{"id":33998,"date":"2022-10-05T12:48:45","date_gmt":"2022-10-05T05:48:45","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=33998"},"modified":"2022-10-05T14:37:28","modified_gmt":"2022-10-05T07:37:28","slug":"chat-lam-day","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/chat-lam-day\/","title":{"rendered":"Hi\u1ec3u th\u00eam v\u1ec1 c\u00e1c ch\u1ea5t l\u00e0m \u0111\u1ea7y v\u00e0 ti\u00eam filler cho da"},"content":{"rendered":"

Ch\u01b0\u01a1ng 2: Ch\u1ea5t l\u00e0m \u0111\u1ea7y – t\u00e1c gi\u1ea3 Kyle K.Seo<\/p>\n

D\u1ecbch: Bs Nguy\u1ec5n Th\u1ecb Thu Huy\u1ec1n – BV\u0110K Sa Pa<\/p>\n

\u0110\u1ec3 t\u1ea3i file PDF v\u1ec1 c\u00e1c lo\u1ea1i ch\u1ea5t l\u00e0m \u0111\u1ea7y<\/a>, click t\u1ea1i \u0111\u00e2y<\/a>.<\/p>\n

C\u00e1c lo\u1ea1i ch\u1ea5t l\u00e0m \u0111\u1ea7y<\/h2>\n

V\u1ec1 \u0111\u1ecbnh ngh\u0129a, c\u00e1c lo\u1ea1i filler li\u00ean quan \u0111\u1ebfn t\u1ea5t c\u1ea3 c\u00e1c th\u00e0nh ph\u1ea7n \u0111\u01b0\u1ee3c th\u00eam v\u00e0o \u0111\u1ec3 cung c\u1ea5p hi\u1ec7u qu\u1ea3 l\u00e0m \u0111\u1ea7y \u1edf nh\u1eefng v\u00f9ng b\u1ecb thi\u1ebfu h\u1ee5t th\u1ec3 t\u00edch. C\u00e1c quy tr\u00ecnh th\u1ea9m m\u1ef9 v\u00f9ng m\u1eb7t, bao g\u1ed3m c\u00e1c th\u00e0nh ph\u1ea7n \u0111\u01b0a v\u00e0o m\u1eb7t \u0111\u1ec3 n\u00e2ng \u0111\u1ee1 c\u00e1c n\u1ebfp nh\u0103n ho\u1eb7c \u0111\u1ec3 l\u1ea5y l\u1ea1i th\u1ec3 t\u00edch khu v\u1ef1c l\u00f5m v\u00f9ng m\u1eb7t. Trong \u0111\u1ecbnh ngh\u0129a n\u00e0y, m\u1ed9t thu\u1eadt ng\u1eef r\u1ed9ng h\u01a1n c\u00f3 th\u1ec3 bao g\u1ed3m m\u1ee1 t\u1ef1 th\u00e2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong quy tr\u00ecnh c\u1ea5y gh\u00e9p m\u1ee1, th\u1eadm ch\u00ed bao g\u1ed3m c\u1ea3 paraffin ho\u1eb7c silicone tr\u01b0\u1edbc \u0111\u00e2y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng b\u1ea5t h\u1ee3p ph\u00e1p trong \u0111i\u1ec1u tr\u1ecb th\u1ea9m m\u1ef9. \u0110\u1ea7u ti\u00ean ti\u00eam ch\u1ea5t l\u00e0m \u0111\u1ea7y<\/strong> \u0111\u01b0\u1ee3c nh\u00ecn nh\u1eadn nh\u01b0 1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb y khoa h\u1ee3p ph\u00e1p d\u1ef1a tr\u00ean collagen – 1 th\u00e0nh ph\u1ea7n c\u1ea5u tr\u00fac trong ch\u1ea5t n\u1ec1n c\u1ee7a da. \u0110\u1ea7u nh\u1eefng n\u0103m 1980, ZYDERM c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb b\u00f2 (Allergan, the US) \u0111\u00e3 \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u l\u00ean th\u1ecb tr\u01b0\u1eddng, s\u1ea3n ph\u1ea9m ch\u1ea5t l\u00e0m \u0111\u1ea7y hi\u1ec7n \u0111\u1ea1i \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn b\u1edfi FDA Hoa K\u1ef3 (fig.2.1). Tuy nhi\u00ean, do c\u00f3 ngu\u1ed3n g\u1ed1c \u0111\u1ed9ng v\u1eadt, vi\u1ec7c s\u1eed d\u1ee5ng ch\u1ea5t l\u00e0m \u0111\u1ea7y c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb b\u00f2 b\u1ecb h\u1ea1n ch\u1ebf v\u00ec r\u1ee7i ro ban \u0111\u1ea7u c\u1ee7a ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng v\u00e0 hi\u1ec7u qu\u1ea3 ng\u1eafn. Theo \u0111\u00f3, c\u00f3 s\u1ef1 ra \u0111\u1eddi ti\u1ebfp theo v\u00e0 chi\u1ebfm \u01b0u th\u1ebf c\u1ee7a ch\u1ea5t l\u00e0m \u0111\u1ea7y HA, collagen c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb b\u00f2 \u0111\u00e3 s\u1edbm kh\u00f4ng \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng tr\u00ean to\u00e0n c\u1ea7u.<\/p>\n

Ng\u00e0y nay, ti\u00eam filler<\/strong> v\u1eabn \u0111\u01b0\u1ee3c ph\u1ed5 bi\u1ebfn nh\u01b0 1 \u201cch\u1ea5t l\u00e0m \u0111\u1ea7y da\u201d, c\u00f3 th\u1ec3 do ch\u1ea5t l\u00e0m \u0111\u1ea7y<\/strong> \u0111\u1ea7u ti\u00ean \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng d\u1ef1a tr\u00ean collagen. Collagen \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn l\u00e0 m\u1ed9t c\u1ea5u tr\u00fac quan tr\u1ecdng trong c\u1ea5u t\u1ea1o c\u1ee7a da, v\u00e0 qu\u1ea3 nhi\u00ean ch\u1ea5t l\u00e0m \u0111\u1ea7y collagen \u0111\u00e3 \u0111\u1eb7c bi\u1ec7t \u0111\u01b0\u1ee3c ti\u00eam ch\u00ednh x\u00e1c v\u00e0o da \u0111\u1ec3 c\u1ea3i thi\u1ec7n \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u00e0 c\u00e1c n\u1ebfp nh\u0103n c\u1ee7a da. Vi\u1ec7c ti\u00eam ch\u1ea5t l\u00e0m \u0111\u1ea7y \u0111\u00e3 ph\u00e1t tri\u1ec3n \u0111\u00e1ng k\u1ec3 v\u00e0 ng\u00e0y nay ch\u00fang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng kh\u00f4ng ch\u1ec9 \u0111\u1ec3 c\u1ea3i thi\u1ec7n c\u00e1c r\u00e3nh v\u00e0 n\u1ebfp nh\u0103n m\u00e0 c\u00f2n trong 1 m\u1ea3ng m\u1edbi th\u00fa v\u1ecb l\u00e0 quy tr\u00ecnh th\u1ea9m m\u1ef9 x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u t\u1eadn d\u1ee5ng hi\u1ec7u \u1ee9ng n\u00e2ng l\u00ean c\u1ee7a ti\u00eam ch\u1ea5t l\u00e0m \u0111\u1ea7y (fig.2.2)[1]. V\u00ed d\u1ee5 bao g\u1ed3m c\u1ea3 n\u00e2ng cao m\u0169i t\u1eb9t hay l\u00e0m \u0111\u1ea7y \u0111\u1eb7n m\u00f4i m\u1ecfng, \u0111\u1ecbnh h\u00ecnh l\u1ea1i \u0111\u01b0\u1eddng n\u00e9t g\u01b0\u01a1ng m\u1eb7t. H\u01a1n n\u1eefa, thu\u1eadt ng\u1eef \u201cdermal fillers\u201d \u00e1m ch\u1ec9 r\u1eb1ng ch\u00fang \u0111\u01b0\u1ee3c ti\u00eam v\u00e0o trong da, \u0111\u1ed9 s\u00e2u c\u1ee7a m\u0169i ti\u00eam c\u1ee7a nh\u1eefng quy tr\u00ecnh l\u00e0m \u0111\u1ea7y th\u00ec c\u00f3 ngh\u0129a s\u00e2u h\u01a1n th\u1ebf, \u0111\u00f3 l\u00e0 b\u00ean d\u01b0\u1edbi da hay th\u1eadm ch\u00ed s\u00e2u v\u00e0o nh\u1eefng t\u1ed5 ch\u1ee9c s\u00e2u b\u00ean d\u01b0\u1edbi da. Tr\u00ean c\u01a1 s\u1edf n\u00e0y, thu\u1eadt ng\u1eef \u201cdermal filler\u201d tr\u1edf n\u00ean d\u1ec5 nh\u1ea7m l\u1eabn, \u0111\u00e3 \u0111\u1ebfn l\u00fac b\u1ed5 ngh\u0129a \u201cdermal\u201d ph\u00f9 h\u1ee3p \u0111\u1ec3 \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf.<\/p>\n

Sau ch\u1ea5t l\u00e0m \u0111\u1ea7y collagen, HA tr\u1edf n\u00ean th\u1ed1ng tr\u1ecb th\u1ecb tr\u01b0\u1eddng th\u1ebf gi\u1edbi v\u1ec1 ti\u00eam ch\u1ea5t l\u00e0m \u0111\u1ea7y. Ch\u00eca kh\u00f3a d\u1eabn t\u1edbi th\u00e0nh c\u00f4ng c\u1ee7a n\u00f3 l\u00e0 \u0111\u1eb7c \u0111i\u1ec3m an to\u00e0n tuy\u1ec7t v\u1eddi c\u1ee7a th\u00e0nh ph\u1ea7n c\u1ea5u t\u1ea1o n\u00ean da, \u0111\u00e2y l\u00e0 ngu\u1ed3n g\u1ed1c cho ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch t\u1ed1i thi\u1ec3u c\u1ee7a c\u01a1 th\u1ec3, kh\u1ea3 n\u0103ng c\u00f3 th\u1ec3 b\u1ecb ph\u00e2n gi\u1ea3i \u0111\u1ed9c \u0111\u00e1o, k\u1ebft qu\u1ea3 c\u00f3 th\u1ec3 lo\u1ea1i b\u1ecf n\u1ebfu mu\u1ed1n, b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng t\u00e1c nh\u00e2n ph\u00e2n gi\u1ea3i. Tr\u00ean c\u1ea3 s\u1ef1 an to\u00e0n tuy\u1ec7t \u0111\u1ed1i c\u1ee7a n\u00f3, HA c\u0169ng cho th\u1ea5y m\u1ed9t kho\u1ea3ng th\u1eddi gian hi\u1ec7u qu\u1ea3 tuy\u1ec7t v\u1eddi. Khi \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u v\u00e0o \u0111\u1ea7u nh\u1eefng n\u0103m 2000, HA ban \u0111\u1ea7u \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn t\u1ed3n t\u1ea1i t\u1eeb 6 th\u00e1ng \u0111\u1ebfn 1 n\u0103m trong t\u1ed5 ch\u1ee9c, ng\u00e0y nay n\u00f3 \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn r\u1ed9ng r\u00e3i r\u1eb1ng ch\u00fang c\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i t\u1edbi m\u1ed9t v\u00e0i n\u0103m n\u1ebfu \u0111\u01b0\u1ee3c ti\u00eam bolus ho\u1eb7c cho nh\u1eafc l\u1ea1i v\u1edbi li\u1ec1u duy tr\u00ec. \u0110i\u1ec1u n\u00e0y l\u00e0 b\u1edfi v\u00ec khi HA fillers \u0111\u01b0\u1ee3c ti\u00eam v\u1edbi h\u00ecnh th\u1ee9c 1 li\u1ec1u bolus , n\u00f3 gi\u1edbi h\u1ea1n tr\u00ean 1 \u0111\u01a1n v\u1ecb di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t c\u1ee7a HA filler, n\u00f3 ti\u1ebfp x\u00fac v\u00e0 b\u1ecb ph\u00e2n h\u1ee7y b\u1edfi enzim hyaluronidase c\u1ee7a c\u01a1 th\u1ec3. L\u01b0u \u00fd, HA filler \u1edf v\u00f9ng tr\u00e1n, s\u1ed1ng m\u0169i, v\u00e0 khu v\u1ef1c cu\u1ed9n d\u01b0\u1edbi m\u00ed m\u1eaft cho th\u1ea5y t\u1ed3n t\u1ea1i k\u00e9o d\u00e0i 5-10 n\u0103m.<\/p>\n

Trong khi HA filler \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c \u0111\u01b0a l\u00ean th\u1ecb tr\u01b0\u1eddng l\u00e0 Hylaform (Hylan b gel) (Genzyme Biosurgery) \u0111\u01b0\u1ee3c chi\u1ebft su\u1ea5t t\u1eeb m\u00e0o g\u00e0 tr\u1ed1ng, s\u1ea3n ph\u1ea9m \u0111\u00e3 kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u00ec v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn t\u1ea1p ch\u1ea5t protein \u0111\u1ebfn t\u1eeb ngu\u1ed3n g\u1ed1c gia c\u1ea7m v\u00e0 ti\u1ebfp theo \u0111\u00f3 HA filler \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u00e3 \u0111\u01b0\u1ee3c thanh l\u1ecdc HA c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb vi khu\u1ea9n v\u00ed d\u1ee5 nh\u01b0 streptococcus, \u0111\u01b0\u1ee3c duy tr\u00ec \u0111\u1ebfn ng\u00e0y nay \u0111\u1ec3 tr\u1edf th\u00e0nh s\u1ea3n ph\u1ea9m th\u1ed1ng tr\u1ecb th\u1ecb tr\u01b0\u1eddng tr\u00ean th\u1ebf gi\u1edbi.<\/p>\n

