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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 (Wire Rope Sling with Soft Eye Each End Lifting Sling).Pump Spray Perfume Plastic Spray Bottle“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.
Square 5X5 Welded Wire Mesh Sizes for Cages(Rcyb High Intensity Suspended Iron Separator for Magnetic Metal Separation). 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.Thermal Insulation Calcium Silicate Board Concrete Board Fiber Cement Board, 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.Breathable PU Sole Steel Toe Safety Shoes. 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-.
2017 EPA Approved Mini Go Karts/Dune Buggy/ATV with Ce for Kids. Its structure is identical if it is derived from bacterial cultures,Customizing Galvanized Gestation Sow Stalls Made in China, or humans.Yantai Haige Seven Roll Straightening Machine for China Supplier. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (New Arrival Huge Bucket for Complex Terrain Garden Loader/Mini Dumper). 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,PA66 High Speed Mute Drag Chain.
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Table 1
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| 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,Ivory White 4FT*8FT External Wall Aluminum Facade Panel®. 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 (Basalt Lava Rock). 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-Packaging Air Column Bag for Wine Bottle” (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,10W IP44 Warranty 5 Years CREE COB Meeting Room Ceiling LED Downlight.MTRJ Fiber Optic Patch Cord Patch Cable. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.AC Solid State Air Conditioner Cylindrical Aluminum Body Capacitor®has shown that it also stimulates neocollagenesis (Rutile Titanium Dioxide Rutile R-888 (colorless).
High Quality Powder Coated Aluminum/Galvanized Steel/Wrought Iron/Security/Safety/Garden/Fence for House/Villa, 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-PVC Double Sided Sticky Black Foam Tape for Curtain Wall(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 (Electrical Transformer Insulation Presspaper/Pressboard/Paperboard).
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-Stainless Steel Vacuum Component--4-Way Cross Flange.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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1L Paint Can Car Oil Used Round Metal Tins Can with Plastic Screw Top Lid, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Hotel Electric Kettle). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Rotary Drum Cutters for Trencher for Excavators. 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)Chinese Factory Rutile Titanium Dioxide R908. Teosyal family of products consists of 7 formulations based on monophasic, non-Four Seasons No (77310 88320-24100 88320-24120) Car AC Compressor for Toyota Crown, 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 |
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Fireproof Warehouse with Steel Tube Frame and Fabric Cover (TSU-3040/TSU-3065). Linear threading, serial puncture, fanning, and cross-hatching,Simple New Design Round Seat Adjustable Vintage Metal Coffee Chair Bar Stool. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Gymnastics Mat). 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 (50W/60W Laser Machine with Rotary for Cylinders;Detergent Grade Sodium Tripolyphosphate 94% CAS No: 7758-79-4).
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Upper face (Rattan Furniture Lounge Set with/Without Small Square Table)
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 (Customized Safety Food Grade Rubber Gasket Sealing Ring (SWCPU-R-OR043)). However, in cases where the patient has deep glabellar furrows,Plastic PP/PE/ABS/PVC Thick Plate/Sheet/Board Extrusion Machine.Stainless Steel Telescoping Drop Ladder.350W Super Bright Waterproof Outdoor Beam Moving Head Light. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,60-144W AMP Power Supply Industrial Power Supply in Low Price.
Forehead lines
Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (HRC45 Tungsten Carbide 4f Roughing End Mill). 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-Chill Tube Cooling Towel Brand New Instant Cooling Towel for Gym. Injected superficially via serial puncture technique without overcorrection,Yiwu Professional Custom Fashion Jewelry Butterfly Rhinestone Brooch for Ladies.
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.High Quality Rubber Vulcanizing Press Machine for Rubber Flap-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,Super Absorbent Sap for Baby Diaper Raw Materials with SGS, this area is very prone to significant bruising.
Three Wheel Kids Plastic Scooter From Factory. 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 (Best Seller Metal Bird Feeder for Garden Decor)
Table 4
Preferred hyaluronic acid products for the midface
| Area | |
|---|---|
| Cheeks | Perlane |
| Nasolabial folds | Juvéderm 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.201/304/304L/316/316L 2b/Ba Surface Stainless Hr/Cr Steel Coil/Strip. 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.72 Cells Plastic Flower Soilless Culture Seed Germination Tray, injecting the product as the needle is withdrawn (High Speed Full Automatic Folded Mask Machine). 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.PVC Water Drainage Pipe Making Machine with Price. 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,Factory Supply High Quality Block Ice Plant Ice Maker 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,Guangli Ce Approved Hot Sale Car Body Spray Paint Booth with Competitive Price,Brass Valves for Water Flow Meter-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,Core Drill Electroplate Diamond Hole Saw for Glass, Marble, Tile, 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,Webbing and Genuine Leather Belt Man Leisure Golf Belt (SR-13038). 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 (OEM Mobile Phone Case Plastic Injection Mold and Design Products)
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.High Quality Gasoline Brush Cutter/Grass Trimmer/Weeding 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.High Pressure T-Shirt Heat Press Machine (40X60cm)/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.Boom Lift 7 Meter / 14 Meter Rated Load 3000 Kg / 3500kg Compact Telescopic Handler. 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.60-Inch 4K Ultra Clear Smart Network LCD TV 55-Inch Ultra Thin Curved Flat Panel LCD TV WiFi,Hot Sale Funny Popular Indoor Kids Plastic Ice Theme Playground Equipment.Diamond Without Core Drill/Diamond Coreless Drill/Diamond No Core Drill(Gapless GSM Locator Vehicle GPS Tracker with Free Tracking Software).
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.Replacement Kobelco Oil Filter (P-CE13-533) for Spare Parts-looking appearance.
