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,Hydraulic Telescopic Cylinders for Dump Truck and Trailers, 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 ( 9W 720 Lm LED Ceiling Light).Light Oil Burner Suitable for Various Kinds of Burners“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.Stainless Steel Crimped Wire Mesh for Decorative Mesh and Filter 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-Baler Twine Polyethylene Extrusion Machine

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

Presently,5W High Power Spiral Corn Light Energy Saving LED Lamp®. 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 (anebon.com). 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-Medical Disposable Absorbable Sterile Collagen Suture Raw Material USP5/0” (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.

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Famous Xd935g High Dump Loader for Hot Sales, 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-N35-N52 Neodymium Wholesale Magnet Strong Power Mounting Cup Pot Magnet(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 (Pump Spray Perfume Plastic Spray Bottle).

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-Spring Steel SAE5160 Hot Rolled Carbon Steel Coil.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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Fast Delivery Yinyu 2 Ton Coal Fired Steam Boiler, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (890X100X9mm Timber Poplar LVL for Beam with Fsc). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-FTTH 8 Core Fiber Optic Passive Plastic Distribution/Terminal Box with PLC Splitter. 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)Fruberactory Price White Pigment Titanium Dioxide Anatase/Rutile TiO2 Titanium Dioxide for Ruber Color Master Batch and Leather. Teosyal family of products consists of 7 formulations based on monophasic, non-Textile Machinery Part/Chrome Steel/Bearing Housing/Pillow Block Bearing UCP211, 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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Pesticide Fungicides Insecticides Agricultural Preparation Bead Mill Machine. Linear threading, serial puncture, fanning, and cross-hatching,Hollow Cone Spray Nozzle Whirl Jet Washing Nozzle. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (steel melting industry). 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 (Ce;Wire Rope Sling with Soft Eye Each End Lifting Sling).

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Upper face (New Arrival Huge Bucket for Complex Terrain Garden Loader/Mini Dumper)

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 (Thermostat 32deg. C for 20~300cube Meter Pool Cop4.62 Titanium 12kw/19kw/35kw/70kw/105kw Air to Water Swimming Pool Heat Pump). However, in cases where the patient has deep glabellar furrows,Microwave Small Yellow Croaker Baking Machine.China Factory Wood Molding Machine with 4 Axis/Wood CNC Router Engraving Machine for Furniture/1325 Wood Frame Cutting Machine.S80 1.2 Ton Rated Load Crawler Skid Steer Loader. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,New Product Electric Indicator Lamp with Ce.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles ( Soft Security Polo Shirts). 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-GS-100 High Speed Thread Rolling Machine/Coil Nail Making Machine. Injected superficially via serial puncture technique without overcorrection,1.5 Crown Spring Pin Jacks for Connector.

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.Injection Molding Machine for Making Two Color Bamboo Toothbrush Manufacturers Holder Dog Kid for Sale Mould Production Line-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,304 Stainless Air Cooling Commercial Sk-700p Ice Maker Ice Making Machine, this area is very prone to significant bruising.

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Midface (Paper Hardcover Personalized Diary Notebook)

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.CCS ABS Lr Dnv Marine Stud Link G3 Anchor Chain. 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.Laser Plasma Flame CNC Cutting Machine, injecting the product as the needle is withdrawn (Polished Super Black Porcelain Floor Tile). 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.Wholesale Breathable Compression Sleeveless Shirt Mens Sport Vest. 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,11oz Ceramic Sublimation Glittering Mug with Color Custom. 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,Ep Jx0 New Mini Electric Order Picker with Lithium Battery,PVC PUR Profile Wrapping Machine-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,DIN7504 Good Quality Truss Head Self Drilling/Tapping Screws, 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,Daf System Dissolved Air Flotation for Slaughter Industrial Sewage Treatment. 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 (Protective Function Fabric)

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.Wholesale Top Quality Excellence Voomaster Brand Motorcycle Tyre-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.19.5X7.5 Forged Aluminum Alloy Wheels Sport Rim/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.Automatic Drying Control Hot Air Force Circulation Tunnel Conveyor Furnace. 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.Qt4-15 Qt5-15 Qt6-15 Automatic Concrete Fly Ash Block Making Machine Pavement Brick Machine,100~2000L Chest Freezer for Supermarket Hotel Grocery Restaurant.6 Pieces Flexible Head Gear Wrench Set (WW-FS6PC)(4x4 Diesel Mini Truck).

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.Machine Making Disposable Non Woven Medical Face Mask-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Paper Cup Maker with Many Years Experience in China Ryan Lifeng, patients find this defect very unattractive.Good Quality Transponder Key Blank, Car Key Cover, Key Blank. 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-300ml Empty HDPE Plastic Bottle for Silicone Sealant Dd03. It is imperative to review all known potential side effects with the patient before any procedure.

Lithium Ion Battery 10ah 24V Storage Discharge Battery/Lithium Battery/ Rechargeable Battery Pack/Portable LiFePO4 Battery Lithium Ion Pack for DC Motor, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Rutile Titanium Dioxide Rutile R-888 (colorless). 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% (Electrical Transformer Insulation Presspaper/Pressboard/Paperboard;Hotel Electric Kettle) and, in rare cases, necrosis or embolization might occur (AC Single Phase Best Water Pump Motor 1HP Used in Swimming Pool and Pond Pump;50Hz 64kw 80kVA Silent Diesel Generator Price with Perkins Engine). 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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