B\u1edfi v\u00ec collagen-base hay HA filler \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf ban \u0111\u1ea7u \u0111\u1ec3 thay th\u1ebf v\u00e0 kh\u00f4i ph\u1ee5c s\u1ef1 m\u1ea5t th\u1ec3 t\u00edch (ch\u1ea5t \u0111\u1ed9n thay th\u1ebf), ch\u1ea5t l\u00e0m \u0111\u1ea7y k\u00edch th\u00edch collagen, c\u0169ng \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn nh\u01b0 ch\u1ea5t \u0111\u1ed9n thay th\u1ebf sinh h\u1ecdc, bao g\u1ed3m c\u00e1c polyme ph\u00e2n h\u1ee7y sinh h\u1ecdc \u1edf khu v\u1ef1c \u0111\u01b0\u1ee3c ti\u00eam, ch\u00fang ph\u00e2n h\u1ee7y ch\u1eadm trong c\u01a1 th\u1ec3. V\u00ed d\u1ee5 v\u1ec1 nh\u1eefng ch\u1ea5t l\u00e0m \u0111\u1ea7y k\u00edch th\u00edch collagen bao g\u1ed3m Radiesse ch\u1ee9a CaHA v\u00e0 Sculptra ch\u1ee9a PLLA (f2.4.3). Nh\u00ecn chung, nh\u1eefng ch\u1ea5t l\u00e0m \u0111\u1ea7y k\u00edch th\u00edch collagen n\u00e0y \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ec3 cho s\u1ee9c b\u1ec1n t\u1ed1t h\u01a1n so v\u1edbi HA filler. Tuy nhi\u00ean h\u1ea1n ch\u1ebf c\u1ee7a c\u00e1c ch\u1ea5t l\u00e0m \u0111\u1ea7y n\u00e0y l\u00e0 ch\u00fang kh\u00f4ng th\u1ec3 cho ph\u00e9p t\u00f9y ch\u1ec9nh th\u1ec3 t\u00edch ch\u00ednh x\u00e1c, k\u1ebft qu\u1ea3 t\u00f9y thu\u1ed9c v\u00e0o s\u1ef1 thay \u0111\u1ed5i c\u1ee7a m\u1ed7i c\u00e1 nh\u00e2n trong s\u1ea3n xu\u1ea5t collagen, v\u00e0 n\u00f3 m\u1ea5t 4-12 tu\u1ea7n \u0111\u1ec3 t\u1ea1o n\u00ean collagen m\u1edbi \u0111\u1ec3 b\u1ed5 sung th\u1ec3 t\u00edch ban \u0111\u1ea7u t\u1eeb ch\u1ea5t mang, carboxymethyl cellulose hay n\u01b0\u1edbc mu\u1ed1i b\u1ecb tan ngay sau khi \u0111i\u1ec1u tr\u1ecb. H\u01a1n n\u1eefa, k\u1ebft qu\u1ea3 c\u1ee7a ch\u1ea5t l\u00e0m \u0111\u1ea7y k\u00edch th\u00edch collagen r\u1ea5t kh\u00f3 \u0111\u1ec3 ph\u00e2n gi\u1ea3i trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 b\u1ea5t k\u1ef3 n\u1ed1t hay nh\u1eefng b\u1ea5t th\u01b0\u1eddng ph\u00e1t sinh do s\u1ef1 kh\u00f4ng \u0111\u1ed3ng \u0111\u1ec1u c\u1ee7a s\u1ea3n ph\u1ea9m.<\/p>\n

Trong khi \u0111\u00f3, c\u00e1c s\u1ea3n ph\u1ea9m v\u00ed d\u1ee5 nh\u01b0 PAAG (polyacrylamide gel) t\u1eeb Bellafill hay PMMA (polymethyl methacrylate) t\u1eeb Aquamid \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec3 k\u00e9o d\u00e0i tu\u1ed5i th\u1ecd d\u1ef1a tr\u00ean s\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t t\u1ed5ng h\u1ee3p v\u0129nh vi\u1ec5n (f.2.4.2). Tuy nhi\u00ean , vi\u1ec7c s\u1eed d\u1ee5ng ch\u1ea5t l\u00e0m \u0111\u1ea7y v\u0129nh vi\u1ec5n c\u00f3 c\u1ea7n thi\u1ebft v\u00e0 c\u00f3 l\u00e0 l\u1ef1a ch\u1ecdn t\u1ed1t v\u1eabn l\u00e0 c\u00e2u h\u1ecfi \u0111\u1ec3 ng\u1ecf, c\u1ea5u tr\u00fac c\u01a1 b\u1ea3n tr\u00ean khu\u00f4n m\u1eb7t kh\u00f4ng ph\u1ea3i l\u00e0 v\u0129nh vi\u1ec5n. V\u1edbi s\u1ef1 l\u00e3o h\u00f3a, g\u01b0\u01a1ng m\u1eb7t m\u1ea5t \u0111i v\u1ebb tr\u1ebb trung do s\u1ef1 ch\u1ea3y x\u1ec7, n\u00f3 c\u1ea3i thi\u1ec7n sau khi ch\u1ea5t l\u00e0m \u0111\u1ea7y v\u0129nh vi\u1ec5n \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o. K\u1ebft qu\u1ea3, \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn xu\u1ea5t hi\u1ec7n s\u1ef1 kh\u00f4ng h\u00e0i l\u00f2ng gi\u1eefa v\u00f9ng \u0111\u01b0\u1ee3c ti\u00eam v\u00e0 ph\u1ea7n l\u00e3o h\u00f3a c\u00f2n l\u1ea1i c\u1ee7a g\u01b0\u01a1ng m\u1eb7t. H\u01a1n n\u1eefa, ch\u1ea5t l\u00e0m \u0111\u1ea7y v\u0129nh vi\u1ec5n c\u0169ng ti\u1ec1m \u1ea9n xu\u1ea5t hi\u1ec7n bi\u1ebfn ch\u1ee9ng v\u0129nh vi\u1ec5n, m\u00e0 ph\u1eabu thu\u1eadt lo\u1ea1i b\u1ecf v\u1eabn l\u00e0 l\u1ef1a ch\u1ecdn duy nh\u1ea5t.<\/p>\n

HA Fillers<\/h2>\n

Hyaluronic acid ( HA) \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn l\u00e0 lo\u1ea1i ch\u1ea5t l\u00e0m \u0111\u1ea7y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1ea5t tr\u00ean th\u1ebf gi\u1edbi, v\u1edbi t\u00ednh ch\u1ea5t t\u01b0\u01a1ng h\u1ee3p tuy\u1ec7t v\u1eddi, t\u00ednh sinh mi\u1ec5n d\u1ecbch th\u1ea5p, v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng \u0111\u01b0\u1ee3c ph\u00e2n gi\u1ea3i \u0111\u00e3 khi\u1ebfn cho n\u00f3 v\u01b0\u1ee3t xa c\u00e1c lo\u1ea1i ch\u1ea5t l\u00e0m \u0111\u1ea7y kh\u00e1c. Trong khi c\u00e1c s\u1ea3n ph\u1ea9m th\u01b0\u01a1ng m\u1ea1i HA filler \u00edt nhi\u1ec1u gi\u1ed1ng nhau v\u1ec1 h\u00ecnh th\u1ee9c, th\u00ec v\u1eabn c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t nh\u1ecf v\u1ec1 n\u1ed3ng \u0111\u1ed9 HA c\u1ee7a h\u1ecd, c\u00f4ng ngh\u1ec7 li\u00ean k\u1ebft ch\u00e9o, kh\u1ea3 n\u0103ng li\u00ean k\u1ebft, \u0111\u1ed9 nh\u1edbt, \u0111\u1ed9 c\u1ee9ng c\u1ee7a gel, v.v.v. S\u1ef1 kh\u00e1c bi\u1ec7t c\u0169ng c\u00f3 gi\u1eefa c\u00e1c d\u00f2ng s\u1ea3n ph\u1ea9m trong c\u00f9ng 1 h\u00e3ng HA, v\u00e0 ki\u1ebfn th\u1ee9c v\u1ec1 m\u1ed7i \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a m\u1ed7i s\u1ea3n ph\u1ea9m l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 t\u00f9y ch\u1ec9nh vi\u1ec7c s\u1eed d\u1ee5ng t\u1eebng s\u1ea3n ph\u1ea9m cho m\u1ed7i m\u1ee5c \u0111\u00edch s\u1eed d\u1ee5ng kh\u00e1c nhau.<\/p>\n

\u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a HA<\/h3>\n

HA l\u00e0 1 lo\u1ea1i polyme tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed cao c\u1ea5u t\u1ea1o t\u1eeb c\u00e1c disaccharide \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n \u0111\u1ea7u ti\u00ean v\u00e0o n\u0103m 1934 b\u1edfi Karl Meyer v\u00e0 John Palmer trong th\u1ee7y tinh th\u1ec3 c\u1ee7a m\u1eaft b\u00f2. HA \u0111\u01b0\u1ee3c \u0111\u1eb7t t\u00ean t\u1eeb hyaloid<\/em> (c\u00f3 ngh\u0129a l\u00e0 th\u1ee7y tinh th\u1ec3) v\u00e0 uronic acid,<\/em> m\u1ed9t th\u00e0nh ph\u1ea7n l\u00e0 c\u00e1c \u0111\u01a1n v\u1ecb dissaccharide \u0111\u01b0\u1ee3c l\u1eb7p l\u1ea1i. Trong t\u1ef1 nhi\u00ean, HA c\u00f3 \u1edf d\u1ea1ng mu\u1ed1i, ph\u1ea7n l\u1edbn d\u1ea1ng mu\u1ed1i HA \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y li\u00ean k\u1ebft v\u1edbi Natri, 1 d\u1ea1ng cation \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y nhi\u1ec1u nh\u1ea5t trong c\u01a1 th\u1ec3 ng\u01b0\u1eddi. N\u0103m 1986, thu\u1eadt ng\u1eef \u201chyaluronan\u201d \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn v\u1edbi danh ph\u00e1p qu\u1ed1c t\u1ebf c\u1ee7a pollysaccharide. T\u01b0\u01a1ng t\u1ef1, thu\u1eadt ng\u1eef hyaluronic acid, mu\u1ed1i hyaluronate v\u00e0 hyaluronan t\u1ea5t c\u1ea3 \u0111\u01b0\u1ee3c thay th\u1ebf v\u00e0 s\u1eed d\u1ee5ng b\u1eb1ng t\u00ean HA.<\/p>\n

HA c\u1ea5u t\u1ea1o n\u00ean 1 ph\u00e2n t\u1eed glicosaminoglycan (GAGs) bao g\u1ed3m c\u00e1c chu\u1ed7i polysaccharide \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh t\u1eeb c\u00e1c \u0111\u01a1n v\u1ecb D-glucuronic acid v\u00e0 N-acetyl-D-glucosamin xen k\u1ebd k\u1ebft h\u1ee3p v\u1edbi nhau 1 c\u00e1ch l\u1eb7p \u0111i l\u1eb7p l\u1ea1i. GAGs g\u1ecdi chung cho c\u00e1c nh\u00f3m polysaccharide d\u00e0i, kh\u00f4ng ph\u00e2n nh\u00e1nh bao g\u1ed3m c\u00e1c amino acid \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh t\u1eeb c\u00e1c \u0111\u01a1n v\u1ecb l\u1eb7p \u0111i l\u1eb7p l\u1ea1i disaccharide. \u0110\u1ea1i di\u1ec7n cho m\u1ed9t th\u00e0nh ph\u1ea7n quan tr\u1ecdng c\u1ee7a ch\u1ea5t n\u1ec1n ngo\u1ea1i b\u00e0o, GAGs \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh 6 lo\u1ea1i d\u1ef1a tr\u00ean c\u1ea5u tr\u00fac mono\u00adsaccharide n\u1eb1m d\u01b0\u1edbi, c\u1ee5 th\u1ec3 l\u00e0 HA, chondroitin sulfate, keratin sulfat, dermatan sulfat, heparin, v\u00e0 heparin sulfat. Trong c\u00e1c lo\u1ea1i GAGs, HA \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y nhi\u1ec1u nh\u1ea5t trong da. Tuy nhi\u00ean, kh\u00f4ng gr\u00f4ng nh\u01b0 c\u00e1c lo\u1ea1i GAGs, n\u00f3 kh\u00f4ng \u0111\u01b0\u1ee3c bi\u1ebfn \u0111\u1ed5i v\u1edbi nh\u00f3m sulfat v\u00e0 kh\u00f4ng li\u00ean k\u1ebft c\u1ed9ng h\u00f3a tr\u1ecb v\u1edbi l\u00f5i protein.<\/p>\n

H\u01a1n n\u1eefa, n\u00f3 l\u00e0 \u0111\u1ea1i di\u1ec7n duy nh\u1ea5t c\u1ee7a GAGs m\u00e0 c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb c\u1ea3 \u0111\u1ed9ng v\u1eadt v\u00e0 vi khu\u1ea9n. L\u00e0 m\u1ed9t ph\u00e2n t\u1eed \u01b0a n\u01b0\u1edbc, HA c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng gi\u1eef n\u01b0\u1edbc g\u1ea5p 1000 tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed c\u1ee7a n\u00f3. Trong dung d\u1ecbch n\u01b0\u1edbc, c\u1ea5u tr\u00fac h\u00f3a h\u1ecdc \u0111i\u1ec7n t\u00edch \u00e2m c\u1ee7a HA \u0111\u1ea9y c\u00e1c ph\u00e2n t\u1eed c\u00f3 \u0111i\u1ec7n t\u00edch \u00e2m kh\u00e1c. \u0110i\u1ec1u n\u00e0y cho ph\u00e9p HA chi\u1ebfm 1 kh\u00f4ng gian l\u1edbn h\u01a1n, v\u00ec to\u00e0n b\u1ed9 m\u1ea1ng l\u01b0\u1edbi ph\u00e2n t\u1eed m\u1edf r\u1ed9ng v\u00e0 \u0111\u01b0\u1ee3c bao quanh b\u1edfi c\u00e1c ph\u00e2n t\u1eed n\u01b0\u1edbc. Ngo\u00e0i ra, ph\u00e2n t\u1eed HA gi\u1ea3m v\u1ec1 th\u1ec3 t\u00edch khi ch\u1ecbu s\u1ef1 gia t\u0103ng \u00e1p su\u1ea5t b\u00ean ngo\u00e0i, h\u1ea7u h\u1ebft ch\u00fang th\u01b0\u1eddng kh\u00f4i ph\u1ee5c l\u1ea1i th\u1ec3 t\u00edch ban \u0111\u1ea7u khi ngo\u1ea1i l\u1ef1c bi\u1ebfn m\u1ea5t, do l\u1ef1c \u0111\u1ea9y l\u1eabn nhau gi\u1eefa c\u00e1c \u0111i\u1ec7n t\u00edch \u00e2m. Nh\u1eefng t\u00ednh ch\u1ea5t n\u00e0y cho ph\u00e9p HA t\u1ed3n t\u1ea1i d\u1ea1ng gel khi k\u1ebft h\u1ee3p ch\u00fang v\u1edbi n\u01b0\u1edbc, c\u00f3 c\u00e1c \u0111\u1eb7c t\u00ednh c\u1ea3 v\u1ec1 \u0111\u1ed9 nh\u1edbt v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i. Trong m\u00f4i tr\u01b0\u1eddng pH sinh l\u00fd b\u00ecnh th\u01b0\u1eddng, c\u00e1c nh\u00f3m cacboxyl (-COOH) bao g\u1ed3m D-glucuronic acid c\u1ee7a HA \u0111\u01b0\u1ee3c chuy\u1ec3n th\u00e0nh mu\u1ed1i natri. HA s\u1edf h\u1eefu 4 nh\u00f3m hydroxyl (-OH) v\u00e0 1 nh\u00f3m mu\u1ed1i natri trong m\u1ed7i \u0111\u01a1n v\u1ecb disaccharide. C\u00e1c nh\u00f3m -OH c\u1ee7a HA h\u00ecnh th\u00e0nh li\u00ean k\u1ebft hidro v\u1edbi c\u00e1c ph\u00e2n t\u1eed n\u01b0\u1edbc v\u00e0 do \u0111\u00f3 d\u1ec5 d\u00e0ng h\u00f2a tan trong n\u01b0\u1edbc.<\/p>\n

