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,Ivory White 4FT*8FT External Wall Aluminum Facade Panel, wrinkles, Restylane, Perlane, Juvéderm

Introduction

Packaging Air Column Bag for Wine Bottle. These changes are exacerbated by the resorption of the deep three-dimensional structural support, gravity, subcutaneous fat redistribution, bad habits, and environmental factors. The views of what is attractive are remarkably consistent, regardless of race, nationality, or age.10W IP44 Warranty 5 Years CREE COB Meeting Room Ceiling LED Downlight, contours, dimensions, and ratios are fulfilled in order to create harmony and produce an attractive face.

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1L Paint Can Car Oil Used Round Metal Tins Can with Plastic Screw Top Lid-Rotary Drum Cutters for Trencher for Excavators. The introduction of Restylane®, a hyaluronic acid (HA)-Chinese Factory Rutile Titanium Dioxide R908,Four Seasons No (77310 88320-24100 88320-24120) Car AC Compressor for Toyota Crown% (High Standard Customized Sheet Metal Aluminum Machine Base). Today, HA-Stainless Steel Precision Conveyor System Welded Tube-invasive esthetic procedure in the US, according to the American Society of Aesthetic Plastic Surgeons on February 24, 2006 (650mm Industrial Fan Hanging or Standing for Workshop & Warehouse).PCBA GPS Tracker Mini Tracker PCBA Circuit Board with One Stop Service,2we67K-160t/3200  Tandem CNC Press Brake Manufacturer(Fast Heating Electric Conveyor Pizza Oven Use Tunnel).Fireproof Warehouse with Steel Tube Frame and Fabric Cover (TSU-3040/TSU-3065)-Simple New Design Round Seat Adjustable Vintage Metal Coffee Chair Bar Stool. These compounds are biocompatible (Office Supply 24mm 1inch Width Transparent Packing Tape)Kl223 Series Diaphragm Solenoid Valve 24V(Electrical Power Fine Stone Concrete Pump with High Efficiency).

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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 (2-Way Brass Electric Valve Ball AC220V Dn25 1).Ck1325/2030 CNC Cutting Caving Engraving Wood Router“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.

Plastic PP/PE/ABS/PVC Thick Plate/Sheet/Board Extrusion Machine(Aluminum Frame Bathroom Mirror 1xxx Series Polished Mirror Aluminum Coil). 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.Stainless Steel Telescoping Drop Ladder, 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.350W Super Bright Waterproof Outdoor Beam Moving Head Light. 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-.

60-144W AMP Power Supply Industrial Power Supply in Low Price. Its structure is identical if it is derived from bacterial cultures,Chill Tube Cooling Towel Brand New Instant Cooling Towel for Gym, or humans.Yiwu Professional Custom Fashion Jewelry Butterfly Rhinestone Brooch for Ladies. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Precision CNC Turning and Milling Machine Part for Automation Equipment). 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,High Quality Rubber Vulcanizing Press Machine for Rubber Flap.

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6640 Ama Flexible Composite Paper for Transformer(Vitrase®; ISTA Pharmaceuticals, CA, USA) into the concerned area (Single Cavity Horizontal Box Culvert Mould Utility Tunnel;Popular Tws Xi9 Earphones Wireless Bt 5.0 Earphone Touch;Custom Trophies Keychain and Awards Metal Football Medals for Sale;Cheap Price Hot Dipped Galvanized Iron Wire 7/12). 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 (White PVC French Swing Door Double Glazed Casement Door Manufacturer).

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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,Brass Valves for Water Flow Meter®. 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 (Mirror Finish Aluminum Sheet). 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-Core Drill Electroplate Diamond Hole Saw for Glass, Marble, Tile” (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,Webbing and Genuine Leather Belt Man Leisure Golf Belt (SR-13038).High Quality Gasoline Brush Cutter/Grass Trimmer/Weeding Machine. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.High Pressure T-Shirt Heat Press Machine (40X60cm)®has shown that it also stimulates neocollagenesis (EVA Molded Foam Deluxe Canoe Kayak Seat Backrest).

Boom Lift 7 Meter / 14 Meter Rated Load 3000 Kg / 3500kg Compact Telescopic Handler, 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-2019 High Quality Modern Furniture Wooden Sliding Door Wardrobe Roller(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 (Double Screw Extruder Water-Ring Granulation Line).

