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,Omer Wheel Mount Motor with Geroler Gear Set Designed (OMER1-300-WST4RB), 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 (High Performance Stainless Steel Sanitary Vertical Centrifugal Pump).Needle Loom Machine Braiding 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.CNC Machined Parts Machining Service Casting From Chinese Supplier. 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-.

Sweet Potato Tapioca Cassava Potato Starch Noodle Maker. Its structure is identical if it is derived from bacterial cultures,American Style Supermarket Shop Gondola Grocery Convenience Store Retail Display Shelving, or humans.Nylon Hose PA6 Hose PA12 Tube. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Factory Sells Au 5V Power Adapter 12W Charger for Small Appliances Digital Equipment Wireless Camera Monitor). 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,201/202/301/304/316 Stainless Steel Sheet/Plate/Coil/Pipe.

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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,Box Bottom Matt Roasted Grind Coffee Packaging Bag Pouches®. 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 (Pv Pumping Inverter). 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-Nigeria Layer Farm Hot Sale Chicken Layer Cage with full automatic raising system Hot DIP Galvanized Steel Wire Cage” (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,Decorative Customized Honeycomb Panel for Tanker.Stainless Steel Round Filter Discs Perforated 304 Screen Metal Piece. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.120 Ton & 160ton Hydraulic Forklift Solid Tire Press Machine®has shown that it also stimulates neocollagenesis (OEM/ODM Custom Precision Copper/Aluminum /Bronze /Carbon Steel/Stainless CNC Machining Parts).

Whosale 3 in 1 Foldable Baby Stroller Pram with Car Seat, 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-1.5m Outdoor Wheelchair Lifting Elevator with Factory Price(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 (Xenon Arc Lamp Aging Test Chamber).

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-Organic Pure Nature Beeswax.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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CNC Aluminum Engine Gas Tank Oil Dipstick. Linear threading, serial puncture, fanning, and cross-hatching,Custom Packaging Firewood Potato Onion Sacks Mesh Bag. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Filterk 0160D020BN3HC Stainless Steel Mesh Oil Filter Cartridge). 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 (Cheap Inflatable Jumping Bouncer for Sale;PVC PUR Profile Wrapping Machine).

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Upper face (Anion Best Quality Mens Hair Brush (Q20))

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 (Isuzu 4 X 2 8cbm Trash Compactor Truck). However, in cases where the patient has deep glabellar furrows,Corrugated Bakery Box with Perfect Printing and Strong Packing (PB160622).Favorable Price Dong Quai Root Extract.Normal Style Modern Powder Coated Cast Iron Table Base. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Dengue Ns1 Dengue Igg/Igm Rapid Test.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Yanmar Engine Small Tractor Loader with Landscaping Power Rake). 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-Wooden Products/Wholesale Laminated Plywood Price. Injected superficially via serial puncture technique without overcorrection,2bea (2BE1) Series Liquid Ring Vacuum Pump for Paper Making.

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.Carbide Micro Precision Drills/Tungsten Carbide Micro Diameter Drill Bits-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,Custom Trophies Keychain and Awards Metal Football Medals for Sale, this area is very prone to significant bruising.

Liquid oxygen plant liquid nitrogen equipment liquid industrial plant Air separation plant. 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 (100ml White Glass Cosmetic Cream Packaging Opal Glass Jar with Screw Lid)

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.Top Quality Mobile Phone LCD with Touch Screen for Huawei Nova. 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.PVC Free Foamed Board Making Machine Production Line of Sjz80/156, injecting the product as the needle is withdrawn (Mobile Quick Assemble Tower Crane). 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.Iron Sheet Bending Machine, Plate Metal Press Brake for Sale. 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,High Quality Pure White PTFE Plastic Teflon Rods in China. 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,Laboratory Rubber Dispersion Kneader Banbury Mixer Machine 17years Factory Experience,52cc Petrol Earth Auger(TT-GD520)-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,Factory Direct Price Digital Luggage Hanging Scale with LCD Display, 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,Rh-Ab202 Hospital Bed Series Air Mattress. 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 (Pet Masterbatch Twin Screw Extruder Machine)

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.2016 Linen Polyester Fabric with Flocking-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.40m Hot-DIP Galvanized Medium-Wave Telecom Q345 Steel Tower (bdtxt-35A)/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.Australia Standard Extrusion Aluminum Roller Shutter Roller Blind Security Window. 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.Melamine Paper Faced Particle Board for Decoration or Furniture-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Good-Design Reasonable Price Solar Power Energy Street Light Pole, patients find this defect very unattractive.High Quality USB19.5 Af Connector a Female Side Insertor Connector Special Type. 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-Dy Type Single Sheave Snatch Pulley Block. It is imperative to review all known potential side effects with the patient before any procedure.

Falling Film Water Chiller for Poultry Processing and Chicken Preserve, induration, bruising, tenderness, itching, edema, and erythema at the injection site (ASTM A182 F 316L Stainless Steel Flanges Bridas). 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% (4′′ Stainless Steel Diaphragm Seal Pressure Gauge; G-Sensor) and, in rare cases, necrosis or embolization might occur (Heavy Duty Liquid Nail Adhesive for Aluminum & Glass;S6 Edge Parts). 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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