M\u1ed7i \u0111\u01a1n v\u1ecb disaccharide c\u1ee7a HA bao g\u1ed3m D-glucuronic acid v\u00e0 N- acetyl-D-glucosamin \u0111\u1ea1i di\u1ec7n cho m\u1ed9t \u0111\u01a1n ph\u00e2n t\u1eed c\u00f3 tr\u1ecdng l\u01b0\u1ee3ng 400Da, v\u1edbi m\u1ed7i \u0111\u01a1n ph\u00e2n li\u00ean k\u1ebft v\u1edbi nhau th\u00f4ng qua li\u00ean k\u1ebft beta 1,4 glycosidic \u0111\u1ec3 t\u1ea1o th\u00e0nh HA polyme. C\u00e1c HA c\u00f3 trong ch\u1ea5t l\u1ecfng ho\u1ea1t d\u1ecbch c\u1ee7a con ng\u01b0\u1eddi \u0111\u01b0\u1ee3c bi\u1ebft bao g\u1ed3m 20.000 monome ho\u1eb7c tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed l\u00e0 7 tri\u1ec7u Da. L\u00e0 1 th\u00e0nh ph\u1ea7n ch\u00ednh c\u1ee7a ch\u1ea5t n\u1ec1n ngo\u1ea1i b\u00e0o c\u1ee7a c\u01a1 th\u1ec3, HA ch\u1ecbu tr\u00e1ch nhi\u1ec7m h\u1ea5p th\u1ee5 \u0111\u1ed9 \u1ea9m v\u00e0 gi\u1eef cho c\u00e1c m\u00f4 \u0111\u01b0\u1ee3c b\u00f4i tr\u01a1n v\u00e0 ng\u1eadm n\u01b0\u1edbc \u0111\u1ed3ng th\u1eddi h\u1ed7 tr\u1ee3 c\u1ea5u tr\u00fac c\u1ea7n thi\u1ebft. H\u01a1n n\u1eefa, n\u00f3 c\u0169ng ch\u1ecbu tr\u00e1ch nhi\u1ec7m cho vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh s\u1ef1 di chuy\u1ec3n v\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ebf b\u00e0o, c\u0169ng nh\u01b0 \u0111i\u1ec1u ch\u1ec9nh qu\u00e1 tr\u00ecnh vi\u00eam v\u00e0 s\u1eeda ch\u1eefa\/ t\u00e1i t\u1ea1o v\u1ebft th\u01b0\u01a1ng. T\u1ed5ng h\u00e0m l\u01b0\u1ee3ng HA \u1edf 1 ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh n\u1eb7ng 70kg \u01b0\u1edbc t\u00ednh l\u00e0 kho\u1ea3ng 15g, \u0111\u01b0\u1ee3c bi\u1ebft l\u01b0\u1ee3ng n\u00e0y n\u1eb1m trong da. HA c\u0169ng \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y n\u1ed3ng \u0111\u1ed9 cao trong ch\u1ea5t l\u1ecfng ho\u1ea1t d\u1ecbch, s\u1ee5n, v\u00e0 th\u1ee7y tinh th\u1ec3 c\u1ee7a m\u1eaft. C\u01a1 th\u1ec3 \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 duy tr\u00ec c\u00e2n b\u1eb1ng n\u1ed9i m\u00f4i HA t\u1ed1i \u01b0u, theo \u0111\u00f3 1\/3 HA c\u1ee7a c\u01a1 th\u1ec3 \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a, ph\u00e2n h\u1ee7y v\u00e0 t\u1ed5ng h\u1ee3p m\u1edbi m\u1ed7i ng\u00e0y. Trong khi HA li\u00ean t\u1ee5c \u0111\u01b0\u1ee3c b\u1ed5 sung trong c\u01a1 th\u1ec3 ng\u01b0\u1eddi, qu\u00e1 tr\u00ecnh l\u00e3o h\u00f3a l\u00e0m gi\u1ea3m d\u1ea7n qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p m\u1edbi HA t\u1ef1 nhi\u00ean, d\u1eabn \u0111\u1ebfn theo th\u1eddi gian l\u00e0n da m\u1ea5t d\u1ea7n \u0111i \u0111\u1ed9 \u1ea9m v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i.<\/p>\n

Kh\u00f4ng gi\u1ed1ng collagen, c\u1ea5u tr\u00fac ph\u00e2n t\u1eed c\u1ee7a HA t\u1ed3n t\u1ea1i c\u1ea5u tr\u00fac gi\u1ed1ng h\u1ec7t nhau \u1edf t\u1ea5t c\u1ea3 c\u00e1c lo\u00e0i \u0111\u1ed9ng v\u1eadt, v\u1edbi s\u1ef1 kh\u00e1c nhau duy nh\u1ea5t l\u00e0 chi\u1ec1u d\u00e0i c\u1ee7a chu\u1ed7i polime. Chu\u1ed7i HA c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb c\u00e1c lo\u00e0i vi khu\u1ea9n th\u01b0\u1eddng c\u00f3 chi\u1ec1u d\u00e0i 4000-6000 monome, ng\u1eafn h\u01a1n so v\u1edbi chu\u1ed7i HA \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf \u0111\u1ed9ng v\u1eadt 10.000-15.000, v\u00e0 do \u0111\u00f3 c\u00f3 tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p h\u01a1n, 1.5-2.5 tri\u1ec7u Da.<\/p>\n

HA – qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t ch\u1ea5t l\u00e0m \u0111\u1ea7y<\/h3>\n

Nh\u00ecn chung, qu\u00e1 tr\u00ecnh t\u1ea1o ra HA bao g\u1ed3m c\u00e1c b\u01b0\u1edbc sau: h\u00f2a tan b\u1ed9t HA (nguy\u00ean li\u1ec7u th\u00f4) trong dung d\u1ecbch NaOH, ti\u1ebfp theo l\u00e0 t\u1ea1o ph\u1ea3n \u1ee9ng li\u00ean k\u1ebft ch\u00e9o, c\u1eaft, l\u00e0m s\u1ea1ch, cho gel HA v\u00e0o \u1ed1ng ti\u00eam, v\u00e0 ti\u1ec7t tr\u00f9ng. Trong s\u1ed1 c\u00e1c b\u01b0\u1edbc n\u00e0y, t\u1ea1o li\u00ean k\u1ebft ch\u00e9o cho chu\u1ed7i polyme HA l\u00e0 giai \u0111o\u1ea1n s\u1ea3n xu\u1ea5t quan tr\u1ecdng nh\u1ea5t, v\u00ec n\u00f3 quy\u1ebft \u0111\u1ecbnh c\u00e1c \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn c\u1ee7a ch\u1ea5t \u0111\u1ed9n HA \u0111\u1ed3ng th\u1eddi \u1ed5n \u0111\u1ecbnh HA \u0111\u1ec3 k\u00e9o d\u00e0i tu\u1ed5i th\u1ecd in vivo. Sau khi tr\u1ea3i qua giai \u0111o\u1ea1n t\u1ea1o li\u00ean k\u1ebft ch\u00e9o, gel HA kh\u1ed1i l\u01b0\u1ee3ng l\u1edbn \u0111\u01b0\u1ee3c ph\u00e2n t\u00e1ch th\u00e0nh nhi\u1ec1u m\u1ea3nh nh\u1ecf (\u201ccutting\u201d) \u0111\u1ec3 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho qu\u00e1 tr\u00ecnh l\u00e0m s\u1ea1ch. Ti\u1ebfp theo, c\u00e1c ph\u1ea7n HA \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e2n t\u00e1ch \u0111\u01b0\u1ee3c r\u1eeda s\u1ea1ch b\u1eb1ng n\u01b0\u1edbc tinh khi\u1ebft ho\u1eb7c n\u01b0\u1edbc mu\u1ed1i \u0111\u1ec3 l\u1ea1i b\u1ecf b\u1ea5t k\u1ef3 t\u1ea1p ch\u1ea5t kh\u00f4ng mong mu\u1ed1n. Trong b\u01b0\u1edbc ti\u1ebfp theo, gel \u0111\u01b0\u1ee3c x\u1eed l\u00fd \u0111\u1ebb l\u00e0m gi\u1ea3m k\u00edch th\u01b0\u1edbc h\u1ea1t gel, sau \u0111\u00f3 \u0111\u01b0\u1ee3c \u0111\u01b0a qua l\u01b0\u1edbi c\u00f3 k\u00edch th\u01b0\u1edbc x\u00e1c \u0111\u1ecbnh c\u1ee7a m\u00e1y \u0111\u1ed3ng nh\u1ea5t. Vi\u1ec7c gi\u1ea3m k\u00edch th\u01b0\u1edbc h\u1ea1t gel cho ph\u00e9p ti\u00eam gel v\u00e0o da th\u00f4ng qua kim c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf. V\u00ec ph\u01b0\u01a1ng ph\u00e1p l\u01b0\u1edbi t\u1ea1o ra c\u00e1c h\u1ea1t c\u00f3 k\u00edch th\u01b0\u1edbc ki\u1ec3m so\u00e1t, n\u00f3 c\u0169ng cho ph\u00e9p \u0111i\u1ec1u ch\u1ec9nh c\u00e1c h\u1ea1t gel \u0111\u1ec3 ph\u00f9 h\u1ee3p v\u1edbi mong mu\u1ed1n ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e1ng. Sau khi \u0111\u01b0\u1ee3c l\u00e0m nh\u1ecf, gel<\/p>\n

HA \u0111\u01b0\u1ee3c \u0111\u1ed5 \u0111\u1ea7y v\u00e0o c\u00e1c \u1ed1ng ti\u00eam ri\u00eang l\u1ebb, sau \u0111\u00f3 \u0111\u01b0\u1ee3c chuy\u1ec3n v\u00e0o 1 clave t\u1ef1 \u0111\u1ed9ng \u0111\u1ec3 kh\u1eed tr\u00f9ng.<\/p>\n

M\u1ed9t c\u00e2n nh\u1eafc ch\u00ednh trong qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t HA filler l\u00e0 ki\u1ec3m so\u00e1t trong qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t c\u00e1c protein ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ecdn l\u1ecdc, c\u00e1c n\u1ed9i \u0111\u1ed9c t\u1ed1 v\u00e0 c\u00e1c ch\u1ea5t x\u00fac t\u00e1c ph\u1ea3n \u1ee9ng li\u00ean k\u1ebft ch\u00e9o c\u00f2n d\u01b0. Protein l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y vi\u00eam v\u00e0 ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng, do \u0111\u00f3 \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i \u0111\u1ea3m b\u1ea3o nguy\u00ean li\u1ec7u th\u00f4 HA ph\u1ea3i \u0111\u00e1p \u1ee9ng c\u00e1c y\u00eau c\u1ea7u c\u1ee7a D\u01b0\u1ee3c \u0111i\u1ec3n c.\u00c2u (EP) v\u1ec1 h\u00e0m l\u01b0\u1ee3ng pro (<0.1% nguy\u00ean li\u1ec7u th\u00f4). \u0110\u1ed1i v\u1edbi h\u1ea7u h\u1ebft HA filler c\u00f3 s\u1eb5n tr\u00ean th\u1ecb tr\u01b0\u1eddng, c\u00e1c nh\u00e0 s\u1ea3n xu\u1ea5t c\u1ed1 g\u1eafng gi\u1eef m\u1ee9c pro c\u00f2n l\u1ea1i \u1edf m\u1ee9c 10 microgram\/ml ho\u1eb7c th\u1ea5p h\u01a1n \u0111\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 g\u00e2y ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng trong khi \u0111\u00f3, m\u1ee9c \u0111\u1ed9 n\u1ed9i \u0111\u1ed9c t\u1ed1 \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t \u1edf m\u1ee9c 0.5EU\/ml (\u0111\u01a1n v\u1ecb n\u1ed9i \u0111\u1ed9c t\u1ed1) ho\u1eb7c th\u1ea5p h\u01a1n theo quy \u0111\u1ecbnh trong EP \u0111\u1ec3 tr\u00e1nh ph\u1ea3n \u1ee9ng vi\u00eam v\u00e0\/ho\u1eb7c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra. Trong khi m\u1ee9c BDDE c\u0169ng \u0111\u01b0\u1ee3c quy \u0111\u1ecbnh \u1edf m\u1ee9c d\u01b0\u1edbi 2ppm, tr\u00ean th\u1ef1c t\u1ebf, BDDE h\u1ea7u nh\u01b0 r\u1ea5t kh\u00f3 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong s\u1ea3n ph\u1ea9m filler HA cu\u1ed1i c\u00f9ng.<\/p>\n

S\u1ea3n xu\u1ea5t nguy\u00ean li\u1ec7u HA<\/h4>\n

Ng\u00e0nh c\u00f4ng nghi\u1ec7p s\u1ea3n xu\u1ea5t nguy\u00ean li\u1ec7u HA th\u00f4 (HA s\u1ed1 l\u01b0\u1ee3ng l\u1edbn) d\u1ef1a tr\u00ean vi\u1ec7c chi\u1ebft xu\u1ea5t t\u1eeb m\u00e0o g\u00e0 tr\u1ed1ng ho\u1eb7c nu\u00f4i c\u1ea5y c\u00e1c ch\u1ee7ng vi sinh v\u1eadt. Trong giai \u0111o\u1ea1n ph\u00e1t tri\u1ec3n \u0111\u1ea7u ti\u00ean c\u1ee7a HA filler, HA sinh h\u1ecdc \u0111\u01b0\u1ee3c chi\u1ebft xu\u1ea5t t\u1eeb m\u00e0o g\u00e0 tr\u1ed1ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho h\u1ea7u h\u1ebft c\u00e1c s\u1ea3n ph\u1ea9s, qu\u00e1 tr\u00ecnh n\u00e0y t\u1ea1o ra HA c\u00f3 tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed cao t\u1ef1 nhi\u00ean. V\u00ed d\u1ee5, Hylaform (Genzyme Biosugery) \u0111\u01b0\u1ee3c FDA Hoa K\u1ef3 ph\u00ea duy\u1ec7t v\u00e0o n\u0103m 2004, \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng HA c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb m\u00e0o g\u00e0 tr\u1ed1ng, c\u00f3 tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed 3.000kDa. tuy nhi\u00ean, vi\u1ec7c cung c\u1ea5p HA th\u01b0\u01a1ng m\u1ea1i t\u1eeb m\u00e0o g\u00e0 tr\u1ed1ng t\u1ed1n nhi\u1ec1u th\u1eddi gian v\u00e0 chi ph\u00ed, bao g\u1ed3m quy tr\u00ecnh nhi\u1ec1u b\u01b0\u1edbc v\u00e0 th\u1eddi gian ho\u00e0n th\u00e0nh \u0111\u00e1ng k\u1ec3. H\u01a1n n\u1eefa, c\u00f3 nh\u1eefng sai s\u00f3t k\u1ef9 thu\u1eadt \u0111\u00e1ng k\u1ec3 trong vi\u1ec7c lo\u1ea1i b\u1ecf virus c\u00f3 th\u1ec3 c\u00f3 (thu\u1ed9c gia c\u1ea7m) ho\u1eb7c protein v\u00e0 nucleic acid c\u00f3 kh\u1ea3 n\u0103ng c\u00f2n trong c\u01a1 quan \u0111\u1ed9ng v\u1eadt. Ngo\u00e0i ra, t\u1ef7 l\u1ec7 m\u1eafc c\u00e1c b\u1ec7nh nghi\u00eam tr\u1ecdng nh\u01b0 Bovine<\/p>\n

