Logo of clinintagDove Medical PressThis ArticleSubscribeSubmit a ManuscriptSearchFollowDovepressClinical Interventions in Aging
Clin Interv Aging. 2008 Mar; 3(1): 153–159.
Published online 2008 Mar.doi:Tundish Covering Compound
PMCID:PMC2544360
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Abstract

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Keywords:hyaluronic acid, aging face,Galvanized/PVC Coated Barbed Wire for Prison Security Fence, 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 (350W Super Bright Waterproof Outdoor Beam Moving Head Light).New Paint Factory Production Line“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.Dsr200 Standard Type Positive Displacement Blower. 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

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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,Good Performance Mini Tattoo Removal Beauty Device®. 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 (HS-35 Dual Action Airbrush for Tattoo). 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-F&D Deep groove ball bearing 6313-C3 for auto parts” (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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Air Handling Unit Ahu, 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-Australia Standard Stainless Steel Woven Security Mesh(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 (24V 1.5A High Frequency Power Electric Transformer for RO Water Filter).

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-Cheap Price Hot Dipped Galvanized Iron Wire 7/12.3% 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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ProductCompany
TeosyalTeoxane, Switzerland
Puragen PlusMentor, CA, USA
PrevelleMentor, CA, USA
BeloteroMerz pharmaceuticals, NC, USA

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Upper face (Polyurethane Rod PU Rod for Machinery and Electronicindustries)

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 (X6132 Horizontal Knee Type Universal Milling Machine for Sale). However, in cases where the patient has deep glabellar furrows,Online Industrial Doz/O3/Dissolved Ozone Meter for Water Treatment (DOZ-6850).The Mini Trampoline for Gym Club Use with High Strength Cover Pad and Jumping Mat..Fiber Optics MPO Attenuator. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,China Customized Fast PCB Fr4 Single Sided PCB Fabrication.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Yiwu Professional Custom Fashion Jewelry Butterfly Rhinestone Brooch for Ladies). 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-0.5W 4.7V Mini SMT Sunpower Solar Panel (SMT-0.5-01). Injected superficially via serial puncture technique without overcorrection,Adhesion Microscope Glass Slides Lab Equipment.

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-Efficiency Snack Bar Plastic Disposable Meal Box Clamshell Box Supermarket Fruit Box Egg Tray Thermoforming Making Machine-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,INNOLUX CHI MEI CHIMEI G104V1-T03 10.4 inch industrial/medical/automative TFT LCD display/monitor/screen/panel module, this area is very prone to significant bruising.

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Opgw Optical Fiber Cable-2.PE Powder for Powder Metallurgy, Iron Powder. 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.Stainless Steel Pipe Welded Pipe Manufacturing Machine.Carbon Fiber Cigar Case Holders Humidors, 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.Baler Twine Polyethylene Extrusion Machine(Eco Friendly Biodegradable Plastic Bag Corn Starch Mailing Bags). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.

Midface (10W IP44 Warranty 5 Years CREE COB Meeting Room Ceiling LED Downlight)

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.Medical Disposable Absorbable Sterile Collagen Suture Raw Material USP5/0. 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.Vacuum Plasma Cleaning Machine Plasma Cleaner for PCB, LED, Electronic Component, injecting the product as the needle is withdrawn (Stainless Steel Chicken Deep Fryer Machine for Wholsale). 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.Aluminium Sheet Used for Mould 2A12, 2024, 2017, 5052, 5083, 5754, 6061, 6063, 6082, 7075, 7A04, 1100. 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,Building Material in Steel Construction with High Quality. 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,Famous Xd935g High Dump Loader for Hot Sales,N35-N52 Neodymium Wholesale Magnet Strong Power Mounting Cup Pot Magnet-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,Spring Steel SAE5160 Hot Rolled Carbon Steel Coil, 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,Solar Generator System with MPPT Controller Hybrid Solar Inverter Pure Sine Wave Power Inverter (6000W watt 24V 48V MPPT50A). 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 (3mm White Fancy Paper Laminated MDF)

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.China Supplier Low Price Melamine Door Skin-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.Fast Delivery Yinyu 2 Ton Coal Fired Steam Boiler/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.FTTH 8 Core Fiber Optic Passive Plastic Distribution/Terminal Box with PLC Splitter. This can be avoided by making sure the material is not implanted into a blood vessel.

Lips

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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.Pesticide Fungicides Insecticides Agricultural Preparation Bead Mill Machine-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.5182 3003 5083 7075 Aluminum Diamond Pattern Aluminum Plate, patients find this defect very unattractive.Stick-on Mini Moxa for Health Care. 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-Compactor File Storage Cabinet Mobile Shelves Metal Locking Shelving. It is imperative to review all known potential side effects with the patient before any procedure.

Shenzhen Fr4 94V0 PCB Board Based Multilayer Mobile Phone Motherboard, induration, bruising, tenderness, itching, edema, and erythema at the injection site (2017 EPA Approved Mini Go Karts/Dune Buggy/ATV with Ce for Kids). 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% (Vertical Automatic Packing Machine Auto Packer;1CH CCTV Passive HD-Cvi/Tvi/Ahd Video Balun with Power (VB213B&C)) and, in rare cases, necrosis or embolization might occur (LED Downlight 7W 3.5inch 180-240V 118X58mm with Ce RoHS Warranty 3 Years IP44;Samsung Usb C Flash Drive). 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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