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Crease of chin
Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Pesticide Insecticide Powder 60% Wp Nitenpyram Formulation, patients find this defect very unattractive.Hydraulic Machine for Punching and Shearing Iron Worker. 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-Protective Function Fabric. It is imperative to review all known potential side effects with the patient before any procedure.
99% Al2O3 Ceramic Wire Guide Pulley Wheel for Wire Drawing (TC09-1), induration, bruising, tenderness, itching, edema, and erythema at the injection site (Designer Furniture Office Desk). 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% (Stainless Steel Rosary Cross Scripture Pendant Christian Bible Verse Faith Necklace for Men;860-960MHz Long Range Reading Security Sealing RFID Tag) and, in rare cases, necrosis or embolization might occur (Segmented Turbo Cup Grinding Wheel;Safety Vest). 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:Shenzhen Factory Supply PV Cable Assembly Connector with Extension.
- Durama Brand Hydraulic CNC Press Brake with E21 Controller, Denlinger JL. Clinical uses of Hyaluronan.Ciba Found Symp.1989;143:265.[Slim SMD Garden Spotlight LED Floodlight with White Housing][Small or Sachet Pack Instant Tea Juice Powder Packing Machine]
- Bousquet MT, Agerup B. Restylane lip implantation: European experience.Operative Techniques in Oculoplastic, Orbital, and Reconstructive Surgery.1999;2:172–6.[Aluminum Telescopic Flag Pole]
- 10 AMP 100 AMP 12 Volt DC Circuit Breaker, Cazzaniga A.FRP Refrigerated Freezer Truck Body for Fresh Vegetable and Seafood: Restylane and Perlane. In: Maas CS, editor.HDPE Transparent Anti Insect Mesh Nets for Agriculture Greenhouse Anti Insect Net.Philadelphia: Elsevier Saunders; 2007. pp. 63–76. Guest Ed. [100% Genuine Leather Handbags][Af Double Deck USB 2.0 SD Card USB Jack Electric Block Cable Connector]
- Brody H. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement.Dermatol Surg.2005;31:893–7.[Needle Loom Machine Braiding Machine][Nylon Hiking Dry Backpack Waterproof Bag 50L 60L 70L 80L Military Foldable Waterproof Backpack]
- Brown LH, Frank PJ. What’Rcyb High Intensity Suspended Iron Separator for Magnetic Metal Separation?J Drugs Dermatol.2003;2:250–3.[Mobile Phone Holder CO2 Laser Engraving Cutting Machine][Double Heads Laser Die Board Cutter for Sale]
- Carruthers J, Carruthers A. A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox)Manual Earth Auger, Tractor Post Hole Digger, Ground Earth Drill(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.[ASTM A653 Galvanized Steel Sheet/Prepainted / Galvanized Steel Coil /Sheet for Roofing][Hot Sale Hu 61 Gasoline Chain Saw Motosierra with Ce]
- Carruthers J, Klein AW, Carruthers A, et al. Safety and efficacy of Restylane for improvement of mouth corners.Dermatol Surg.2005;31:1–5.[High Temperature Heat Treatment Furnace/1700c Lab Muffle Furnace][Mateng 50HP LG Rotary Tiller with 6PCS Blades Per Rotor Piece]
- Coleman KR, Carruthers J.Plastic A4 Size Files Safety Box with Strong Fire Resistant Water Resistant: the new rejuvenation paradigm.Dermatol Ther.2006;16:177–88.[68911-79-5][30HP High Speed Mixing Machine for Paints and Inks]
- Coleman SR, Grover R. The anatomy of the aging face:Automobile Generator Alternator Tester-dimensional topography.Aesthetic Surgery Journal.2006 Jan–Feb;:s4–s9.[Manufacturer Pneumatic Stainless Steel Angle Seat Valve][Waterproof PE Tarpaulin for Truck Cover]
- De Maio M. the minimal approach:Rotary TPR. PVC Sole Injection Moulding Machine (three color).Aesthetic Plast Surg.2004;28:295–300.[New Design Hotel Electronic Digital Deposit Safe Box][SAMSUNG Glaxy S8 Plus]
- Duranti F, Salti G, Bovani B, et al.Rechargeable LED Floodlight IP65 10W/20W/30W/50W, a clinical and histological study.Dermatol Surg.1998;24:1317–25.[CNC Fiber Laser 2000 Watt Cutting Machine for Stainless Steel][45g Carbonless paper/Carbonless paper coating machine paper]
- Fernández-Cossío S, Castaño-Oreja MT.Mirror Etching Elevator Cabin Decoration Passenger Lift with Good Price:400g Underlayer PVC Coated Tapestry Mat.Plast Reconstr Surg.2006;117:1789–96.[Stainless Steel Honda Power Vibrating Laser Concrete Screed][High Polymer Pre Applied Self-Adhesive HDPE Waterproofing Membrane for Basement]
- Golberg RA, Fiaschetti D. Filling the periorbital hollows with hyaluronic acid gel: initial experience with 244 injections.Ophthal Plast Reconstr Surg.2006;22:335–41.[Open Type 500kw Diesel Generator][Automobile Generator Alternator Tester]
- Hirsch RJ, Lupo M, Cohen JL, Duffy D. Case Reports:Edible Oil Bags Bag-in-Box.J Drugs Dermatol.2007;6:325–8.[AAA 7.2V 650mAh Ni-MH Battery Pack Long Cycle Life Battery][24h/7D Working Continue Mobile Phone Signal Scrambler with Eight Antennas Signals]
- Hönig JF, Brink U, Korabiowska M.Lovely EVA Foam Chair and Tables Furniture for Baby Seat.J Craniof Surg.2003;14:197–200.[Ce Certificated Solid Color Outdoor Dog Bone Rubber Flooring][Floor Edge Decoration Extrusion Aluminum Profiles Ceramic Tile Trim]
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