Spongiform Encephalopathy cho th\u1ea5y nh\u1eefng c\u0103n b\u1ec7nh ch\u1ebft ng\u01b0\u1eddi c\u00f3 th\u1ec3 l\u00e2y truy\u1ec1n gi\u1eefa c\u00e1c lo\u00e0i ( \u0111\u1ed9ng v\u1eadt > ng\u01b0\u1eddi) theo nh\u1eefng c\u00e1ch m\u00e0 tr\u01b0\u1edbc \u0111\u00e2y ch\u01b0a t\u1eebng bi\u1ebft \u0111\u1ebfn. \u1edf kh\u00eda c\u1ea1nh \u0111\u00f3, vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c nguy\u00ean li\u1ec7u c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb vi khu\u1ea9n \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 r\u1ee7i ro th\u1ea5p h\u01a1n nhi\u1ec1u so v\u1edbi ngu\u1ed3n g\u1ed1c t\u1eeb \u0111\u1ed9ng v\u1eadt, v\u00ec vi khu\u1ea9n r\u1ea5t kh\u00e1c \u0111\u1ed9ng v\u1eadt. K\u1ebft qu\u1ea3 c\u1ee7a c\u00e1c lo ng\u1ea1i v\u1ec1 v\u1ea5n \u0111\u1ec1 an to\u00e0n v\u00e0 \u0111i\u1ec1u ch\u1ec9nh qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t n\u00e0y, n\u00ean vi\u1ec7c chi\u1ebft xu\u1ea5t HA t\u1eeb m\u00e0o g\u00e0 tr\u1ed1ng \u0111\u00e3 kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng v\u00e0 thay v\u00e0o \u0111\u00f3 nu\u00f4i c\u1ea5y vi khu\u1ea9n tr\u1edf th\u00e0nh ph\u01b0\u01a1ng ph\u00e1p thu \u0111\u01b0\u1ee3c HA \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng h\u01a1n. Qu\u00e1 tr\u00ecnh t\u1ea1o ra HA t\u1eeb nu\u00f4i c\u1ea5y vi khu\u1ea9n c\u00f3 chi ph\u00ed th\u1ea5p h\u01a1n \u0111\u00e1ng k\u1ec3, v\u1edbi s\u1ed1 l\u01b0\u1ee3ng l\u1edbn, v\u00e0 d\u1ec5 d\u00e0ng lo\u1ea1i b\u1ecf c\u00e1c protein v\u00e0 n\u1ed9i \u0111\u1ed9c t\u1ed1 h\u01a1n so v\u1edbi chi\u1ebft su\u1ea5t HA t\u1eeb m\u00e0o g\u00e0 tr\u1ed1ng. Streptococcus l\u00e0 vi khu\u1ea9n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1ea5t \u0111\u1ec3 s\u1ea3n xu\u1ea5t HA, trong \u0111\u00f3 Streptococcus Zooepidemicus l\u00e0 ch\u1ee7ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nhi\u1ec1u nh\u1ea5t. Restylane, \u0111\u1ea1i di\u1ec7n cho ch\u1ea5t l\u00e0m \u0111\u1ea7y ti\u00eam d\u1ef1a tr\u00ean HA \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c FDA Hoa K\u1ef3 ch\u1ea5p thu\u1eadn v\u00e0o n\u0103m 2003, c\u0169ng d\u1ef1a tr\u00ean HA \u0111\u01b0\u1ee3c chi\u1ebft xu\u1ea5t t\u1eeb q\u00faa tr\u00ecnh nu\u00f4i c\u1ea5y vi sinh v\u1eadt, c\u00f3 tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed 1.000kDa. \u0111\u01b0\u1ee3c th\u00fac \u0111\u1ea9y b\u1edfi nh\u1eefng ti\u1ebfn b\u1ed9 trong c\u00f4ng ngh\u1ec7 nu\u00f4i c\u1ea5y, tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed HA thu \u0111\u01b0\u1ee3c t\u1eeb qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t HA c\u1ee7a vi sinh v\u1eadt \u0111\u00e3 t\u0103ng d\u1ea7n t\u1eeb d\u01b0\u1edbi 2.000kDa trong nh\u1eefng ng\u00e0y \u0111\u1ea7u ti\u00ean l\u00ean tr\u00ean 3.000kDa nh\u01b0 hi\u1ec7n nay. Trong qu\u00e1 tr\u00ecnh nu\u00f4i c\u1ea5y vi sinh v\u1eadt c\u00f3 th\u1ec3 t\u1ea1o ra HA c\u00f3 \u0111\u1ed9 tinh khi\u1ebft cao h\u01a1n, m\u00e0 kh\u00f4ng c\u00f3 m\u1ea7m b\u1ec7nh c\u00f2n s\u00f3t l\u1ea1i nh\u01b0 c\u00fam gia c\u1ea7m, tuy nhi\u00ean nguy c\u01a1 k\u1ebft h\u1ee3p v\u1edbi n\u1ed9i \u0111\u1ed9c t\u1ed1 vi khu\u1ea9n, b\u00e0o quan n\u1ed9i b\u00e0o v\u00e0 c\u00e1c protein kh\u00f4ng mong mu\u1ed1n v\u1eabn c\u00f2n, do \u0111\u00f3 qu\u00e1 tr\u00ecnh thanh l\u1ecdc ph\u1ee9c t\u1ea1p v\u00e0 k\u1ef9 l\u01b0\u1ee1ng l\u00e0 y\u00eau c\u1ea7u. \u0110\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee5c \u0111\u00edch n\u00e0y, c\u00e1c t\u1ebf b\u00e0o vi khu\u1ea9n ph\u1ea3i \u0111\u01b0\u1ee3c ly t\u00e2m \u0111\u1ec3 t\u00e1ch t\u1ebf b\u00e0o v\u00e0 sau \u0111\u00f3 \u0111\u01b0\u1ee3c ph\u00e2n gi\u1ea3i trong dung d\u1ecbch NaOH. Dung d\u1ecbch kh\u00f4ng ch\u1ee9a t\u1ebf b\u00e0o thu \u0111\u01b0\u1ee3c sau \u0111\u00f3 tr\u1ea3i qua c\u00e1c giai \u0111o\u1ea1n si\u00eau l\u1ecdc ti\u1ebfp theo, h\u1ea5p ph\u1ee5 v\u00e0o cacbon ho\u1eb7c alumina, v\u00e0 k\u1ebft t\u1ee7a c\u1ed3n \u0111\u1ec3 lo\u1ea1i b\u1ecf c\u00e1c t\u1ea1p ch\u1ea5t ho\u1eb7c m\u1ea3nh v\u1ee5n t\u1ebf b\u00e0o c\u00f3 th\u1ec3 c\u00f2n c\u00f3 trong s\u1ea3n ph\u1ea9m. Qu\u00e1 tr\u00ecnh thanh l\u1ecdc n\u00e0y c\u00f3 th\u1ec3 kh\u00e1c nhau gi\u1eefa c\u00e1c nh\u00e0 s\u1ea3n xu\u1ea5t. Tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed trung b\u00ecnh c\u1ee7a HA \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t th\u00f4ng qua \u0111i\u1ec1u ki\u1ec7n nu\u00f4i c\u1ea5y v\u00e0 x\u1eed l\u00fd trong qu\u00e1 tr\u00ecnh tinh ch\u1ebf.<\/p>\n

Nh\u01b0 \u0111\u00e3 gi\u1ea3i th\u00edch, \u0111\u1ed9 tinh khi\u1ebft c\u1ee7a nguy\u00ean li\u1ec7u th\u00f4 HA \u0111\u01b0\u1ee3c x\u00e1c d\u1ecbnh ph\u1ea7n l\u1edbn b\u1edfi ph\u01b0\u01a1ng ph\u00e1p v\u00e0 m\u1ee9c \u0111\u1ed9 tinh ch\u1ebf c\u1ee5 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng trong qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t. Nh\u1eefng c\u00e2n nh\u1eafc ch\u00ednh trong vi\u1ec7c l\u1ef1a ch\u1ecdn nguy\u00ean li\u1ec7u th\u00f4 HA l\u00e0 n\u1ed9i \u0111\u1ed9c t\u1ed1 c\u1ee7a vi khu\u1ea9n v\u00e0 protein c\u00f3 ngu\u1ed3n g\u1ed1c t\u1ebf b\u00e0o c\u00f2n l\u1ea1i trong s\u1ea3n ph\u1ea9m v\u00e0 li\u1ec7u s\u1ed1 l\u01b0\u1ee3ng c\u00f3 n\u1eb1m trong th\u00f4ng s\u1ed1 k\u1ef9 thu\u1eadt \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u hay kh\u00f4ng. M\u1ee9c \u0111\u1ed9 t\u1ea1p ch\u1ea5t t\u01b0\u01a1ng \u1ee9ng s\u1ebd x\u00e1c \u0111\u1ecbnh t\u00ednh an to\u00e0n sinh h\u1ecdc c\u1ee7a HA, theo \u0111\u00f3 l\u00e0 m\u1ee9c \u0111\u1ed9 \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a n\u00f3. Nguy\u00ean li\u1ec7u th\u00f4 HA \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong c\u00f4ng nghi\u1ec7p \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i c\u1ea5p \u0111\u1ed9 th\u1ef1c ph\u1ea9m, c\u1ea5p \u0111\u1ed9 m\u1ef9 ph\u1ea9m ho\u1eb7c c\u1ea5p \u0111\u1ed9 y t\u1ebf, v\u1edbi c\u1ea5p \u0111\u1ed9 y t\u1ebf HA ti\u1ebfp t\u1ee5c \u0111\u01b0\u1ee3c chia th\u00e0nh c\u00e1c lo\u1ea1i ch\u1ebf ph\u1ea9m \u0111\u1ec3 s\u1eed d\u1ee5ng trong nh\u00e3n khoa (thu\u1ed1c nh\u1ecf m\u1eaft) ho\u1eb7c ch\u1ebf ph\u1ea9m ti\u00eam ( c\u1ea5p \u0111\u1ed9 ti\u00eam) t\u00f9y thu\u1ed9c v\u00e0o \u0111\u1ed9 thanh l\u1ecdc. HA d\u1ea1ng ch\u1ebf ph\u1ea9m nh\u00e3n khoa \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng s\u1ea3n xu\u1ea5t thu\u1ed1c nh\u1ecf m\u1eaft, ch\u1ea5t b\u1ea3o qu\u1ea3n k\u00ednh \u00e1p tr\u00f2ng v\u00e0 c\u00e1c ch\u1ebf ph\u1ea9m b\u00f4i cho c\u00e1c t\u1ed5n th\u01b0\u01a1ng ni\u00eam m\u1ea1c mi\u1ec7ng, trong khi d\u1ea1ng ti\u00eam \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong ph\u1eabu thu\u1eadt c\u1ea5y gh\u00e9p th\u1ee7y tinh th\u1ec3, thu\u1ed1c ti\u00eam n\u1ed9i nh\u00e3n, ch\u1ea5t ch\u1ed1ng d\u00ednh (\u0111\u1ec3 g\u0103n ng\u1eeba k\u1ebft d\u00ednh m\u00f4 h\u1eadu ph\u1eabu), v\u00e0 ti\u00eam ch\u1ea5t l\u00e0m \u0111\u1ea7y. HA d\u1ea1ng ti\u00eam th\u01b0\u1eddng \u0111\u1eaft h\u01a1n 3-4 l\u1ea7n so v\u1edbi HA d\u1ea1ng thu\u1ed1c nh\u1ecf m\u1eaft, b\u1ed9t HA \u0111\u1ec3 ti\u00eam c\u00f3 \u0111\u1ed9 tinh khi\u1ebft cao nh\u1ea5t trong s\u1ed1 c\u00e1c c\u00f4ng th\u1ee9c HA.<\/p>\n

V\u00ec s\u1ef1 an to\u00e0n c\u1ee7a c\u00e1c s\u1ea3n ph\u1ea9m ch\u1ea5t l\u00e0m \u0111\u1ea7y HA ti\u00eam kh\u00f4ng ch\u1ec9 ph\u1ee5 thu\u1ed9c v\u00e0o ch\u1ea5t l\u01b0\u1ee3ng c\u1ee7a c\u00e1c b\u01b0\u1edbc tinh ch\u1ebf trong q\u00faa tr\u00ecnh s\u1ea3n xu\u1ea5t m\u00e0 ch\u00fang c\u00f2n ph\u1ee5 thu\u1ed9c v\u00e0o ch\u00ednh nguy\u00ean li\u1ec7u HA c\u01a1 b\u1ea3n, ch\u1ea5t l\u01b0\u1ee3ng v\u00e0 \u0111\u1ed9 tinh khi\u1ebft c\u1ee7a nguy\u00ean li\u1ec7u HA th\u00f4 l\u00e0 \u0111i\u1ec1u c\u1ea7n thi\u1ebft, n\u1ebfu kh\u00f4ng th\u00ec kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u1ed9 an to\u00e0n c\u1ee7a s\u1ea3n ph\u1ea9m ch\u1ea5t l\u00e0m \u0111\u1ea7y HA cu\u1ed1i c\u00f9ng. Do \u0111\u00f3, c\u00e1c ch\u1ea5t l\u00e0m \u0111\u1ea7y HA ph\u1ea3i \u0111\u00e1p \u1ee9ng t\u1ed1i thi\u1ec3u ti\u00eau chu\u1ea9n v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng n\u1ebfu ch\u00fang \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1eb1ng nguy\u00ean li\u1ec7u HA c\u00f3 ngu\u1ed3n g\u00f3c t\u1eeb c\u00e1c nh\u00e0 cung c\u1ea5p c\u00f3 trong danh s\u00e1ch H\u1ed3 s\u01a1 t\u1ed5ng h\u1ee3p d\u01b0\u1ee3c ch\u1ea5t (Drug Master File – DMF) c\u1ee7a FDA Hoa K\u1ef3 v\u00e0 \u0111\u01b0\u1ee3c C\u1ee5c qu\u1ea3n l\u00fd ch\u1ea5t l\u01b0\u1ee3ng thu\u1ed1c v\u00e0 ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe c\u1ee7a ch\u00e2u \u00c2u (EDQM) ph\u00ea duy\u1ec7t. V\u00e0o n\u0103m 2020, c\u00e1c nh\u00e0 s\u1ea3n xu\u1ea5t nguy\u00ean li\u1ec7u HA th\u00f4 trong danh s\u00e1ch DMF c\u1ee7a FDA bao g\u1ed3m: LG Chem LTD (Korean entity), Kewpie Corp, Kikkoman Biochemifa Co, Kybun Food Chemifa Co.LTD, Kyowa Hakko Kogyo Co LTD, Shandong Fresa Biochem Co LTD, Shandong Awa Biofarm Co LTD (Chinese entities), Bioiberica SA, Contipro \u00c1, Fidia Farmaceutici SPA, Novozymes \u00c1 (EU entities), Dermal R\u00easeach Laboratories INC, Lifecore Biomedical LLC, Mahura Nichiro Corp (us entities). V\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y, YVOIRE c\u1ee7a LG Chem d\u1ef1a tr\u00ean c\u00f4ng th\u1ee9c HA n\u1ed9i b\u1ed9 c\u1ee7a ri\u00eang m\u00ecnh v\u00e0 Neuramis c\u1ee7a Meditox Inc \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t v\u1edbi HA th\u00f4 do Shiseido Co LTD (Nh\u1eadt B\u1ea3n) cung c\u1ea5p trong khi h\u1ea7u h\u1ebft c\u00e1c nh\u00e0 s\u1ea3n xu\u1ea5t ch\u1ea5t l\u00e0m \u0111\u1ea7y HA kh\u00f4ng ti\u1ebft l\u1ed9 ngu\u1ed3n cung c\u1ea5p HA c\u1ee7a h\u1ecd.<\/p>\n

