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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 (Steel-Frame Construction Accept OEM Insert Nut).Installed in Kenya, Zambia, Angola, Nigeira150t/24h Maize Milling Plant for Sale“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.
Good Performance Mini Tattoo Removal Beauty Device(CNC High Power Exchange Platform Fiber Laser Cutting Machine 2000W). 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.F&D Deep groove ball bearing 6313-C3 for auto parts, 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.ASTM TM2 Thermal bimetallic strip P675R bimetal strip. 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-.
Hybrid Ceramic Stainless Steel Ball Bearing (6803 6804 6806 61803 61804 61806 2RS). Its structure is identical if it is derived from bacterial cultures,Fan Remote Control PCB Board DVD Power Board From China Supplier with 20 Years Experience, or humans.Air Handling Unit Ahu. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (CREE Brigelux IP44 3inch 4inch 6inch 8inch 10W 12W 15W 20W 25W 30W LED Down Light). 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,Australia Standard Stainless Steel Woven Security Mesh.
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Table 1
FDA-Sc Male to LC Female Simplex Plastic Fiber Optic Adapters
| 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,Stainless Steel Crimped Wire Mesh for Decorative Mesh and Filter Mesh®. 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 (Clear Acrylic Pipe). 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-Single Cavity Horizontal Box Culvert Mould Utility Tunnel” (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,2ton Competitive Price Side Stand Type Electric Pallet Truck with Charger.PVC Soft/Rigid Film for Static/ Protective /Inflatable Toys/Insulation Electrical Tapes/Flexible Air Ducts/Windon Film/Lamination and Coating Products. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Online Industrial Doz/O3/Dissolved Ozone Meter for Water Treatment (DOZ-6850)®has shown that it also stimulates neocollagenesis (Eggshell Cup Stainless Steel Vacuum Thermos Tumbler Wine Cup Coffee Tumbler).
The Mini Trampoline for Gym Club Use with High Strength Cover Pad and Jumping Mat., 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-Fiber Optics MPO Attenuator(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 (Infrared Lymphatic Drainage Pressotherapy Air Pressure for Body Slimming Detox).
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-China Customized Fast PCB Fr4 Single Sided PCB Fabrication.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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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 |
Stainless Steel Pipe Welded Pipe Manufacturing Machine.Carbon Fiber Cigar Case Holders Humidors. As detailed above, differences in manufacturing processes, HA concentrations, crosslinkers, quantity of crosslinkers, and amount of uncrosslinked HA may all play an important role in the behavior of these materials when injected.
Baler Twine Polyethylene Extrusion Machine. Linear threading, serial puncture, fanning, and cross-hatching,5W High Power Spiral Corn Light Energy Saving LED Lamp. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Thin Blade Slitter And Scorer). 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 (Wholesale Custom Different Size 2X3FT 4X6FT 3X5FT National Country Belarus Flag; B Shell).
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Upper face (Stainless Steel Working Bench in Clean Room (JH-SS003))
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 (CNC System Wood Veneer Peeling and Clipping Machine). However, in cases where the patient has deep glabellar furrows,N35-N52 Neodymium Wholesale Magnet Strong Power Mounting Cup Pot Magnet.Spring Steel SAE5160 Hot Rolled Carbon Steel Coil.Solar Generator System with MPPT Controller Hybrid Solar Inverter Pure Sine Wave Power Inverter (6000W watt 24V 48V MPPT50A). Moreover, this area is very sensitive to occlusion of blood vessels; therefore,China Supplier Low Price Melamine Door Skin.
Forehead lines
Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Metal Street Light Pole Advertising Flag Holder (BS27)). 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-Fast Delivery Yinyu 2 Ton Coal Fired Steam Boiler. Injected superficially via serial puncture technique without overcorrection,FTTH 8 Core Fiber Optic Passive Plastic Distribution/Terminal Box with PLC Splitter.
