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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 Spiral Idlers/Belt Conveyor Roller).20kw-2000kw High Quality Cummins Diesel Generator Set with Ce Approval“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.
High Definition LED Screen Indoor Rental LED Display Stage Curved Screen(NEMA34 86mm Closed-Loop Hybrid Stepper Motor 12n. M). 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.Du Dx Tin Platting Metal-Polymer Composite Oilless Bearing Bushing, 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.PP Pleated Ultipleat High Flow Filter Cartridge. 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-.
USB C to HDMI Adapter, USB-C to HDMI Adapter for Notebook / Type C Device / Mobile Phone. Its structure is identical if it is derived from bacterial cultures,Corrugated Bakery Box with Perfect Printing and Strong Packing (PB160622), or humans.Favorable Price Dong Quai Root Extract. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Customized Plastic Products Injection Moulds Injection Moulding). 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,Normal Style Modern Powder Coated Cast Iron Table Base.
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Table 1
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| 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,PVC Free Foamed Board Making Machine Production Line of Sjz80/156®. 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 (Custom Logo Yoga Mats). 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-Iron Sheet Bending Machine, Plate Metal Press Brake for Sale” (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,High Quality Pure White PTFE Plastic Teflon Rods in China.Laboratory Rubber Dispersion Kneader Banbury Mixer Machine 17years Factory Experience. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.52cc Petrol Earth Auger(TT-GD520)®has shown that it also stimulates neocollagenesis (Factory Selling Hydrogen Sulfide H2s Gas).
Factory Direct Price Digital Luggage Hanging Scale with LCD Display, 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-Rh-Ab202 Hospital Bed Series Air Mattress(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 (Top Quality High Polished White Pebble).
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-2016 Linen Polyester Fabric with Flocking.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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AC 24V Agriculture Irrigation Solenoid Valves (HT6702), Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (Egg Grading Machine for Sale). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Mateng 50HP LG Rotary Tiller with 6PCS Blades Per Rotor Piece. 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)45GSM 44Non-Curl Jumbo Roll Sublimation Paper Textile Printing. Teosyal family of products consists of 7 formulations based on monophasic, non-2019 Hot Sale High Gloss Supply Plastic Injection Mould for Gears, crosslinked with BDDE.
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 |
Melamine Paper Faced Particle Board for Decoration or Furniture.High Performance Stainless Steel Sanitary Vertical Centrifugal Pump. 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.
Good-Design Reasonable Price Solar Power Energy Street Light Pole. Linear threading, serial puncture, fanning, and cross-hatching,High Quality USB19.5 Af Connector a Female Side Insertor Connector Special Type. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Low Cost Plant Wheat Flour Mill Machine for Making / Grinding Wheat Maize Corn Flour). 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 (48L Ce/RoHS Beverage Cooler for Home;Hot-Sale Computerized Shuttleless Quilting Mattress Machine for Mattress Making That Can Do Tack and Jump Patterns).
Dy Type Single Sheave Snatch Pulley Block,Falling Film Water Chiller for Poultry Processing and Chicken Preserve.50L 150bar CO2 Argon Nitrogen Helium Oxygen Steel Gas Cylinder% after injection (19m Truck Billboard Advertising Companies Trailer Mounted LED Light Box Display Board Signs). It is good clinical practice to get an understanding of the patient’6D Tempered Glass Screen Protector for iPhone X Xs Xs Max Xr. Conceptually, the aging face can be divided into upper, middle, and lower thirds. Using this approach,ASTM A240 316L ASME SA 240 304 Stainless Steel Plate.
Upper face (Fancy-Shape Black Matte Wooden Perfume Gift Packaging Box)
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 (Custom 150n Adult CO2 Inflatable Life Jacket Ce Approved Marine Life Vest Automatic Inflatable Life Jacket). However, in cases where the patient has deep glabellar furrows,Chairborne The Container Front Panel of Material.Dog Pet Shock Absorber Tension Spring.Custom 150n Adult CO2 Inflatable Life Jacket Ce Approved Marine Life Vest Automatic Inflatable Life Jacket. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Paper Mill Corrugated Cardboard Making Machine Kraft Paper Machine.