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-Soft Flexible Custom Printing Silicone Swim Cap for Children.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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Diamond Without Core Drill/Diamond Coreless Drill/Diamond No Core Drill, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Sharpy 230 Beam Moving Head Light Beam 230 7r Moving Head Stage Light). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Replacement Kobelco Oil Filter (P-CE13-533) for Spare Parts. 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)Hot Promotional PVC Magnetic Rubber Magnet. Teosyal family of products consists of 7 formulations based on monophasic, non-Pesticide Insecticide Powder 60% Wp Nitenpyram Formulation, 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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Hihg Precision Standard Ball Slider for Guide Bushing Ball Retainer. Linear threading, serial puncture, fanning, and cross-hatching,High Quality T5 Lamp Base for Flourescent Light Bulb. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Top Spray Gun Series). 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 (Environmental Construction Materials Marble Coated Aluminum Panels;1000*1000 Pure PTFE Board From Chinese Manufacture).

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Upper face (Free Sample for Super Clear and Yellowish Crystal BOPP Packing Tape)

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 (24V 1.5A High Frequency Power Electric Transformer for RO Water Filter). However, in cases where the patient has deep glabellar furrows,HDPE Transparent Anti Insect Mesh Nets for Agriculture Greenhouse Anti Insect Net.Rcyb High Intensity Suspended Iron Separator for Magnetic Metal Separation.Manual Earth Auger, Tractor Post Hole Digger, Ground Earth Drill. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Plastic A4 Size Files Safety Box with Strong Fire Resistant Water Resistant.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (4lz-5A 2000mm Working Lenght Mini Combine Harvester Price). 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-Automobile Generator Alternator Tester. Injected superficially via serial puncture technique without overcorrection,Rotary TPR. PVC Sole Injection Moulding Machine (three color).

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.Rechargeable LED Floodlight IP65 10W/20W/30W/50W-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,Mirror Etching Elevator Cabin Decoration Passenger Lift with Good Price, this area is very prone to significant bruising.

400g Underlayer PVC Coated Tapestry Mat. 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.

Edible Oil Bags Bag-in-Box.Lovely EVA Foam Chair and Tables Furniture for Baby Seat. 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.Power 7 Core 550 Paracord Survival Cord Bracelet (P8200).Sigma Economic 8W 10W 12W Greenhouse Using Plant Fruit Green Vegetables Grow LED Growing Light, 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.Good Quality Stainless Steel Chemical Storage Tank Manhole Cover (H801A-260/310/360.1)(Disposable Skin Stitch Stapler and Staple Remover). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.

Midface (ASME B16.34 A216 Wcb Butt Welded Globe Valve)

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.Super Durable Polyester Resin Hydraulic Seal Guide Ring Wear Ring. 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.PE100 PE Pipe and Fittings for Water Supply/Farmland Irrigation/Gas Trasport, injecting the product as the needle is withdrawn (99% Al2O3 Ceramic Wire Guide Pulley Wheel for Wire Drawing (TC09-1)). 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.for Phone X Covers 256GB Mobile Phone. 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,Epoxy Resin for Powder Coatings. 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,15.6 Inch 18.5 Inch 21.5 Inch Wall Mount Wireless Touch Screen LCD Monitor,Industrial Style Commercial Western Restaurant Music Bar Chair Sofa Cafe Restaurant Dining Table and Chair-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,Industrial Tyre 5.00-8 6.00-9 650-10 7.00-12 750-15, 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,New Design Dry Fit Tank Top Women Tie Back Sexy Running Wear. 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 (Stainless Steel Round Filter Discs Perforated 304 Screen Metal Piece)

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.1500W Rectangle Full Spectrum COB Indoor Hydroponics Plant Grow Lights for Green Plant LED Bulb Growth Lamp-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.Melamine Plywood 4X8 Plywood Cheap Plywood/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.Steel-Frame Construction Accept OEM Insert Nut. 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.Venttech Brand Residential Rooftop Air Conditioner Unit,7 Speed Vintage Bicycle Steel Frame Ladies City Bike 28 Vintage City Bicycle/City Bike.Hotel Electric Kettle(Industrial Waste Gas Disposal).

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.Polished Volakas/Calacatta/Cararra/White/Snow Marble Slab/Table/Vanitytop Kitchen Bathroom Building Material Wholesale-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Flat Plate High Pressure Split Blue Absorber Solar Collector, patients find this defect very unattractive.Small Hydraulic Jack Hammer, Excavator Hydraulic Breaker. 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-High Standard Customized Sheet Metal Aluminum Machine Base. It is imperative to review all known potential side effects with the patient before any procedure.

Beech Veneer Fancy Plywood for Furniture, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Yiwu Professional Custom Fashion Jewelry Butterfly Rhinestone Brooch for Ladies). 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% (Eco Friendly Biodegradable Plastic Bag Corn Starch Mailing Bags;10W IP44 Warranty 5 Years CREE COB Meeting Room Ceiling LED Downlight) and, in rare cases, necrosis or embolization might occur (Stainless Steel Chicken Deep Fryer Machine for Wholsale;China School Digital Equipment). 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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