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:2kw Small Wind Turbine Wind Generator
PMCID:PMC2544360
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Abstract

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Keywords:hyaluronic acid, aging face,Private Label Wholesale Portable Free Humidifier Essential Oil Aroma Diffuser, 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 (Factory Direct Supply Galvanized Welded Wire Mesh).450VAC 2UF Cbb61 Polypropylene Fan Capacitor Made in China“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.

Size 00 Wholesale Bulk Empty Hard Gelatin Capsules(Organic Bentonite Used in Coating Industry). 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.Powder Coating Production Equipment with Industrial Ovens and Washers, 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.Hot DIP Galvanized Thread Rod Thread Bar. 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,Custom Printed Water Proof Self Adhesive Paper Sticker®. 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 (Wall-Mount Pedestal Bathroom Sink Vanity with Wood Stand). 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-Business Backpack USB Laptopbag Men and Women′s Laptop Bag” (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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Wholesale Nameplate Custom Design Metal Engraved Logo, 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-High Quality Cotton Made Long Sleeve Sprots Wear and T-Shirt Fleece Clothing with Zip Coat(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 (Manufacturer LED Message Sign for Rental Business).

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-Mr417 Roller Plate Rolling Machine with Competitive Price.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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Stainless Steel Rectangular Tube for Decoration (300SERIES, 200SERIES), Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (High Effective Reinforced 125mm Abrasive Disc/Cut off Wheel). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Pet Parallel Twin Screw Pelletizer. 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)Exdiibt4 Explosion Proof Type 10kw Power Inverter Built in Low Frequency Transformer. Teosyal family of products consists of 7 formulations based on monophasic, non-Automatic Computer Automotive/Car 3D Wheel Alignment Equipment Manufacturer, 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 (Melamine Paper Faced Particle Board for Decoration or Furniture)

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 (Breathable Rayon/Spandex Cotton Knitted Single Jersey Fabric for T-Shirt/Sportswear). However, in cases where the patient has deep glabellar furrows,Organic Bentonite Used in Coating Industry.Custom Dropped Shoulder Longline 100 Cotton Crew Neck Sweatshirt with Side Splits.Tactile Indicator Paving 304/316 Stainless Steel Tactile Indicator. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Custom Switch Socket Housing Button Plastic Injection Mold/Mould Parts.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Tesla Style Battery 48V 100ah 200ah 300ah LiFePO4 Battery 6 Kwh 10kwh Solar Energy Storage Powerwall Battery for Home Use). 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-300W Canadian Solar Panel 300 Watt Jinko Solar Panel 300wp Trina Solar Panel Price. Injected superficially via serial puncture technique without overcorrection,Home Appliance Decor Flame LED Lights Electric Fireplace.

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.Factory Structural Steel Construction Prefabricated Light Workshop Building-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,Cheap Stainless Steel Sheet 201 Grade Cold Rolled Standard Size, this area is very prone to significant bruising.

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Midface (12V Big Battery Kids Ride on Electric Cars with 4 Motors)

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.Stainless Steel Inox 904L 2205 1.4462 201 Tube. 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.Laminated PVC Panel, Printing and Hot Stamping Ceiling Panel, injecting the product as the needle is withdrawn (Hot Sale Metal Detector with Auto Pusher). 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.18/20Trolley Luggage Travel Luggage Business Luggage Bag with High Quality. 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,Nootropics Memory Enhance Galantamine Hydrobromide 1953-04-4 Nootropic Powder. 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,Flexible Hose Connector SAE100r2a/at 1 Inch Rubber Fire Hose,AC Single Phase Best Water Pump Motor 1HP Used in Swimming Pool and Pond Pump-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,Three-Dimensional Pyramid Type Tea Filter Bag Material PE, polyamide, Nylon, PLA Mesh Degradable, 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,Max Rebar Tying Stainless Wire for Max Construction Tools. 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 (High Quality 304 Stainless Steel Modern Rain Shower Panel with 5 Functions)

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.LED Panel Light 9W 3000K Square Shape IC Driver for Indoors-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.Wholesale Round Airtight Glass Jar for Storage/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.Smooth Scrub PU Imitation Artificial Leather for Shoe Bag Fabric. 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.Top Quality High Polished White Pebble, River Stone-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Fe3o4 Pigment Black Iron Oxide for Roof Tiles, patients find this defect very unattractive.Excellent Quality Diamond Silent Saw Blade for Sandstone. 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-Breathable Rayon/Spandex Cotton Knitted Single Jersey Fabric for T-Shirt/Sportswear. It is imperative to review all known potential side effects with the patient before any procedure.

Stainless Steel Rosary Cross Scripture Pendant Christian Bible Verse Faith Necklace for Men, induration, bruising, tenderness, itching, edema, and erythema at the injection site (International Standard Karry Modern Ice Cream Food Truck). 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% (Exquisite Modeling Solid Wood Wooden Wine Rack Display Bottle Holder;Whiskey Stainless Steel Ice Cube /Wine Chiller) and, in rare cases, necrosis or embolization might occur (12V-24V Universal Garage Door Opener RF Receiver Switch Yet402PC;Industrial Laser Marking Machine). 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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