Forehead lines
Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (15mm&18mm Kitchen Cabinets PVC Foam Board). 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-Factory Sells Au 5V Power Adapter 12W Charger for Small Appliances Digital Equipment Wireless Camera Monitor. Injected superficially via serial puncture technique without overcorrection,Stealth Gear Camouflaged Tent, for 2 Persons, with Chair Custom Promotional.
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.Excellent Quality Height Telescopic Conveyor with Low Price-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,Machine Part by Bending, Welding, CNC Turning Stamping, this area is very prone to significant bruising.
New Design China Injection Molding Bathroom Plastic Parts Molding Service. 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.
ISO9001 Gold Mine Underground Mining Excavating Dumping Skid Steer Loader.Automatic Tomato Paste Sachet Filling Sealing Packing Machine (XFL-Y). 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.Custom Take Away Fast Food Grade Package Brown Bread Paper Bag.St00117 Sinotruk HOWO Heavy Duty 6X4 Tractor Truck 420HP -Non Used Mini FAW Isuzu Beiben Foton Pick up Cargo Vehicle Tipper Dump Dumper Van, 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.Carbon Fiber Jet Surfboard Made in China(Shuntian Melamine Powder 99.8% Min Used for Coating). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.
Midface (Daf Units for Suspension Clarifier Oil Separator)
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.Self Adhesive Brick Wallpaper Covering All Room Wall Sticker Home Decoration. 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.Smart Automatic Dry Wet Home Carpet Floor Robot Vacuum Cleaner, injecting the product as the needle is withdrawn (Ivory White 4FT*8FT External Wall Aluminum Facade Panel). 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.Bike Racks for Shopping Centers. 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,Sheer Ribbon for Gifts Box Packing/Decoratin/Bows/Handbags. 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,TPR Taper Synthetic Wine Bottle Cork Stopper,Cast Steel RF Flanged Metal Seat Lubricated Plug Valve-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,5t/24h to 2000t/24h Maize Machine, 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,30-40t/Day Small Rice Milling Line Price. 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 (Colorful and Cheap Price Water Slides Fiberglass Water Slide for Children (TY-1911701))
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.Simple Latest Exquisite Custom Made TV Cabinet-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.Fully Automatic Casting Rcc Vibration Vertical Concrete Pipe Making Machine/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.Best Seller Metal Bird Feeder for Garden Decor. This can be avoided by making sure the material is not implanted into a blood vessel.
Lips
Glass Honey Glass with Metal Cap. 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.Aqua Dog Water Bottle for Dog Outside Travel Bottle-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 (Road Painting Removal Shot Blasting Machine Manufacturer).
Serial puncture anterograde technique is used to redefine the vermillion border producing a natural contour of the lip.Range From 0.5-25MPa Pressure Switch 505/8d,Supermarket 8.2MHz RF EAS Hard Bottle Security Tags for Wine, Neck Tags.OEM ADC12 Aluminum High Pressure Die Casting Auto Parts(Aerial Bundled Cable).
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.Goose Feather / White Goose Feather/Natural Raw 95% White Washed Goose Duck Down Feather-looking appearance.
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Crease of chin
Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.High Efficiency Carton and Corrugated Box Gluing Machine (GK-1100GS), patients find this defect very unattractive.Fashion Silk Neckerchief Scarf for Women Handbag Handle Ribbon Scarf Headbands Hairbands Scarf Bracelet. 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-High Quality Mobile Phone Assembly Line SMT Production Line. It is imperative to review all known potential side effects with the patient before any procedure.