Episode: c\u01a1 h\u1ed9i v\u00e0 s\u1ef1 c\u1ea7n thi\u1ebft<\/strong><\/p>\n

M\u1ed9t ng\u01b0\u1eddi th\u1ee3 l\u1ee3p m\u00e1i \u0111ang th\u1ef1c hi\u1ec7n c\u00f4ng vi\u1ec7c s\u1eeda ch\u1eefa tr\u00ean 1 t\u00f2a nh\u00e0 cao t\u1ea7ng \u0111\u00e3 v\u00f4 t\u00ecnh l\u00e0m r\u01a1i chi\u1ebfc b\u00faa c\u1ee7a m\u00ecnh tr\u00fang \u0111\u1ea7u 1 ng\u01b0\u1eddi \u0111i b\u1ed9 v\u00e0 gi\u1ebft ch\u1ebft anh ta. Trong khi vi\u1ec7c ng\u01b0\u1eddi th\u1ee3 l\u1ee3p m\u00e1i l\u00e0m r\u01a1i chi\u1ebfc b\u00faa ho\u00e0n to\u00e0n l\u00e0 ng\u1eabu nhi\u00ean, n\u00f3 ch\u1eafc ch\u1eafn d\u1eabn \u0111\u1ebfn s\u1ef1 ki\u1ec7n x\u00e1c \u0111\u1ecbnh l\u00e0 c\u00e1i ch\u1ebft c\u1ee7a ng\u01b0\u1eddi \u0111i b\u1ed9. \u0110\u00f3 l\u00e0 l\u00fd do \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y trong cu\u1ed1n s\u00e1ch Chance and necessity c\u1ee7a ng\u01b0\u1eddi \u0111o\u1ea1t gi\u1ea3i Nobel Jaques Monod \u0111\u1ec3 gi\u1ea3i th\u00edch qu\u00e1 tr\u00ecnh ti\u1ebfn h\u00f3a. V\u1ec1 b\u1ea3n ch\u1ea5t, \u00f4ng cho r\u1eb1ng \u0111\u00f3 l\u00e0 s\u1ef1 tr\u00f9ng h\u1ee3p ng\u1eabu nhi\u00ean m\u00e0 1 t\u1ebf b\u00e0o \u1edf d\u1ea1ng s\u1ed1ng th\u00f4 s\u01a1 nh\u1ea5t d\u01b0\u1ee3c t\u1ea1o ra th\u00f4ng qua 1 chu\u1ed7i ph\u1ea3n \u1ee9ng sinh h\u00f3a kh\u00f3 gi\u1ea3i th\u00edch v\u00e0 r\u1ea5t kh\u00f3 x\u1ea3y ra gi\u1eefa c\u00e1c ch\u1ea5t v\u00f4 c\u01a1, c\u00e1c \u0111\u1ed9ng v\u1eadt b\u1eadc th\u1ea5p hay b\u1eadc cao ng\u00e0y nay l\u00e0 \u0111\u1ea1i di\u1ec7n cho s\u1ea3n ph\u1ea9m c\u1ea7n thi\u1ebft c\u1ee7a qu\u00e1 tr\u00ecnh ti\u1ebfn h\u00f3a l\u1ed9n x\u1ed9n v\u00e0 ph\u1ee9c t\u1ea1p m\u00e0 c\u00e1c t\u1ebf b\u00e0o \u0111\u00e3 tr\u1ea3i qua. L\u1ea7n \u0111\u1ea7u ti\u00ean t\u00f4i \u0111\u1ecdc cu\u1ed1n s\u00e1ch n\u00e0y \u1edf tr\u01b0\u1eddng \u0111\u1ea1i h\u1ecdc, t\u00f4i ch\u1ec9 \u0111\u01a1n gi\u1ea3n coi \u0111\u00f3 l\u00e0 1 t\u1eadp h\u1ee3p c\u00e1c l\u1eadp lu\u1eadn th\u00f4ng minh, \u0111\u00fang h\u01a1n l\u00e0 c\u00e1c ngh\u1ecbch l\u00fd, \u1ee7ng h\u1ed9 h\u1ecdc thuy\u1ebft ti\u1ebfn h\u00f3a. Tuy nhi\u00ean, th\u1eddi gian d\u1ea7n qua, t\u00f4i \u0111\u00e1nh gi\u00e1 cao nh\u1eefng \u00fd t\u01b0\u1edfng \u0111\u01b0\u1ee3c t\u00e1n th\u00e0nh trong cu\u1ed1n Chance and necessity c\u00f3 li\u00ean quan \u0111\u1ebfn cu\u1ed9c s\u1ed1ng c\u1ee7a ch\u00fang ta r\u00f5 r\u00e0ng nh\u01b0 th\u1ebf n\u00e0o.<\/p>\n

N\u0103m 1998, khi \u0111ang l\u00e0 nghi\u00ean c\u1ee9u sinh \u1edf B\u1ec7nh vi\u00ean \u0110\u1ea1i h\u1ecdc Qu\u1ed1c gia Seoul (Seoul National University Hospital), khoa Da li\u1ec5u, t\u00f4i t\u00ecnh c\u1edd th\u1ea5y 1 nghi\u00ean c\u1ee9u h\u1ea5p d\u1eabn c\u1ee7a ti\u1ebfn s\u0129 Shelley \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1’ tr\u00ean T\u1ea1p ch\u00ed H\u1ecdc vi\u1ec7n Da li\u1ec5u Hoa K\u1ef3 li\u00ean quan \u0111\u1ebfn ti\u00eam \u0111\u1ed9c r\u00f4 Botulinum toxin tr\u00ean l\u00f2ng b\u00e0n tay c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb Hyperhidrosis. Th\u1ef1c t\u1ebf, c\u00e1c hi\u1ec7u qu\u1ea3 k\u00e9o d\u00e0i 5-6 th\u00e1ng \u0111\u00e3 \u0111\u1eb7c bi\u1ec7t h\u1ea5p d\u1eabn t\u00f4i. M\u1eb7c d\u00f9 r\u00f5 r\u00e0ng kh\u00f4ng ph\u1ea3i l\u00e0 t\u00ecnh tr\u1ea1ng nguy hi\u1ec3m t\u00ednh m\u1ea1ng ho\u1eb7c c\u0103n b\u1ec7nh truy\u1ec1n nhi\u1ec5m, nh\u01b0ng b\u1ec7nh Hyperhidrosis khu tr\u00fa, \u0111\u1eb7c bi\u1ec7t l\u00e0 ch\u1ee9ng t\u0103ng ti\u1ebft m\u1ed3 h\u00f4i l\u00f2ng b\u00e0n tay c\u00f3 th\u1ec3 g\u00e2y \u0111au kh\u1ed5 s\u00e2u s\u1eafc cho b\u1ea3n th\u00e2n b\u1ec7nh nh\u00e2n, do n\u00f3 c\u1ea3n tr\u1edf c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y c\u1ee7a anh \u1ea5y theo 1 c\u00e1ch r\u1eafc r\u1ed1i. B\u00e0n tay \u0111\u1eabm m\u1ed3 h\u00f4i c\u00f3 nguy c\u01a1 b\u1ecb t\u00ea c\u00f3ng nhi\u1ec1u h\u01a1n v\u00e0o m\u00f9a \u0111\u00f4ng. Ngo\u00e0i ra khi vi\u1ebft ho\u1eb7c ho\u00e0n th\u00e0nh c\u00e1c b\u00e0i ki\u1ec3m tra vi\u1ebft c\u1ea7n ph\u1ea3i \u0111\u1eb7t 1 chi\u1ebfc kh\u0103n tay b\u00ean d\u01b0\u1edbi b\u00e0n tay \u0111\u1ec3 ko l\u00e0m \u01b0\u1edbt gi\u1ea5y. B\u00e0n tay \u01b0\u1edbt kh\u00f4ng ti\u1ec7n \u0111\u1ec3 b\u1eaft tay v\u00e0 c\u00f3 th\u1ec3 khi\u1ebfn m\u1ed7i ng\u01b0\u1eddi g\u1eb7p b\u1ea5t l\u1ee3i kh\u00f4ng nh\u1ecf trong c\u00e1c t\u01b0\u01a1ng t\u00e1c x\u00e3 h\u1ed9i kh\u00e1c nhau. Theo 1 nghi\u00ean c\u1ee9u m\u1ee9c \u0111\u1ed9 \u0111au kh\u1ed5 c\u1ee7a b\u1ec7nh nh\u00e2n v\u1ec1 c\u1ea3m x\u00fac v\u00e0 t\u00e2m l\u00fd do ch\u1ee9ng hyperhidrosis g\u00e2y ra c\u00f2n l\u1edbn h\u01a1n so v\u1edbi b\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p v\u00e0 suy th\u1eadn m\u00e3n. M\u1eb7c d\u00f9 c\u00f3 1 s\u1ed1’ bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng hyperhidrosis l\u00f2ng b\u00e0n tay bao g\u1ed3m thu\u1ed1c b\u00f4i v\u00e0 thu\u1ed1c u\u1ed1ng, nh\u01b0ng t\u00e1c d\u1ee5ng ph\u1ea7n l\u1edbn l\u00e0 tho\u00e1ng qua v\u00e0 t\u1ed1i thi\u1ec3u, trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p, b\u1ec7nh nh\u00e2n ch\u1ec9 \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ebfn khoa ph\u1eabu thu\u1eadt l\u1ed3ng ng\u1ef1c \u0111\u1ec3 ti\u1ebfn h\u00e0nh ph\u1eabu thu\u1eadt n\u1ed9i soi x\u00e2m l\u1ea5n nhi\u1ec1u h\u01a1n. Tuy nhi\u00ean, b\u1ea5t ch\u1ea5p ph\u01b0\u01a1ng ph\u00e1p ch\u1eefa tr\u1ecb v\u0129nh vi\u1ec5n m\u00e0 n\u00f3 mag l\u1ea1i, ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf h\u1ea1ch giao c\u1ea3m c\u0169ng c\u00f3 nh\u1eefng v\u1ea5n \u0111\u1ec1 ri\u00eang c\u1ee7a n\u00f3, bao g\u1ed3m c\u1ea3 nguy c\u01a1 ph\u00e1t tri\u1ec3n hyperhidrosis b\u00f9 tr\u1eeb. N\u00f3i 1 c\u00e1ch \u0111\u01a1n gi\u1ea3n \u0111i\u1ec1u tr\u1ecb b\u1ec7nh hyperdrosis l\u00e0 1 c\u00f4ng vi\u1ec7c \u0111\u00f2i h\u1ecfi nghi\u00ean c\u1ee9u s\u00e2u v\u00e0 kh\u00f4ng th\u00fa v\u1ecb \u0111\u1ed1i v\u1edbi 1 b\u00e1c s\u0129 da li\u1ec5u b\u00ecnh th\u01b0\u1eddng.<\/p>\n

Nh\u1eefng kh\u00f3 kh\u0103n n\u00e0y c\u0169ng x\u1ea3y ra v\u1edbi t\u00f4i trong kh\u00f3a hu\u1ea5n luy\u1ec7n n\u1ed9i tr\u00fa \u0111\u1ea7u ti\u00ean c\u1ee7a t\u00f4i t\u1ea1i SNUH, m\u1ed9t trong nh\u1eefng nhi\u1ec7m v\u1ee5 c\u1ee7a t\u00f4i l\u00e0 \u0111o l\u01b0\u1ee3ng m\u1ed3 h\u00f4i ti\u1ebft ra c\u1ee7a nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb hyperhydrosis v\u00f9ng l\u00f2ng b\u00e0n tay theo h\u01b0\u1edbng d\u1eabn c\u1ee7a gi\u00e1o s\u01b0 t\u1ea1i khoa Da li\u1ec5u. \u0110\u00e2y l\u00e0 c\u00f4ng vi\u1ec7c v\u1ea5t v\u1ea3 v\u00e0 t\u1ed1n nhi\u1ec1u th\u1eddi gian, v\u00ec thang \u0111o ch\u00ednh x\u00e1c s\u1eed d\u1ee5ng cho c\u00e1c ph\u00e9p \u0111o \u0111\u01b0\u1ee3c \u0111\u1ec3 t\u1ea1i 1 v\u0103n ph\u00f2ng ri\u00eang bi\u1ec7t tr\u00ean t\u1ea7ng 12 c\u1ee7a t\u00f2a nh\u00e0. M\u1ed7i chuy\u1ebfn \u0111i t\u1eeb v\u0103n ph\u00f2ng l\u01b0u tr\u1eef t\u1edbi ch\u1ed7 b\u1ec7nh nh\u00e2n m\u1ea5t t\u1edbi 30p. Tuy nhi\u00ean nh\u1eefng chuy\u1ebfn \u0111i v\u00e0 b\u00e0i ki\u1ec3m tra h\u00e0ng ng\u00e0y kh\u00f4ng \u0111\u00e1ng k\u1ec3 g\u00ec so v\u1edbi m\u1ed9t lu\u1eadn \u00e1n \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1’ d\u01b0\u1edbi danh ngh\u0129a c\u1ee7a gi\u00e1o s\u01b0 ph\u1ee5 tr\u00e1ch. T\u00f4i kh\u00f4ng th\u1ea5y n\u00f3 c\u00f3 g\u00ec t\u1ed1t cho b\u1ec7nh nh\u00e2n khi m\u00e0 cu\u1ed1i c\u00f9ng h\u1ecd v\u1eabn ph\u1ea3i chuy\u1ec3n \u0111\u1ebfn khoa ph\u1eabu thu\u1eadt l\u1ed3ng ng\u1ef1c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n