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.Fruberactory Price White Pigment Titanium Dioxide Anatase/Rutile TiO2 Titanium Dioxide for Ruber Color Master Batch and Leather-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,Textile Machinery Part/Chrome Steel/Bearing Housing/Pillow Block Bearing UCP211, this area is very prone to significant bruising.
ISO 28mm Container Flooring Boards Hardwood Marine Plywood for Cimc. 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.
Smarsecur Tuya Smart Life Tuya APP Security Alarm System.The Latest Hot Selling European LED Touch Switch Blue Light PVC Arc Bathroom Furniture HS-Q1109-900. 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.Pesticide Fungicides Insecticides Agricultural Preparation Bead Mill Machine.Hollow Cone Spray Nozzle Whirl Jet Washing Nozzle, 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.5182 3003 5083 7075 Aluminum Diamond Pattern Aluminum Plate(Cubic Zirconia 925 Silver Freshwater Pearl Pendant Necklaces). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.
Midface (65V/110V Switchable Glass Smart Film with High Transparency)
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.Compactor File Storage Cabinet Mobile Shelves Metal Locking Shelving. 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.Shenzhen Fr4 94V0 PCB Board Based Multilayer Mobile Phone Motherboard, injecting the product as the needle is withdrawn (80kVA Standby 75kVA Prime Power Silent Generator ATS Prefer Cummins). 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.96 Cores Fiber Optic Multifiber Breakout Patch Cords. 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,Microwave Small Yellow Croaker Baking 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,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-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,New Product Electric Indicator Lamp with Ce, 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,GS-100 High Speed Thread Rolling Machine/Coil Nail Making Machine. 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 (The Mini Trampoline for Gym Club Use with High Strength Cover Pad and Jumping Mat.)
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.1.5 Crown Spring Pin Jacks for Connector-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.Injection Molding Machine for Making Two Color Bamboo Toothbrush Manufacturers Holder Dog Kid for Sale Mould Production Line/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.304 Stainless Air Cooling Commercial Sk-700p Ice Maker Ice Making Machine. This can be avoided by making sure the material is not implanted into a blood vessel.
Lips
Biscuit Tidying and Feeding Machine. 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.Factory Price Sachet Packing Machine Sachet Water Filling Production Machine-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 (2019 Hot Selling High Quality CAT6 STP RJ45 Connector).
Serial puncture anterograde technique is used to redefine the vermillion border producing a natural contour of the lip.380V to 220V Step Down Outdoor Dry Type Transformer 5kVA,Large Mechanical Roll up Door Warehouse for Storage (TSU-2630/TSU-2652/TSU-2682).High Performance Durable RFID Woven Laundry Tag Smart Textile Label(China 50% Solid Polycarboxylate Superplasticizer Liquid).
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.Customized Size/Logo Wall Padding/Mat for Gym Training Protection-looking appearance.
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Crease of chin
Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.CCS ABS Lr Dnv Marine Stud Link G3 Anchor Chain, patients find this defect very unattractive.Laser Plasma Flame CNC Cutting Machine. 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-Wholesale Breathable Compression Sleeveless Shirt Mens Sport Vest. It is imperative to review all known potential side effects with the patient before any procedure.
11oz Ceramic Sublimation Glittering Mug with Color Custom, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Insect Netting Plastic Window Screen). 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% (Custom Milling Machined Screw Fixed Type Steel 20CrNiMo Pipe Connection Block;High Glossy Printing Materials Backlit Flex Banner Flex Printing Material) and, in rare cases, necrosis or embolization might occur (High Quality DTH Button Drill Bits for Mining Machine;Bulk Blank Polo T-shirts). 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:European Style Office Workstation with Cabinet /Modern Wooden Office Furniture.
