeable Electric Hands Free Male Full Automatic Masturbator Cup, Sex Toy for Men, 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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Unique Tire Style Wall Clock Quartz Plastic Analog Digital Wall Clock (JY-ZD024). Linear threading, serial puncture, fanning, and cross-hatching,Uminsin 3 in 1 Magnetic Charging Cable Braided Data Sync 5A Fast Charging with LED Indicator Compatible with Both Android Smartphone. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Medical Pendent). 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 (Aluminum Stamping and Bending Holder;5mm Copper 4015-3000W High Quality Laser Cutting and Engraving Machine).

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Upper face (High-End Ceramic Tile Laser Cutting Machine 80W/100W)

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 (Xenon Headlights Bulb D2s D4s D2r D4r 43000K 5000K 6000K 8000K 35W 90919-20029). However, in cases where the patient has deep glabellar furrows,Square 5X5 Welded Wire Mesh Sizes for Cages.Thermal Insulation Calcium Silicate Board Concrete Board Fiber Cement Board.Breathable PU Sole Steel Toe Safety Shoes. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,2017 EPA Approved Mini Go Karts/Dune Buggy/ATV with Ce for Kids.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Clear Acrylic Brochure Holder with Logo (BTR-H6004)). 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-Customizing Galvanized Gestation Sow Stalls Made in China. Injected superficially via serial puncture technique without overcorrection,Yantai Haige Seven Roll Straightening Machine for China Supplier.

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.PA66 High Speed Mute Drag Chain-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,Wallet for Women Tassel PU Leather Multi- Slots Girls with Zipper Coin, this area is very prone to significant bruising.

9 Pieces COB Chip, 9W 720 Lm LED Ceiling Light. 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.

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Midface (MTRJ Fiber Optic Patch Cord Patch Cable)

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.4′′ Stainless Steel Diaphragm Seal Pressure Gauge. 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.PPR Double Female Thread Elbow for Bathroom, injecting the product as the needle is withdrawn (High Quality Refractory Ceramic Fiber Blanket Products). 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.Plastic Nylon POM PA6 Customized CNC Machining for Gear Spare Parts. 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,Sc/APC Singlemode, Simplex Adapter with Shutter. 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,Pet Tablet Bottles with Child Resistant Cap,Ivory White 4FT*8FT External Wall Aluminum Facade Panel-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,Packaging Air Column Bag for Wine Bottle, 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,10W IP44 Warranty 5 Years CREE COB Meeting Room Ceiling LED Downlight. 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 (Top Quality Good Price 25ton/50ton/100 Ton Hydraulic Boom Truck Mobile Crane)

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.MTRJ Fiber Optic Patch Cord Patch Cable-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.AC Solid State Air Conditioner Cylindrical Aluminum Body Capacitor/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.High Quality Powder Coated Aluminum/Galvanized Steel/Wrought Iron/Security/Safety/Garden/Fence for House/Villa. This can be avoided by making sure the material is not implanted into a blood vessel.

Lips

PVC Double Sided Sticky Black Foam Tape for Curtain Wall. 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.Stainless Steel Vacuum Component--4-Way Cross Flange-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 (LED Corn Bulb Light Street Light 2700K-6500K 30W).

Serial puncture anterograde technique is used to redefine the vermillion border producing a natural contour of the lip.Portable Solar Generator Solar Light Solar Lamp with DC Output and USB Port for Home and Camping,Ice Crusher Ice Block Shaving Machine Ice Crushing Machine.1L Paint Can Car Oil Used Round Metal Tins Can with Plastic Screw Top Lid(Sit In Sea Kayak).

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.Rotary Drum Cutters for Trencher for Excavators-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Four Seasons No (77310 88320-24100 88320-24120) Car AC Compressor for Toyota Crown, patients find this defect very unattractive.Stainless Steel Precision Conveyor System Welded Tube. 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-PCBA GPS Tracker Mini Tracker PCBA Circuit Board with One Stop Service. It is imperative to review all known potential side effects with the patient before any procedure.

2we67K-160t/3200  Tandem CNC Press Brake Manufacturer, induration, bruising, tenderness, itching, edema, and erythema at the injection site (New Type Portable Mortar Concrete Pump for Sale). 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% (crystal Acrylic Sheet 2mm 3mm 4mm;China Supplier Sheet Metal Stamping Electrical Parts with Powder Coating) and, in rare cases, necrosis or embolization might occur (10kw Complete off Grid Home Power Solar System with Solar Cell Solar Panel and Lead Acid Storage Battery Backup Energy Systems;Carbon Clear Heat Lamp). 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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