K\u00fd \u1ee9c v\u1ec1 qu\u00e3ng th\u1eddi gian v\u1ea5t v\u1ea3 \u0111\u00f3 v\u1eabn c\u00f2n in \u0111\u1eadm trong t\u00e2m tr\u00ed t\u00f4i, t\u00f4i th\u1eadt s\u1ef1 r\u1ea5t t\u00e2m \u0111\u1eafc khi bi\u1ebft r\u1eb1ng 1 m\u0169i ti\u00eam duy nh\u1ea5t c\u00f3 th\u1ec3 gi\u1ea3m \u0111\u1ebfn v\u00e0i th\u00e1ng cho b\u1ec7nh nh\u00e2n hyperhydrosis. Lo\u1ea1i thu\u1ed1c \u0111\u00f3 c\u0169ng c\u00f3 gi\u00e1 ph\u1ea3i ch\u0103ng, ch\u1ec9 kho\u1ea3ng 60USD cho m\u1ed7i l\u1ecd botox. Khi \u0111\u00e1nh gi\u00e1 th\u00eam t\u00e0i li\u1ec7u, t\u00f4i ph\u00e1t hi\u1ec7n ra r\u1eb1ng nh\u1eefng b\u00e0i b\u00e1o nghi\u00ean c\u1ee9u \u00edt \u1ecfi v\u1eabn ch\u1ec9 \u1edf giai \u0111o\u1ea1n s\u01a1 khai v\u00e0 ngay l\u00fac \u0111\u00f3 t\u00f4i \u0111\u00e3 quy\u1ebft \u0111\u1ecbnh ch\u1ecdn v\u00e0 ti\u1ebfp theo \u0111\u00f3 t\u00f4i \u0111\u00e3 t\u00ecm th\u1ea5y con \u0111\u01b0\u1eddng th\u00edch h\u1ee3p cho m\u00ecnh. Nhanh ch\u00f3ng, t\u00f4i \u0111\u01b0a ra m\u1ed9t \u0111\u1ec1 xu\u1ea5t nghi\u00ean c\u1ee9u trong v\u00f2ng 3 ng\u00e0y, v\u00e0 \u0111\u01b0\u1ee3c chu\u1ea9n b\u1ecb \u0111\u1ec3 th\u1ef1c hi\u1ec7n. R\u1eafc r\u1ed1i duy nh\u1ea5t \u0111\u00e3 x\u1ea3y ra l\u00e0 gi\u00e1 ni\u00eam y\u1ebft kho\u1ea3ng 60 USD c\u1ee7a SNUH l\u1ea1i l\u00e0 1 sai s\u00f3t. Th\u00ec ra s\u1ed1’ 0 cu\u1ed1i c\u00f9ng b\u1ecb b\u1ecf qua l\u00e0 do nh\u1ea7m l\u1eabn, c\u00f3 ngh\u0129a l\u00e0 gi\u00e1 th\u1ef1c t\u1ebf l\u00e0 1 con s\u1ed1 kh\u1ed5ng l\u1ed3 600 USD. 2 \u1ed1ng Botox \u0111\u1ec3 ti\u00eam c\u1ea3 2 tay s\u1ebd c\u00f3 gi\u00e1 l\u00e0 1200 USD cho m\u1ed7i l\u1ea7n \u0111i\u1ec1u tr\u1ecb, v\u00e0 t\u00f4i \u0111\u00e3 ph\u1ea3i suy ngh\u0129 1 c\u00e1ch nghi\u00eam t\u00fac t\u1eeb g\u00f3c nh\u00ecn c\u1ee7a b\u1ec7nh nh\u00e2n, li\u1ec7u r\u1eb1ng 5-6 th\u00e1ng kh\u1ecfi m\u1ed3 h\u00f4i tay c\u00f3 x\u1ee9ng \u0111\u00e1ng v\u1edbi chi ph\u00ed \u0111\u00f3 hay kh\u00f4ng. Tuy nhi\u00ean, cu\u1ed1i c\u00f9ng t\u00f4i quy\u1ebft \u0111\u1ecbnh r\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00e0y v\u1eabn c\u00f3 s\u1ee9c h\u1ea5p d\u1eabn nh\u01b0 1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00f4ng x\u00e2m l\u1ea5n m\u1edbi, li\u00ean quan \u0111\u1ebfn thu\u1ed1c ti\u00eam v\u00e0 \u0111\u01b0\u1ee3c th\u00fac \u0111\u1ea9y nhanh h\u01a1n so v\u1edbi k\u1ebf ho\u1ea1ch. \u0110\u00f3 l\u00e0 c\u00e1ch l\u1ea7n \u0111\u1ea7u ti\u00ean t\u00f4i b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng \u0111\u1ed9c t\u1ed1 Botulinum. Ph\u1ea7n c\u00f2n l\u1ea1i t\u00f4i cho r\u1eb1ng \u0111\u00f3 l\u00e0 qu\u00e1 tr\u00ecnh l\u1ecbch s\u1eed.<\/p>\n

Ch\u1eafc ch\u1eafn r\u1eb1ng cu\u1ed9c s\u1ed1ng di\u1ec5n ra 1 c\u00e1ch k\u1ef3 di\u1ec7u. N\u1ebfu kh\u00f4ng ph\u1ea3i v\u00ec s\u1ef1 v\u1ea5t v\u1ea3 c\u1ee7a nh\u1eefng ph\u00e9p \u0111o m\u1ed3 h\u00f4i \u0111\u00f3, hay s\u1ef1 ng\u1eabu nhi\u00ean c\u1ee7a b\u00e0i b\u00e1o JAAD v\u1ec1 ch\u1ee9ng hyperhidrosis l\u00f2ng b\u00e0n tay, ho\u1eb7c gi\u00e1 Botox c\u1ee7a d\u01b0\u1ee3c ph\u1ea9m SNUH \u0111\u01b0\u1ee3c ni\u00eam y\u1ebft kh\u00f4ng ch\u00ednh x\u00e1c, th\u00ec t\u00f4i t\u1ef1 h\u1ecfi li\u1ec7u t\u00f4i c\u00f3 th\u1ef1c hi\u1ec7n \u0111i\u1ec1u tr\u1ecb b\u1eb1ng botox hay kh\u00f4ng. Ch\u00fang ta l\u00e0 s\u1ea3n ph\u1ea9m c\u1ee7a v\u00f4 s\u1ed1 s\u1ef1 ki\u1ec7n ng\u1eabu nhi\u00ean \u0111\u00e3 x\u1ea3y ra trong qu\u00e1 kh\u1ee9. S\u1ef1 kh\u00e1c bi\u1ec7t duy nh\u1ea5t gi\u1eefa cu\u1ed9c s\u1ed1ng c\u1ee7a ch\u00fang ta v\u00e0 qu\u00e1 tr\u00ecnh ti\u1ebfn ho\u00e1 l\u00e0 cu\u1ed9c s\u1ed1ng c\u1ee7a con ng\u01b0\u1eddi kh\u00f4ng k\u00e9o d\u00e0i h\u00e0ng t\u1ef7 n\u0103m, v\u00e0 do \u0111\u00f3 \u0111\u00f2i h\u1ecfi ch\u00fang ta ph\u1ea3i n\u1ed7 l\u1ef1c \u0111\u1ec3 thu h\u1eb9p kho\u1ea3ng c\u00e1ch gi\u1eefa c\u01a1 h\u1ed9i v\u00e0 k\u1ebft qu\u1ea3 ch\u00fang ta mong mu\u1ed1n. C\u0169ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1ch ch\u00fang ta t\u00ecm ra ng\u01b0\u1eddi b\u1ea1n \u0111\u1eddi c\u1ee7a m\u00ecnh t\u1eeb nhi\u1ec1u cu\u1ed9c g\u1eb7p g\u1ee1 ng\u1eabu nhi\u00ean trong \u0111\u1eddi, t\u00f4i cho r\u1eb1ng ch\u00ednh ni\u1ec1m \u0111am m\u00ea, t\u1ef1 t\u1eadn t\u00e2m v\u00e0 nh\u1eefng gi\u1ecdt m\u1ed3 h\u00f4i, cu\u1ed1i c\u00f9ng \u0111\u00e3 bi\u1ebfn nh\u1eefng s\u1ef1 ki\u1ec7n b\u1ea5t ng\u1edd \u0111\u01a1n thu\u1ea7n c\u1ee7a ng\u00e0y h\u00f4m qua th\u00e0nh th\u00e0nh qu\u1ea3 x\u1ee9ng \u0111\u00e1ng c\u1ee7a ng\u00e0y mai ( th\u00e1ng 6 n\u0103m 2019).<\/p>\n

T\u00e1c nh\u00e2n ph\u1ea3n \u1ee9ng li\u00ean k\u1ebft ch\u00e9o\/ ph\u1ea3n \u1ee9ng li\u00ean k\u1ebft ch\u00e9o<\/h4>\n

Khi h\u00f2a tan trong n\u01b0\u1edbc, b\u1ed9t HA chuy\u1ec3n th\u00e0nh d\u1ea1ng keo \u0111\u1eb7c – gi\u1ed1ng nh\u01b0 ch\u1ea5t l\u1ecfng c\u00f3 k\u1ebft c\u1ea5u nh\u1edbt gi\u1ed1ng n\u01b0\u1edbc s\u1ed1t chua ng\u1ecdt, m\u1ed9t tr\u1ea1ng th\u00e1i \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 HA t\u1ef1 do. HA t\u1ef1 do h\u1ea7u nh\u01b0 kh\u00f4ng c\u00f3 b\u1ea5t k\u1ef3 t\u00e1c d\u1ee5ng c\u1ea5u tr\u00fac hay \u0111\u1ed9 \u0111\u00e0n h\u1ed3i n\u00e0o v\u00e0 do \u0111\u00f3 kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng cung c\u1ea5p h\u1ed7 tr\u1ee3 ho\u1eb7c l\u00e0m \u0111\u1ea7y trong m\u00f4. N\u1ebfu HA t\u1ef1 do \u0111\u01b0\u1ee3c ti\u00eam \u0111\u1ec3 l\u00e0m ch\u1ea5t \u0111\u1ed9n, n\u00f3 s\u1ebd b\u1ecb tho\u00e1i h\u00f3a trong v\u00f2ng 1 tu\u1ea7n do ho\u1ea1t \u0111\u1ed9ng c\u1ee7a hyaluronidase n\u1ed9i sinh ho\u1eb7c c\u00e1c g\u1ed1c t\u1ef1 do trong c\u01a1 th\u1ec3 ng\u01b0\u1eddi. Do \u0111\u00f3, \u0111\u1ec3 t\u1ea1o \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cho HA t\u1ef1 do v\u00e0 t\u0103ng th\u1eddi gian t\u1ed3n t\u1ea1i c\u1ee7a n\u00f3 trong c\u01a1 th\u1ec3 s\u1ed1ng, li\u00ean k\u1ebft ch\u00e9o \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o gi\u1eefa c\u00e1c chu\u1ed7i HA \u0111\u1ec3 \u1ed5n \u0111\u1ecbnh HA th\u00e0nh d\u1ea1ng gel. Li\u00ean k\u1ebft ch\u00e9o c\u00f3 th\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p v\u1eadt l\u00fd ho\u1eb7c h\u00f3a h\u1ecdc. M\u1ed7i quy tr\u00ecnh t\u1ea1o li\u00ean k\u1ebft ch\u00e9o ho\u1eb7c c\u00f4ng ngh\u1ec7 t\u1ea1o gel c\u1ee5 th\u1ec3 c\u00f3 \u0111\u1eb7c t\u00ednh thu\u1ed9c v\u00e0o c\u1ea3 y\u1ebfu t\u1ed1 v\u1eadt l\u00fd v\u00e0 h\u00f3a h\u1ecdc. Y\u1ebfu t\u1ed1 v\u1eadt l\u00fd l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c ch\u1ea5t t\u1ea1o li\u00ean k\u1ebft ch\u00e9o gi\u1eefa c\u00e1c chu\u1ed7i HA. Quy tr\u00ecnh n\u00e0y t\u1ea1o n\u00ean m\u1ed9t m\u1ea1ng l\u01b0\u1edbi ch\u1eb7t ch\u1ebd gi\u1eefa c\u00e1c chu\u1ed7i HA (h\u00ecnh 2.7) \u0111\u01b0\u1ee3c gi\u1eef v\u1edbi nhau ch\u1ec9 b\u1eb1ng 1 s\u1ed1 li\u00ean k\u1ebft ch\u00e9o h\u00f3a h\u1ecdc. \u0110\u1ed1i v\u1edbi c\u00e1c y\u1ebfu t\u1ed1 h\u00f3a h\u1ecdc, nhi\u1ec7t \u0111\u1ed9 c\u1ee7a ch\u1ea5t l\u1ecfng HA ( t\u1ee9c l\u00e0 HA \u0111\u01b0\u1ee3c pha trong n\u01b0\u1edbc) t\u1ea1i ph\u1ea3n \u1ee9ng v\u00e0 th\u1eddi gian ph\u1ea3n \u1ee9ng v\u1edbi ch\u1ea5t li\u00ean k\u1ebft ch\u00e9o l\u00e0 c\u00e1c th\u00f4ng s\u1ed1 quan tr\u1ecdng nh\u1ea5t \u0111\u1ec3 li\u00ean k\u1ebft c\u00e1c ph\u00e2n t\u1eed HA v\u1edbi nhau. M\u1ed9t v\u00ed d\u1ee5 \u0111i\u1ec3n h\u00ecnh v\u1ec1 \u0111\u1eb7c t\u00ednh c\u1ee7a s\u1ea3n ph\u1ea9m l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a y\u1ebfu t\u1ed1 v\u1eadt l\u00fd l\u00e0 Restylane. C\u00f4ng ngh\u1ec7 NASHA \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 t\u1ea1o gel \u0111\u1ec3 t\u1ea1o ch\u1ea5t gel b\u1ec1n v\u1eefng v\u1edbi G’ cao nh\u01b0ng c\u00f3 \u0111\u1ed9 s\u1eeda \u0111\u1ed5i d\u01b0\u1edbi 1% (MoD), \u0111i\u1ec1u quan tr\u1ecdng \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o kh\u1ea3 n\u0103ng t\u01b0\u01a1ng th\u00edch sinh h\u1ecdc t\u1ed1t.<\/p>\n