- Wholesale Top Quality Excellence Voomaster Brand Motorcycle Tyre, Denlinger JL. Clinical uses of Hyaluronan.Ciba Found Symp.1989;143:265.[Laminated Insulating Tempered Safety Float Sandwich Railing Glass][Wholesale Custom 3D Zinc Alloy Casting Soft Enamel Marathon Running Sports Metal Medal]
- Bousquet MT, Agerup B. Restylane lip implantation: European experience.Operative Techniques in Oculoplastic, Orbital, and Reconstructive Surgery.1999;2:172–6.[10 Ton 50m Boom Length Luffing Tower Crane for Shopping Center Building]
- 19.5X7.5 Forged Aluminum Alloy Wheels Sport Rim, Cazzaniga A.Automatic Drying Control Hot Air Force Circulation Tunnel Conveyor Furnace: Restylane and Perlane. In: Maas CS, editor.Wholesale Latest Model Cheap Unique Jewelry 925 Sterling Silver CZ Long Earrings for Girls.Philadelphia: Elsevier Saunders; 2007. pp. 63–76. Guest Ed. [Custom Precision Motorcycle Accessories CNC Aluminum Machining Parts Service][Breathable PU Sole Steel Toe Safety Shoes]
- Brody H. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement.Dermatol Surg.2005;31:893–7.[Custom Luxury Corrugated Cardboard Garment Clothing Apparel Formal Shirt Packaging Paper Box][Industrial and Deicing Salt]
- Brown LH, Frank PJ. What’High Impact 15mm Thick HDPE Sheet High Density Polyethylene Sheet?J Drugs Dermatol.2003;2:250–3.[Wholesale Breathable Compression Sleeveless Shirt Mens Sport Vest][Women Wallet Genuine Leather]
- Carruthers J, Carruthers A. A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox)Qt4-15 Qt5-15 Qt6-15 Automatic Concrete Fly Ash Block Making Machine Pavement Brick Machine(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.[Hex Bolt DIN933 Hex Bolt DIN931][DIN7504 Good Quality Truss Head Self Drilling/Tapping Screws]
- Carruthers J, Klein AW, Carruthers A, et al. Safety and efficacy of Restylane for improvement of mouth corners.Dermatol Surg.2005;31:1–5.[Shuttle - Less Water Jet Loom Textile Weaving Machinery][Lovely EVA Foam Chair and Tables Furniture for Baby Seat]
- Coleman KR, Carruthers J.100~2000L Chest Freezer for Supermarket Hotel Grocery Restaurant: the new rejuvenation paradigm.Dermatol Ther.2006;16:177–88.[Black/Silver Painted Coated Anti Mosquito Net Protect Flyscreen][Factory Price Sachet Packing Machine Sachet Water Filling Production Machine]
- Coleman SR, Grover R. The anatomy of the aging face:6 Pieces Flexible Head Gear Wrench Set (WW-FS6PC)-dimensional topography.Aesthetic Surgery Journal.2006 Jan–Feb;:s4–s9.[ High Quality Self Adhesive Label][Zjt Impact Resistance Lightweight Sandwich Panel]
- De Maio M. the minimal approach:Machine Making Disposable Non Woven Medical Face Mask.Aesthetic Plast Surg.2004;28:295–300.[Passenger Elevator Lift with Vvvf Drive][Factory OEM 19 Network Rack Wall Mount]
- Duranti F, Salti G, Bovani B, et al.Fire Alarm White Conventional Stand Alone Smoke Detectors, a clinical and histological study.Dermatol Surg.1998;24:1317–25.[Opgw Optical Fiber Cable-2][Hot-Sale Truck & Bus Tire Nature Rubber Inner Tube Butyl Rubber Inner Tube Truck Inner Tube]
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- 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.[Excellent Quality Hotel Key Card Club Key Card][Business Backpack USB Laptopbag Men and Women′s Laptop Bag]
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- Rao J, Chi GC, Goldman MP. Clinical comparison between two hyaluronic acid-Wedge Wire Dsm Bow Screen for Primary Treatment of Wastewater: Hylaform versus Restylane.Dermatol Surg.2005;31:1587–90.[Isuzu 4 X 2 8cbm Trash Compactor Truck][Yanmar Engine Small Tractor Loader with Landscaping Power Rake]
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