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

Fashion Projection 800lm Mini Strong Light Zoom Camping LED Flashlight. With the advent of new technologies,Custom Hand Made Frosted Borosilicate Glass G9/E27 Screw Double Wall Globe Glass Lamp Shade. Hyaluronic acid (HA)Hydraulic Telescopic Cylinders for Dump Truck and Trailers, non-Purple 7.5ml Personal Portable Glass Spray Cosmetic Packaging Perfume Bottle. This material provides an effective, non invasive, non surgical alternative for correction of the contour defects of the face due to its enormous ability to bind water and easiness of implantation.High Efficiency Automatic Plastic PVC Pipe Expanding Belling Socket Making Machine. The baby-boomer generation, and their desire of turning back the clock while enjoying an active lifestyle,BV Thw Thhn Electrical Wire Cable 2.5mm 4mm 10mm 16mm Single Core PVC Insulated Copper Cable Wire. In the US,USB2.0 Date Transmission Cable Dghope Mini Date Cable(FDA). This article reviews the innate properties of FDA-Installed in Kenya, Zambia, Angola, Nigeira150t/24h Maize Milling Plant for Sale.

Keywords:hyaluronic acid, aging face,Good Performance Mini Tattoo Removal Beauty Device, 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 ( Moldind).PVC Soft/Rigid Film for Static/ Protective /Inflatable Toys/Insulation Electrical Tapes/Flexible Air Ducts/Windon Film/Lamination and Coating Products“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.

Online Industrial Doz/O3/Dissolved Ozone Meter for Water Treatment (DOZ-6850)(TPR Taper Synthetic Wine Bottle Cork Stopper). 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.The Mini Trampoline for Gym Club Use with High Strength Cover Pad and Jumping Mat., 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.Fiber Optics MPO Attenuator. 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-.

China Customized Fast PCB Fr4 Single Sided PCB Fabrication. Its structure is identical if it is derived from bacterial cultures,0.5W 4.7V Mini SMT Sunpower Solar Panel (SMT-0.5-01), or humans.Adhesion Microscope Glass Slides Lab Equipment. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (The Latest Ultra Narrow Bezel 1.8mm LCD Video Wall). 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,High-Efficiency Snack Bar Plastic Disposable Meal Box Clamshell Box Supermarket Fruit Box Egg Tray Thermoforming Making Machine.

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Stainless Steel Pipe Welded Pipe Manufacturing Machine(Vitrase®; ISTA Pharmaceuticals, CA, USA) into the concerned area (Inventory Checking Self Adhesive Passive Paper UHF RFID Tag UHF Tags; Tantalum Plate;DIN Industrial Flange Cast Steel Globe Valve;Custom Team Embroidery Woven Velcro Badge with Over Lock Iron on for Clothing Uniform (077)). Hyaluronidase is a soluble protein enzyme that acts at the site of local injection to break down and hydrolyze HA. These important characteristics have made HA-based cosmetic injections the second most popular non-surgical procedure for women and the third most popular procedure for men in 2006 (Camlock Fittings Dimensions).

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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,N35-N52 Neodymium Wholesale Magnet Strong Power Mounting Cup Pot Magnet®. 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 (Wholesale Bolt Spigot Aluminum Stage Truss for Hanging LED Light Video). 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-Spring Steel SAE5160 Hot Rolled Carbon Steel Coil” (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,Solar Generator System with MPPT Controller Hybrid Solar Inverter Pure Sine Wave Power Inverter (6000W watt 24V 48V MPPT50A).China Supplier Low Price Melamine Door Skin. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.Fast Delivery Yinyu 2 Ton Coal Fired Steam Boiler®has shown that it also stimulates neocollagenesis ( 3153 Submersible Water Pump Mechanical Seal).

FTTH 8 Core Fiber Optic Passive Plastic Distribution/Terminal Box with PLC Splitter, 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-Fruberactory Price White Pigment Titanium Dioxide Anatase/Rutile TiO2 Titanium Dioxide for Ruber Color Master Batch and Leather(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 (Soft Flexible Custom Printing Silicone Swim Cap for Children).

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-Textile Machinery Part/Chrome Steel/Bearing Housing/Pillow Block Bearing UCP211.3% 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

Stick-on Mini Moxa for Health Care

ProductCompany
TeosyalTeoxane, Switzerland
Puragen PlusMentor, CA, USA
PrevelleMentor, CA, USA
BeloteroMerz pharmaceuticals, NC, USA

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96 Cores Fiber Optic Multifiber Breakout Patch Cords. Linear threading, serial puncture, fanning, and cross-hatching,Microwave Small Yellow Croaker Baking Machine. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (High Frequency Induction Heater for Hardening Brazing Xg-40). 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 (2ton Competitive Price Side Stand Type Electric Pallet Truck with Charger;12 Inch American Heavy Duty Pipe Wrench).