Trong khi y\u1ebfu t\u1ed1 v\u1eadt l\u00fd t\u1ea1o li\u00ean k\u1ebft ch\u00e9o \u0111\u00f3ng 1 vai tr\u00f2 quan tr\u1ecdng, th\u00ec c\u00e1c \u0111\u1eb7c t\u00ednh c\u1ee7a gel ph\u1ee5 thu\u1ed9c nhi\u1ec1u h\u01a1n v\u00e0o vi\u1ec7c \u0111\u01b0a v\u00e0o c\u00e1c t\u00e1c nh\u00e2n x\u00fac t\u00e1c t\u1ea1o li\u00ean k\u1ebft ch\u00e9o gi\u1eefa c\u00e1c ph\u00e2n t\u1eed HA. \u1ede \u0111\u00e2y ch\u1ea5t x\u00fac t\u00e1c t\u1ea1o li\u00ean k\u1ebft ngang \u0111\u00f3ng vai tr\u00f2 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi gluten trong b\u1ed9t m\u00ec. Kh\u00f4ng gi\u1ed1ng nh\u01b0 c\u00e1c lo\u1ea1i ng\u0169 c\u1ed1c kh\u00e1c, b\u1ed9t m\u00ec tr\u1ed9n v\u1edbi n\u01b0\u1edbc t\u1ea1o ra b\u1ed9t nh\u00e3o, co gi\u00e3n v\u00e0 dai, nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ebfu l\u00e0 do s\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a gluten c\u00f3 trong l\u00faa m\u00ec. Trong qu\u00e1 tr\u00ecnh nh\u00e0o b\u1ed9t, gluten c\u00f3 trong b\u1ed9t m\u00ec li\u00ean k\u1ebft v\u1edbi tinh b\u1ed9t \u0111\u1ec3 t\u1ea1o th\u00e0nh 1 m\u1ea1ng l\u01b0\u1edbi, gi\u00fap b\u1ed9t c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u00e0 cho ph\u00e9p n\u00f3 gi\u1eef h\u00ecnh d\u1ea1ng \u1edf tr\u1ea1ng th\u00e1i ngh\u1ec9 v\u00e0 k\u00e9o ra 1 c\u00e1ch d\u1ec5 d\u00e0ng. Theo c\u00e1ch \u0111\u00f3, c\u00e1c ch\u1ea5t x\u00fac t\u00e1c t\u1ea1o li\u00ean k\u1ebft ch\u00e9o v\u1edbi c\u00e1c chu\u1ed7i HA ri\u00eang l\u1ebb, v\u00e0 li\u00ean k\u1ebft ch\u00fang v\u1edbi nhau \u0111\u1ec3 x\u00e2y d\u1ef1ng n\u00ean 1 m\u1ea1ng l\u01b0\u1edbi HA ch\u1eb7t ch\u1ebd, chuy\u1ec3n \u0111\u1ed5i c\u00e1c chu\u1ed7i HA d\u1ea1ng l\u1ecfng sang d\u1ea1ng gel (h\u00ecnh 2.8). Do \u0111\u00f3, kh\u1ed1i gel HA \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t hi\u1ec7u qu\u1ea3 \u0111\u1ec3 t\u1ea1o th\u00e0nh 1 c\u1ea5u tr\u00fac th\u1ed1ng nh\u1ea5t ch\u1ed1ng l\u1ea1i s\u1ef1 ph\u00e2n h\u1ee7y c\u1ee7a c\u00e1c g\u1ed1c t\u1ef1 do. Cu\u1ed1i c\u00f9ng, t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1ch b\u1ed9t m\u00ec \u0111\u01b0\u1ee3c chia th\u00e0nh c\u00e1c lo\u1ea1i r\u1eafn ch\u1eafc, trung b\u00ecnh ho\u1eb7c m\u1ec1m t\u00f9y thu\u1ed9c v\u00e0o h\u00e0m l\u01b0\u1ee3ng gluten c\u1ee7a n\u00f3, th\u00ec c\u00e1c s\u1ea3n ph\u1ea9m ch\u1ea5t \u0111\u1ed9n HA c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh c\u1ee9ng ( c\u00f3 \u0111\u1ed9 nh\u1edbt cao) ho\u1eb7c m\u1ec1m ( c\u00f3 \u0111\u1ed9 nh\u1edbt th\u1ea5p) \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1edfi c\u00e1c ph\u00e9p \u0111o l\u01b0u bi\u1ebfn.<\/p>\n

Trong khi c\u00f3 s\u1eb5n c\u00e1c ch\u1ea5t kh\u00e1c nhau \u0111\u1ec3 s\u1eed d\u1ee5ng l\u00e0m ch\u1ea5t x\u00fac t\u00e1c t\u1ea1o li\u00ean k\u1ebft ch\u00e9o, bao g\u1ed3m 1.4-butanediol diglicidyl ether (BDDE), divinyl sulfone (DVS), v\u00e0 biscarbodiimidie (BCDI), th\u00ec cho \u0111\u1ebfn nay BDDE l\u00e0 ch\u1ea5t x\u00fac t\u00e1c t\u1ea1o li\u00ean k\u1ebft ch\u00e9o \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1ea5t trong ng\u00e0nh s\u1ea3n xu\u1ea5t ch\u1ea5t \u0111\u1ed9n HA th\u01b0\u01a1ng m\u1ea1i do \u0111\u1eb7c t\u00ednh \u0111\u1ed9c t\u00ednh th\u1ea5p \u0111\u1eb7c bi\u1ec7t c\u1ee7a n\u00f3. Li\u1ec1u g\u00e2y ch\u1ebft trung b\u00ecnh (LD 50) c\u1ee7a BDDE d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng cho chu\u1ed9t l\u00e0 1134mg\/kg so v\u1edbi 32mg\/kg \u0111\u1ed1i v\u1edbi DVS. C\u00e1c ti\u00eau chu\u1ea9n nghi\u00eam ng\u1eb7t \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng v\u1edbi l\u01b0\u1ee3ng BDDE c\u00f2n l\u1ea1i trong s\u1ea3n ph\u1ea9m v\u00ec l\u01b0\u1ee3ng d\u01b0 c\u1ee7a BDDE ch\u01b0a ph\u1ea3n \u1ee9ng c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i cho c\u01a1 th\u1ec3 ng\u01b0\u1eddi. Tuy nhi\u00ean, \u1edf gi\u1edbi h\u1ea1n hi\u1ec7n t\u1ea1i l\u00e0 < 2 microgram BDDE c\u00f2n l\u1ea1i trong c\u00e1c s\u1ea3n ph\u1ea9m ch\u1ea5t l\u00e0m \u0111\u1ea7y HA ch\u1ec9 b\u1eb1ng 1\/25 tri\u1ec7u li\u1ec1u g\u00e2y t\u1eed vong \u1edf ng\u01b0\u1eddi l\u1edbn 50kg. D\u00f9 v\u1eady, c\u00e1c c\u00f4ng ti s\u1ea3n xu\u1ea5t v\u1eabn cam k\u1ebft gi\u1ea3m thi\u1ec3u h\u01a1n n\u1eefa l\u01b0\u1ee3ng BDDE c\u00f2n s\u00f3t l\u1ea1i b\u1eb1ng c\u00e1ch t\u0103ng th\u1eddi gian ph\u1ea3n \u1ee9ng ho\u1eb7c t\u1ed1c \u0111\u1ed9 ph\u1ea3n \u1ee9ng trong qu\u00e1 tr\u00ecnh ph\u1ea3n \u1ee9ng t\u1ea1o li\u00ean k\u1ebft ch\u00e9o v\u00e0 b\u1eb1ng c\u00e1ch lo\u1ea1i b\u1ecf t\u1ed1i \u0111a c\u00e1c m\u1ea3nh v\u1ee1 BDDE trong qu\u00e1 tr\u00ecnh l\u00e0m s\u1ea1ch v\u00e0 tinh ch\u1ebf gel HA \u0111\u00e3 c\u00f3 li\u00ean k\u1ebft ch\u00e9o. Trong khi \u0111\u00f3, trong qu\u00e1 tr\u00ecnh t\u1ea1o li\u00ean k\u1ebft ch\u00e9o, c\u00e1c nh\u00f3m epoxit c\u1ee7a BDDE ph\u1ea3n \u1ee9ng v\u1edbi c\u00e1c nh\u00f3m hydroxyl c\u1ee7a HA trong m\u00f4i tr\u01b0\u1eddng ki\u1ec1m, t\u1ea1o th\u00e0nh c\u00e1c d\u1eabn xu\u1ea5t 1.4-butanediol di -(propan-2.3- diolyl) ether (BDPE). Tuy nhi\u00ean, khi l\u00e0m nh\u01b0 v\u1eady m\u1ed9t s\u1ed1 ph\u00e2n t\u1eed BDDE li\u00ean k\u1ebft v\u1edbi HA \u1edf c\u1ea3 2 \u0111\u1ea7u (“BDDE li\u00ean k\u1ebft \u0111\u00f4i”) trong khi nh\u1eefng ph\u00e2n t\u1eed kh\u00e1c li\u00ean k\u1ebft v\u1edbi HA \u1edf 1 \u0111\u1ea7u d\u1ea1ng m\u1eb7t d\u00e2y chuy\u1ec1n (“BDPE li\u00ean k\u1ebft \u0111\u01a1n”).<\/p>\n

M\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o cao h\u01a1n v\u1edbi BDDE c\u00f3 li\u00ean quan \u0111\u1ebfn th\u1eddi gian t\u1ed3n t\u1ea1i d\u00e0i h\u01a1n c\u1ee7a HA trong m\u00f4, c\u0169ng nh\u01b0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u00e0 k\u1ebft d\u00ednh cao h\u01a1n c\u1ee7a gel HA. Do \u0111\u00f3, s\u1ed1 li\u00ean k\u1ebft ch\u00e9o l\u00e0 y\u1ebfu t\u1ed1 ch\u00ednh trong ph\u00e9p so s\u00e1nh c\u00e1c \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn c\u1ee7a s\u1ea3n ph\u1ea9m HA kh\u00e1c nhau. C\u00e1c th\u00f4ng s\u1ed1 ch\u00ednh m\u00f4 t\u1ea3 m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o bao g\u1ed3m: m\u1ee9c \u0111\u1ed9 s\u1eeda \u0111\u1ed5i (MoD), m\u1ee9c \u0111\u1ed9 thay th\u1ebf (DS), m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o (CrD), m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o (DC), v\u00e0 t\u1ec9 l\u1ec7 li\u00ean k\u1ebft ch\u00e9o hi\u1ec7u qu\u1ea3 (CrR), \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a t\u01b0\u01a1ng \u1ee9ng nh\u01b0 sau:<\/p>\n

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  • M\u1ee9c \u0111\u1ed9 s\u1eeda \u0111\u1ed5i (MoD): t\u1ec9 l\u1ec7 gi\u1eefa t\u1ed5ng s\u1ed1 li\u00ean k\u1ebft \u0111\u01a1n ( lo\u1ea1i m\u1eb7t d\u00e2y chuy\u1ec1n) v\u00e0 li\u00ean k\u1ebft \u0111\u00f4i BDPE v\u1edbi t\u1ed5ng s\u1ed1 \u0111\u01a1n ph\u00e2n HA ( \u0111\u01a1n v\u1ecb disaccharide).<\/li>\n
  • M\u1ee9c \u0111\u1ed9 thay th\u1ebf (DS): t\u1ec9 l\u1ec7 gi\u1eefa c\u00e1c disaccharide HA li\u00ean k\u1ebft v\u1edbi BDPE v\u00e0 t\u1ed5ng s\u1ed1 c\u00e1c monomer HA ( \u0111\u01a1n v\u1ecb disaccharide).<\/li>\n
  • M\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o (CrD): t\u1ec9 l\u1ec7 gi\u1eefa c\u00e1c g\u1ed1c BDPE \u0111\u01b0\u1ee3c li\u00ean k\u1ebft \u0111\u00f4i v\u00e0 t\u1ed5ng s\u1ed1 monomer HA ( \u0111\u01a1n v\u1ecb disaccharide)<\/li>\n
  • M\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o (DC): s\u1ed1 l\u01b0\u1ee3ng c\u00e1c disaccharide HA th\u1ef1c s\u1ef1 \u0111\u01b0\u1ee3c li\u00ean k\u1ebft ch\u00e9o so v\u1edbi t\u1ed5ng s\u1ed1’ c\u00e1c disaccharide HA.<\/li>\n
  • T\u1ec9 l\u1ec7 li\u00ean k\u1ebft ch\u00e9o hi\u1ec7u qu\u1ea3 (CrR): t\u1ec9 l\u1ec7 gi\u1eefa BDDE li\u00ean k\u1ebft \u0111\u00f4i so v\u1edbi t\u1ed5ng s\u1ed1 BDDE.<\/li>\n<\/ul>\n

    Trong t\u1ea5t c\u1ea3 c\u00e1c thu\u1eadt ng\u1eef tr\u00ean, m\u1eabu s\u1ed1 \u0111\u01b0\u1ee3c bi\u1ec3u th\u1ecb b\u1eb1ng t\u1ed5ng s\u1ed1 \u0111\u01a1n v\u1ecb monomer HA ( \u0111\u01a1n v\u1ecb disacharide), trong khi t\u1eed s\u1ed1’ thay \u0111\u1ed5i v\u1edbi m\u1ed7i tham s\u1ed1. N\u00f3i m\u1ed9t c\u00e1ch \u0111\u01a1n gi\u1ea3n, MoD v\u00e0 CrD bi\u1ec3u th\u1ecb t\u1ec9 l\u1ec7 BDPE li\u00ean k\u1ebft ch\u00e9o v\u1edbi HA, trong khi DS v\u00e0 DC bi\u1ec3u th\u1ecb t\u1ec9 l\u1ec7 c\u00e1c \u0111\u01a1n v\u1ecb disaccharide HA li\u00ean k\u1ebft ch\u00e9o so v\u1edbi t\u1ed5ng s\u1ed1 HA. Trong khi \u0111\u00f3, CrD \u0111\u1ea1i di\u1ec7n cho t\u1ec9 l\u1ec7 BDDE \u0111\u01b0\u1ee3c li\u00ean k\u1ebft \u0111\u00f4i v\u1edbi HA (li\u00ean k\u1ebft \u0111\u00f4i v\u1edbi BDPE), trong khi MoD bao g\u1ed3m t\u1ec9 l\u1ec7 c\u1ee7a c\u1ea3 BDPE \u0111\u01a1n (h\u00ecnh m\u1eb7t d\u00e2y chuy\u1ec1n) v\u00e0 li\u00ean k\u1ebft \u0111\u00f4i BDPE.<\/p>\n

    V\u00ed d\u1ee5, CrD l\u00e0 20% t\u01b0\u01a1ng \u0111\u01b0\u01a1ng DC l\u00e0 40%, v\u00ec DC \u0111\u1ea1i di\u1ec7n cho g\u1ea5p \u0111\u00f4i gi\u00e1 tr\u1ecb c\u1ee7a CrD. C\u00f3 ngh\u0129a l\u00e0 trong m\u1ed7i tr\u01b0\u1eddng h\u1ee3p, \u0111\u1ed1i v\u1edbi m\u1ed7i 10 \u0111\u01a1n ph\u00e2n HA ( ho\u1eb7c \u0111v disaccharid) trong gel th\u00ec 2 ph\u00e2n t\u1eed BDDE (CrD l\u00e0 20%) ho\u1eb7c 4 \u0111\u01a1n v\u1ecb HA disaccharide (DC l\u00e0 40%) \u0111\u00e3 \u0111\u01b0\u1ee3c li\u00ean k\u1ebft ch\u00e9o. Trong khi \u0111\u00f3, MoD l\u00e0 50% v\u00e0 CrR l\u00e0 40% d\u1eabn \u0111\u1ebfn DS l\u00e0 70%, nh\u01b0 v\u1eady v\u1edbi m\u1ed7i 10 \u0111\u01a1n ph\u00e2n HA ( ho\u1eb7c \u0111v disaccharide), c\u00e1c li\u00ean k\u1ebft \u0111\u00e3 \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh v\u1edbi trung b\u00ecnh 5 ph\u00e2n t\u1ee7 BDDE (MoD l\u00e0 50%), trong \u0111\u00f3 ch\u1ec9 c\u00f3 2 l\u00e0 BDDE li\u00ean k\u1ebft \u0111\u00f4i (CrR l\u00e0 40%), v\u00e0 do \u0111\u00f3 7\/10 \u0111\u01a1n v\u1ecb disaccharide HA \u0111\u01b0\u1ee3c li\u00ean k\u1ebft v\u1edbi BDDE (DS l\u00e0 70%) (h\u00ecnh 2.11).<\/p>\n