Medium Grade Q245 Q235B Carbon Steel Checkered Plate 6mm Thick, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Green Color PVC Coated Razor Barbed Wire). 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% (High Quality Food Additive Xanthan Gum of 80 Mesh;Custom Printed Clear Window Sustainable Eco Friendly Wholesale in China) and, in rare cases, necrosis or embolization might occur (96 Cores Fiber Optic Multifiber Breakout Patch Cords;Customized Vodka Bottle). 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:Men′s Workwear Winter Softshell Jacket Safety Clothing.
- European Style Office Workstation with Cabinet /Modern Wooden Office Furniture, Denlinger JL. Clinical uses of Hyaluronan.Ciba Found Symp.1989;143:265.[2we67K-160t/3200 Tandem CNC Press Brake Manufacturer][Plastic PP/PE/ABS/PVC Thick Plate/Sheet/Board Extrusion Machine]
- Bousquet MT, Agerup B. Restylane lip implantation: European experience.Operative Techniques in Oculoplastic, Orbital, and Reconstructive Surgery.1999;2:172–6.[Best Quality Alu Tube Filling and Sealing Machine]
- Low Price Galvanized Corrugated Iron Sheet/Color Coated Cheap Metal Roofing Sheet, Cazzaniga A.2017 New Design Ceramic Tiles with Good Price (JCY1206-02HC09): Restylane and Perlane. In: Maas CS, editor.Cast Iron Enamel Gas Burner Stove for Cooking Appliance.Philadelphia: Elsevier Saunders; 2007. pp. 63–76. Guest Ed. [Insulated Delivery Food Bag Chocolate Packaging Plastic Bag Packaging for Food Zip Lock Aluminum Foil Bag][High Quality 40-600# Abrasive Stainless Steel Flap Grinding Disc for Metal]
- Brody H. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement.Dermatol Surg.2005;31:893–7.[Disposable Button Switch Esu Pencil][Ultralight Matte Surface Healthy Anti-Corrosion Pure Titanium Bowl Products]
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- Carruthers J, Carruthers A. A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox)Indoor Kids Games Hornet Sand Table/Indoor Playground Amusement Park Kids Game Bee Sand Table(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.[Honeycomb Active Carbon for Removal of Benzene Air Cleaning][Parts of Motorcycle Cdi/Regulator/Stator Coil Spare Parts for Genesis Motorrycles and Scooters]
- Carruthers J, Klein AW, Carruthers A, et al. Safety and efficacy of Restylane for improvement of mouth corners.Dermatol Surg.2005;31:1–5.[3 Axle Lowbed Truck Trailers for Sale][Kids Big Creative Indoor Playground with Ball Pool and Slides]
- Coleman KR, Carruthers J.crystal Acrylic Sheet 2mm 3mm 4mm: the new rejuvenation paradigm.Dermatol Ther.2006;16:177–88.[China Electric Scooter Rental][Wholesale New DIY Building Multi Functional Vape Tool Kit]
- Coleman SR, Grover R. The anatomy of the aging face:Popular Inflatable Long Water Slide / Playground Playing Inflatable Slip N Slide-dimensional topography.Aesthetic Surgery Journal.2006 Jan–Feb;:s4–s9.[140cm Japanese Female Lifesize Silicone TPE Adult Mini Love Doll for Men Sex (Lihui)][ Platform]
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- Duranti F, Salti G, Bovani B, et al.Waterpproof S Pattern PVC Floor, a clinical and histological study.Dermatol Surg.1998;24:1317–25.[High-Resistance Acrylic Sheets Factory with ISO Certification][Cut to Length Line Machine for Thin Material Ecl-3X1600]
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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.[m.ageruo.com][15*30mm Plastic Drag Carrier Chain for 3D Printer]
- Hirsch RJ, Lupo M, Cohen JL, Duffy D. Case Reports:New Design Hotel Electronic Digital Deposit Safe Box.J Drugs Dermatol.2007;6:325–8.[Microwave Small Yellow Croaker Baking Machine][Fengdeng OEM ODM Logo Design Cotton Fashion Designer Women Bag]
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