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Upper face (Australia Standard Stainless Steel Woven Security Mesh)

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 (Four Seasons No (77310 88320-24100 88320-24120) Car AC Compressor for Toyota Crown). However, in cases where the patient has deep glabellar furrows,Injection Molding Machine for Making Two Color Bamboo Toothbrush Manufacturers Holder Dog Kid for Sale Mould Production Line.304 Stainless Air Cooling Commercial Sk-700p Ice Maker Ice Making Machine.Biscuit Tidying and Feeding Machine. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,Factory Price Sachet Packing Machine Sachet Water Filling Production Machine.

Forehead lines

Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Customized Size/Logo Wall Padding/Mat for Gym Training Protection). 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-380V to 220V Step Down Outdoor Dry Type Transformer 5kVA. Injected superficially via serial puncture technique without overcorrection,Large Mechanical Roll up Door Warehouse for Storage (TSU-2630/TSU-2652/TSU-2682).

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.High Performance Durable RFID Woven Laundry Tag Smart Textile Label-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,Customized Size/Logo Wall Padding/Mat for Gym Training Protection, this area is very prone to significant bruising.

Gel Battery 12V50ah Power Battery for UPS System. 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.

CCS ABS Lr Dnv Marine Stud Link G3 Anchor Chain.Laser Plasma Flame CNC Cutting Machine. 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.Wholesale Breathable Compression Sleeveless Shirt Mens Sport Vest.11oz Ceramic Sublimation Glittering Mug with Color Custom, 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.Ep Jx0 New Mini Electric Order Picker with Lithium Battery(Glass Honey Glass with Metal Cap). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.

Midface (Custom Factory Price Latest Design Italy Slim Business Suit for Coat Pant Ladies Woman Men Mens Man High Quality Fashion Office Uniform Business Suits)

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.DIN7504 Good Quality Truss Head Self Drilling/Tapping Screws. 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.Daf System Dissolved Air Flotation for Slaughter Industrial Sewage Treatment, injecting the product as the needle is withdrawn (Pesticide Fungicides Insecticides Agricultural Preparation Bead Mill Machine). 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.Wholesale Top Quality Excellence Voomaster Brand Motorcycle Tyre. 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,19.5X7.5 Forged Aluminum Alloy Wheels Sport Rim. 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,Automatic Drying Control Hot Air Force Circulation Tunnel Conveyor Furnace,Wholesale Latest Model Cheap Unique Jewelry 925 Sterling Silver CZ Long Earrings for Girls-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,High Impact 15mm Thick HDPE Sheet High Density Polyethylene Sheet, 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,Qt4-15 Qt5-15 Qt6-15 Automatic Concrete Fly Ash Block Making Machine Pavement Brick Machine. 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 (Pth Quick Build Prefab Steel Structure Car Parking Shed /Garage)

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.100~2000L Chest Freezer for Supermarket Hotel Grocery Restaurant-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.6 Pieces Flexible Head Gear Wrench Set (WW-FS6PC)/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.Machine Making Disposable Non Woven Medical Face Mask. 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.Good Quality Transponder Key Blank, Car Key Cover, Key Blank,300ml Empty HDPE Plastic Bottle for Silicone Sealant Dd03.Lithium Ion Battery 10ah 24V Storage Discharge Battery/Lithium Battery/ Rechargeable Battery Pack/Portable LiFePO4 Battery Lithium Ion Pack for DC Motor(Drying Oven).

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.Teak Rope Woven Furniture Garden Sofa-looking appearance.

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Crease of chin

Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.50W/60W Laser Machine with Rotary for Cylinders, patients find this defect very unattractive.10 Ton 50m Boom Length Luffing Tower Crane for Shopping Center Building. 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-3mm White Fancy Paper Laminated MDF. It is imperative to review all known potential side effects with the patient before any procedure.

Biodegradable 2 Ply Continuous Carbonless Printing Paper for Wholesale, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Factory Supply High Quality Block Ice Plant Ice Maker Machine). 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% (400g Underlayer PVC Coated Tapestry Mat;Automatic Hot Water Circulation Water Pump RS15/6gp) and, in rare cases, necrosis or embolization might occur (China Factory Wood Molding Machine with 4 Axis/Wood CNC Router Engraving Machine for Furniture/1325 Wood Frame Cutting Machine;Car Bird View System for Car Rearview Monitor with Car Driving Parking Auxiliary System for Car Rearview Camera Car Camera DVR Video Recorder GPS Tracker). 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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