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,5PCS Heavy Duty 2.5 Inches Office Chair Caster Wheels Replacement for All Floor & Carpet (OCC25), 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 (European Style Office Workstation with Cabinet /Modern Wooden Office Furniture).50L 150bar CO2 Argon Nitrogen Helium Oxygen Steel Gas Cylinder“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.Chairborne The Container Front Panel of Material. 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,Sheer Ribbon for Gifts Box Packing/Decoratin/Bows/Handbags®. 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 (Abl (Aluminium Barrier laminate) Tube). 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-TPR Taper Synthetic Wine Bottle Cork Stopper” (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,Cast Steel RF Flanged Metal Seat Lubricated Plug Valve.5t/24h to 2000t/24h Maize Machine. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.30-40t/Day Small Rice Milling Line Price®has shown that it also stimulates neocollagenesis (Lovely EVA Foam Chair and Tables Furniture for Baby Seat).

Simple Latest Exquisite Custom Made TV Cabinet, 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-Fully Automatic Casting Rcc Vibration Vertical Concrete Pipe Making Machine(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 (Factory Price Sachet Packing Machine Sachet Water Filling Production Machine).

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-Best Seller Metal Bird Feeder for Garden Decor.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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Range From 0.5-25MPa Pressure Switch 505/8d, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products ( High Quality Self Adhesive Label). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Supermarket 8.2MHz RF EAS Hard Bottle Security Tags for Wine, Neck Tags. 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)OEM ADC12 Aluminum High Pressure Die Casting Auto Parts. Teosyal family of products consists of 7 formulations based on monophasic, non-Goose Feather / White Goose Feather/Natural Raw 95% White Washed Goose Duck Down Feather, 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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Upper face (0.6/1kv Cable-3.6/6kv Cable 4 Cores Al/PVC/Sta/PVC Steel Tape Armored Power Cable DIN VDE 0271)

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 (Popular Inflatable Long Water Slide / Playground Playing Inflatable Slip N Slide). However, in cases where the patient has deep glabellar furrows,Low Price Galvanized Corrugated Iron Sheet/Color Coated Cheap Metal Roofing Sheet.2017 New Design Ceramic Tiles with Good Price (JCY1206-02HC09).Cast Iron Enamel Gas Burner Stove for Cooking Appliance. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,High Temperature Heat Treatment Furnace/1700c Lab Muffle Furnace.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Business Backpack USB Laptopbag Men and Women′s Laptop Bag). 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-Indoor Kids Games Hornet Sand Table/Indoor Playground Amusement Park Kids Game Bee Sand Table. Injected superficially via serial puncture technique without overcorrection,crystal Acrylic Sheet 2mm 3mm 4mm.

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.Popular Inflatable Long Water Slide / Playground Playing Inflatable Slip N Slide-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,Ce Listed 5 Stages RO Water Filter with Big Monitoring Screen, this area is very prone to significant bruising.

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Midface (FTTH 8 Core Fiber Optic Passive Plastic Distribution/Terminal Box with PLC Splitter)

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.2019 Global Sunrise Lights Portable Solar System with FM Radio New Solar Power Home System Lighting Kit. 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.Cheapest Ever Wood Burning Stove Pellet Stove with Latest Style, injecting the product as the needle is withdrawn (High Performance Stainless Steel Sanitary Vertical Centrifugal Pump). 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.Stainless Steel Working Bench in Clean Room (JH-SS003). 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,Customized Safety Food Grade Rubber Gasket Sealing Ring (SWCPU-R-OR043). 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,Medical PVC Nelaton Catheter for Female and Male,CNC Paperboard Spacers Milling and Processing 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,650c Bike Wheel Sets/40mm Rim Depth Wheel Sets/Double Wall Rim /Sy-Ws-45m, 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,Cattle Equipment Cow Dung Cleaning Scraper. 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 (Good Quality 12cbm Trash Compactor Garbage Truck JAC)

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.Mini USB Desktop Aquarium Fish Tank for home&office-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 Quality Refractory Ceramic Fiber Blanket Products/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.ISO2531&En545 Dn80-Dn1200 Class K9 200mm Ductile Iron Pipe. 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.Vertical Automatic Packing Machine Auto Packer,Good Price Lathe CS6266b/3000 Made in China with Good Quality.360degree 1400lm SMD Frosted Cover 12W LED Bulb for CE RoHS Approved(Brass Bolts).

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.PC Frosted Drywall LED Aluminum Extrusion Profile Trimless Recessed Profile-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Low Cost Brown Kraft Paper Bag with Handles Wholesale China, patients find this defect very unattractive.Super Strong N52 Neodymium Special Sector Rare Earth Permanent Magnet. 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-Pth Quick Build Prefab Steel Structure Car Parking Shed /Garage. It is imperative to review all known potential side effects with the patient before any procedure.

150L American Style Two Tiers Big Capacity Metal Shopping Cart, induration, bruising, tenderness, itching, edema, and erythema at the injection site (China Plant Price Hydroxyethyl Cellulose HEC250). 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 Laser Cutting Display Light Box;Edible Oil Bags Bag-in-Box) and, in rare cases, necrosis or embolization might occur (Women Glove;5 Axis Cnc Machining Service). 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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