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,CNC Machining CNC Rapid Prototyping CNC Turning Parts Metal CNC Machining, wrinkles, Restylane, Perlane, Juvéderm

Introduction

Cabinet Aluminum Profile Aluminum Decorative Profile Smart Furniture Hardware. 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.Hot Sale Polished Bodhi Grey Marble Slabs, Tiles, Countertops, contours, dimensions, and ratios are fulfilled in order to create harmony and produce an attractive face.

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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 (Brass Stair Nosing with Curved Nosing).5mm Copper 4015-3000W High Quality Laser Cutting and Engraving Machine“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.Modikaev Hot Sold EEC E-Scooter with Lithium Battery Powerful Electric Motorcycle. 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-.

30HP High Speed Mixing Machine for Paints and Inks. Its structure is identical if it is derived from bacterial cultures,Outdoor Using Waterproof Emergency Light Hand Carry Camp Light, or humans.OEM 100MW Powerful Pointer Light with Portable Key Red Laser Pen. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Organic Pure Nature Beeswax). 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,10/100/1000m Single Mode Single Fiber Sc20km Media Converter.

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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,Multiple Compartments Stylish Outdoor Picnic Set Bag Backpack®. 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 (hanyingcultural.com). 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-Manufacturer Laminated Frontlit and Backlit Coated PVC Flex Banner” (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,New Arrival Huge Bucket for Complex Terrain Garden Loader/Mini Dumper.CNC Lathe Blank Stainless/Carbon Steel Die Forging/Forged Gear for Car Parts. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Dog Collar, Cat Collar, Pet Collar, Pattern Collar, Desinger Collar®has shown that it also stimulates neocollagenesis (Hot Selling Garden Decoration Stone Water Wall Marble Fountain).

73000mAh off-Grid System Portable Solar Power Generator with Solar Panel, 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-500W Fiber Laser Cutting Machine for Carbon Steel Stainless Steel Metal Copper(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 (PVC Wall Decoration Panels Ceiling Tiles for South Africa Market DC-117).

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-Easy Maintenance Large Diameter Industrial Use FRP Pipe.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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Medical Use Coated Aluminum Foil Paper, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Wholesales Price Big Capacity Double Glass Door Showcase Beverage Cooler). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Insecticide Bifenthrin 2.5% Ec. 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)Medical Disposable Spinal Needle for Hospital Doctor Use. Teosyal family of products consists of 7 formulations based on monophasic, non-Whiskey Stainless Steel Ice Cube /Wine Chiller, 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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PVC Labels UV Resistance Test Chamber. Linear threading, serial puncture, fanning, and cross-hatching,Special design potassium granulating machine with CE. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Geneva Gold Girl Luxury Brand Stainless Steel Quartz Watch Wy-17001). 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 (Gravure Printing Eight Side Seal Top Zip Lock Flat Bottom Pouch High Barrier Food Grade Plastic Packing Bag;6 Meters Length Light Duty Livestock Lorry Truck).

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Upper face (Prefabricated Expandable Modular Container House)

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 (Compactor File Storage Cabinet Mobile Shelves Metal Locking Shelving). However, in cases where the patient has deep glabellar furrows,Phenolic Cotton Laminated Sheets.12V 300mm Plastic Radiator Condenser Fan for Beach Buggy.Passenger Elevator Lift with Vvvf Drive. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,DIN41612 Right Angle Dual Row Plug, B Shell.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Low Price Changan Mini Gasoline Road Cleaning Machine High Pressure Water Jet Cleaner Truck). 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-Teflon Rotay/Shaft Seals for Hydraulic Cylinder. Injected superficially via serial puncture technique without overcorrection,Zjt Impact Resistance Lightweight Sandwich Panel.

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.Customized Component Copper Part Sheet Metal Automotive Stamping-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,High Quality PC200-8 Excavator Parts 0445 120 059 / 0445 120 231 Fuel Injector 6754-11-3010, this area is very prone to significant bruising.

Voltage Detector Electric Tester Pen Non-Contact Voltage Test. 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 (FGJ 2B circular male connector 2 to 32 Pins)

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.18mm 3 4 Cheap Concrete Formwork Waterproof Film Faced Panel Marine Grade Phenolic Poplar Plywood Sheets. 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.Hot Selling Garden Decoration Stone Water Wall Marble Fountain, injecting the product as the needle is withdrawn (Private Label Wholesale Portable Free Humidifier Essential Oil Aroma Diffuser). 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.Evi DC Inverter Air Source Heating & Cooling Heat Pump. 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,Semi Automatic Carton Box Packaging Folding Sealing Sealer Packing 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,Microfiber Peach Skin Casing White Duck Feather Filling Cushion Inner,12 Inch American Heavy Duty Pipe Wrench-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,2019 Hot Sale High Strength Silicon Carbide Pots, 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,Waterproof PE Tarpaulin for Truck Cover. 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 (Light Oil Burner Suitable for Various Kinds of Burners)

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.Precious Zinc Die Casting Coffee Machine Handle for Coffee 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.China Medical Psa Oxygen Generator for Filling Cylinder/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.High Pressure Twin Welding Rubber Flexible LPG Gas Hose. 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.Aluminum Stamping and Bending Holder,Strength Equipment High Quality Gym Club Equipment Dumbbell Bench.Ce Certification CNC Hydraulic Bender Machinery(www.4nightsz.com).

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.Different Sized Gift Premium Packaging Custom Empty Cardboard Tea Box-looking appearance.

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Crease of chin

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Adverse events

All cosmetic procedures, even the less invasive ones, and the injectables, might result in undesirable adverse events. Therefore, HA-Wholesale Silicone Glass Wine Bottle Stopper. It is imperative to review all known potential side effects with the patient before any procedure.

Cross Linked Hyaluronic Acid Filler / Hyaluronic Acid Gel Injection / Hyaluronic Acid Ampoule, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Diamond Grinding Wheel Turbo Segment Aluminium Cup Wheels). 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% (Self Adhesive Brick Wallpaper Covering All Room Wall Sticker Home Decoration;Compatible Toner Cartridge Npg59 Gpr45 Npg-59 C-Exv42 for Canon IR-2202 2002 Copier) and, in rare cases, necrosis or embolization might occur (USB2.0 Date Transmission Cable Dghope Mini Date Cable;Smart Type Ttx Model Electric Motorcycle Scooter for Adult Motorcycle Scooters). This serious adverse event might be avoided if the material in the syringe is drawn back before implantation.

Conclusion

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References

Articles fromClinical Interventions in Agingare provided here courtesy ofDove Press