    M\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o cao h\u01a1n gi\u00fap gel c\u00f3 \u0111\u1ed9 c\u1ee9ng cao h\u01a1n v\u00e0 k\u00e9o d\u00e0i tu\u1ed5i th\u1ecd. Tuy nhi\u00ean, qu\u00e1 nhi\u1ec1u li\u00ean k\u1ebft ch\u00e9o d\u1eabn \u0111\u1ebfn vi\u1ec7c ti\u00eam thu\u1ed1c kh\u00f3 kh\u0103n h\u01a1 do s\u1ef1 k\u1ebft d\u00ednh c\u1ee7a s\u1ea3n ph\u1ea9m, l\u00e0m gi\u1ea3m t\u00ednh gi\u1eef n\u01b0\u1edbc c\u1ee7a HA, v\u00e0 g\u00f3p ph\u1ea7n g\u00e2y ra c\u00e1c ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3. V\u00ec v\u1eady 1 s\u1ef1 c\u00e2n b\u1eb1ng ph\u00f9 h\u1ee3p c\u1ee7a c\u00e1c li\u00ean k\u1ebft ch\u00e9o l\u00e0 1 trong nh\u1eefng y\u1ebfu t\u1ed1 c\u1ea7n thi\u1ebft c\u1ee7a 1 ch\u1ea5t l\u00e0m \u0111\u00e2y HA l\u00fd t\u01b0\u1edfng. V\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y, 1 s\u1ea3n ph\u1ea9m c\u00f3 CrR th\u1ea5p, bao g\u1ed3m ch\u1ee7 y\u1ebfu l\u00e0 BDPE li\u00ean k\u1ebft \u0111\u01a1n thay v\u00ec BDPE li\u00ean k\u1ebft \u0111\u00f4i c\u00f3 xu h\u01b0\u1edbng th\u1ec3 hi\u1ec7n t\u00ednh m\u1ec1m d\u1ebbo v\u00e0 linh ho\u1ea1t h\u01a1n.<\/p>\n

    N\u1ed3ng \u0111\u1ed9 HA<\/h4>\n

    Do s\u1ef1 ti\u1ebfp x\u00fac v\u1edbi nhi\u1ec7t trong qu\u00e1 tr\u00ecnh kh\u1eed tr\u00f9ng, t\u1ea5t c\u1ea3 c\u00e1c gel HA s\u1ebd bao g\u1ed3m c\u1ea3 gel c\u00f3 li\u00ean k\u1ebft ch\u00e9o v\u00e0 ph\u1ea7n c\u00f3 th\u1ec3 chi\u1ebft xu\u1ea5t, th\u01b0\u1eddng \u0111\u01b0\u1ee3c k\u00fd hi\u1ec7u l\u00e0 HA t\u1ef1 do. HA t\u1ef1 do ho\u1ea1t \u0111\u1ed9ng nh\u01b0 1 ch\u1ea5t b\u00f4i tr\u01a1n \u0111\u1ec3 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i cho vi\u1ec7c \u0111\u01b0a c\u00e1c h\u1ea1t HA v\u00e0o m\u00f4 v\u00e0 kh\u00f4ng h\u1ed7 tr\u1ee3 c\u1ea5u tr\u00fac b\u00ean trong m\u00f4 v\u00e0 c\u0169ng kh\u00f4ng h\u1ed7 tr\u1ee3 c\u1ea5u tr\u00fac c\u1ee7a ch\u00ednh n\u00f3. V\u00ed dd, trong khi c\u1ea3 Restylane (Galderma) v\u00e0 Juvederm Voluma (Allergan) c\u00f3 c\u00f9ng n\u1ed3ng \u0111\u1ed9 HA l\u00e0 20mg\/ml v\u00e0 ch\u1ee9a n\u1ed3ng \u0111\u1ed9 HA t\u1ef1 do t\u1eeb 20-30%.<\/p>\n

    H\u1ea7u h\u1ebft c\u00e1c s\u1ea3n ph\u1ea9m l\u00e0m \u0111\u1ea7y HA th\u01b0\u01a1ng m\u1ea1i hi\u1ec7n c\u00f3 tr\u00ean th\u1ecb tr\u01b0\u1eddng c\u00f3 n\u1ed3ng \u0111\u1ed9 HA trong kho\u1ea3ng 20-24mg\/ml. M\u1ed9t quy t\u1eafc chung \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn l\u00e0 n\u1ed3ng \u0111\u1ed9 HA cao h\u01a1n t\u01b0\u01a1ng quan v\u1edbi \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao h\u01a1n v\u00e0 th\u1eddi gian t\u00e1c d\u1ee5ng l\u00e2u h\u01a1n. Trong c\u00e1c th\u01b0\u01a1ng hi\u1ec7u c\u1ee7a H\u00e0n Qu\u1ed1c, Cleviel (Pharmaresearch Products, Korea), c\u00f3 n\u1ed3ng \u0111\u1ed9 HA cao \u0111\u00e1ng ch\u00fa \u00fd l\u00e0 50mg\/ml cho \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u00e0 th\u1eddi gian t\u00e1c d\u1ee5ng t\u1ed1i \u0111a. Tuy nhi\u00ean, nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a vi\u1ec7c s\u1eed d\u1ee5ng 1 s\u1ea3n ph\u1ea9m c\u00f3 n\u1ed3ng \u0111\u1ed9 HA cao nh\u01b0 v\u1eady \u0111\u00f2i h\u1ecfi l\u1ef1c \u0111\u1ea9y l\u1edbn h\u01a1n trong qu\u00e1 tr\u00ecnh ti\u00eam, do k\u1ebft c\u1ea5u c\u1ee9ng c\u1ee7a n\u00f3, kh\u00f4ng d\u1ec5 d\u00e0ng n\u1eafn ch\u1ec9nh sau ti\u00eam, v\u00e0 kh\u00f3 ph\u00e2n gi\u1ea3i h\u01a1n v\u1edbi hyaluronidase ngo\u1ea1i sinh. H\u01a1n n\u1eefa, n\u1ed3ng \u0111\u1ed9 HA cao h\u01a1n trong ch\u1ea5t l\u00e0m \u0111\u1ea7y HA \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 c\u00f3 li\u00ean quan \u0111\u1ebfn s\u1ef1 gia t\u0103ng th\u1ec3 t\u00edch ti\u00eam sau \u0111i\u1ec1u tr\u1ecb 2-4 tu\u1ea7n, do s\u1ef1 hydrat h\u00f3a c\u1ee7a c\u00e1c ph\u00e2n t\u1eed HA li\u00ean k\u1ebft ch\u00e9o. V\u1ec1 m\u1eb7t n\u00e0y, Juvederm Ultra, c\u00f3 n\u1ed3ng \u0111\u1ed9 HA 24mg\/ml v\u00e0 \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1eb1ng c\u00f4ng ngh\u1ec7 HYLACROSS, d\u1ec5 g\u00e2y s\u01b0ng ph\u1ed3ng kh\u00f4ng mong mu\u1ed1n ho\u1eb7c kh\u00f4ng \u0111\u1ec1u sau \u0111i\u1ec1u tr\u1ecb do s\u1ef1 ng\u1eadm n\u01b0\u1edbc c\u1ee7a c\u00e1c ph\u00e2n t\u1eed HA. Do \u0111\u00f3, c\u00e1c phi\u00ean b\u1ea3n ti\u1ebfp theo c\u1ee7a ch\u1ea5t l\u00e0m \u0111\u1ea7y Juvederm , s\u1ea3n xu\u1ea5t b\u1eb1ng c\u00f4ng ngh\u1ec7 VYCROSS, \u0111\u00e3 l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 n\u1ed3ng \u0111\u1ed9 HA \u0111\u1ec3 tr\u00e1nh c\u00e1c v\u1ea5n \u0111\u1ec1 nh\u01b0 v\u1eady. V\u00ed d\u1ee5, Juvederm Voluma \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 ph\u1ee5c h\u1ed3i th\u1ec3 t\u00edch d\u01b0\u1edbi s\u00e2u (d\u01b0\u1edbi da) ch\u1ee9a 20mg\/ml HA, Juvederm Volift \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh n\u1ebfp nh\u0103n s\u00e2u ch\u1ee9a 17.5mg\/ml HA, trong khi Juvederm Volbella cho c\u00e1c r\u00e3nh v\u00e0 n\u1ebfp nh\u0103n bao g\u1ed3m c\u1ea3 n\u1ebfp nh\u0103n quanh m\u1eaft ch\u1ee9a 15mg\/ml HA trong s\u1ea3n ph\u1ea9m.<\/p>\n

    HA 1 pha v\u00e0 2 pha<\/h4>\n

    Th\u00f4ng th\u01b0\u1eddng, ch\u1ea5t l\u00e0m \u0111\u1ea7y HA \u0111\u01b0\u1ee3c chia th\u00e0nh HA 1 pha v\u00e0 2 pha, d\u1ef1a tr\u00ean qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t c\u1ee5 th\u1ec3 c\u1ee7a ch\u00fang. Trong qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t ch\u1ea5t l\u00e0m \u0111\u1ea7y HA, m\u1ed9t khi ph\u1ea3n \u1ee9ng t\u1ea1o li\u00ean k\u1ebft ch\u00e9o \u0111\u01b0\u1ee3c ho\u00e0n t\u1ea5t, gel HA sau \u0111\u00f3 \u0111\u01b0\u1ee3c chuy\u1ec3n v\u00e0o m\u00e1y \u0111\u1ed3ng nh\u1ea5t ho\u1eb7c m\u00e1y xay, n\u01a1i \u0111\u00f3 \u0111\u01b0\u1ee3c nghi\u1ec1n th\u00e0nh c\u00e1c h\u1ea1t m\u1ecbn c\u00f3 th\u1ec3 d\u1ec5 d\u00e0ng \u0111i qua kim. HA 2 pha thu \u0111\u01b0\u1ee3c \u1edf giai \u0111o\u1ea1n n\u00e0y b\u1eb1ng c\u00e1ch \u201cs\u00e0ng l\u1ecdc\u201d gel HA th\u00f4ng qua c\u00e1c s\u00e0ng c\u00f3 k\u00edch c\u1ee1 x\u00e1c \u0111\u1ecbnh, l\u1ecdc ra c\u00e1c h\u1ea1t HA c\u00f3 k\u00edch th\u01b0\u1edbc mong mu\u1ed1n, \u0111\u1ec3 so s\u00e1nh, HA<\/p>\n

      \n
    • pha kh\u00f4ng tr\u1ea3i qua qu\u00e1 tr\u00ecnh \u0111\u1ecbnh c\u1ee1 h\u1ea1t, v\u00e0 do \u0111\u00f3, n\u00f3 gi\u1ed1ng 1 lo\u1ea1i gel \u0111\u1ed3ng nh\u1ea5t ch\u1ee9a c\u00e1c h\u1ea1t c\u00f3 h\u00ecnh d\u1ea1ng v\u00e0 k\u00edch th\u01b0\u1edbc h\u1ed7n h\u1ee3p. Do \u0111\u00f3, HA<\/li>\n
    • pha r\u1eafn ch\u1eafc h\u01a1n, \u0111\u00e0n h\u1ed3i h\u01a1n, v\u00e0 h\u1ea1t trong gel c\u00f3 c\u1ea3m gi\u00e1c r\u1eafn ch\u1eafc, trong khi HA 1 pha c\u00f3 k\u1ebft c\u1ea5u m\u1ec1m h\u01a1n v\u00e0 m\u1ecbn h\u01a1n, l\u1ecfng h\u01a1n v\u1edbi \u0111\u1ed9 k\u1ebft d\u00ednh m\u1ec1m m\u1ea1i nh\u1ea5t qu\u00e1n. V\u1ec1 m\u1eb7t n\u00e0y, Restylane SubQ c\u00f3 k\u00edch th\u01b0\u1edbc h\u1ea1t l\u1edbn nh\u1ea5t trong s\u1ed1 c\u00e1c s\u1ea3n ph\u1ea9m Restylane, bao g\u1ed3m c\u00e1c h\u1ea1t l\u1edbn \u0111\u1ebfn m\u1ee9c c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y b\u1eb1ng m\u1eaft th\u01b0\u1eddng, c\u00f3 \u0111\u01b0\u1eddng k\u00ednh g\u1ea7n 1mm.<\/li>\n<\/ul>\n

      Tuy nhi\u00ean, v\u1ec1 m\u1eb7t khoa h\u1ecdc, vi\u1ec7c ph\u00e2n lo\u1ea1i ch\u1ea5t l\u00e0m \u0111\u1ea7y l\u00e0 1 hay 2 pha l\u00e0 kh\u00f4ng ph\u00f9 h\u1ee3p, v\u00ec t\u1ea5t c\u1ea3 c\u00e1c gel HA \u0111\u1ec1u bao g\u1ed3m c\u00e1c ph\u1ea7n nh\u1ecf gel khi \u0111\u01b0\u1ee3c ki\u1ec3m tra d\u01b0\u1edbi k\u00ednh hi\u1ec3n vi (h\u00ecnh 2.12). Thu\u1eadt ng\u1eef \u201cfiller HA 1 pha\u201d ban \u0111\u1ea7u \u0111\u01b0\u1ee3c Juvederm \u1ee7ng h\u1ed9 v\u1edbi m\u1ee5c \u0111\u00edch ph\u00e2n bi\u1ec7t filler HA m\u1ec1m c\u1ee7a h\u1ecd v\u1edbi filler NASHA ban \u0111\u1ea7u, Restylane v\u1edbi \u0111\u1eb7c \u0111i\u1ec3m gel c\u1ee9ng. Tuy nhi\u00ean, thu\u1eadt ng\u1eef gel HA 1 pha th\u1ef1c s\u1ef1 \u0111\u1ea1i di\u1ec7n cho 1 ngh\u1ecbch l\u00fd, theo \u0111\u1ecbnh ngh\u0129a, ch\u00fang t\u1ed3n t\u1ea1i nh\u01b0 1 h\u1ed7n h\u1ee3p c\u1ee7a pha l\u1ecfng trong 1 pha r\u1eafn, do \u0111\u00f3 \u00edt nh\u1ea5t l\u00e0 ch\u00fang 2 pha v\u1ec1 t\u00ednh ch\u1ea5t v\u1ea5t l\u00fd. Theo logic n\u00e0y, ng\u01b0\u1eddi ta c\u00f3 th\u1ec3 tranh lu\u1eadn r\u1eb1ng ch\u1ea5t l\u00e0m \u0111\u1ea7y HA 2 pha n\u00ean \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 1 c\u00e1ch th\u00edch h\u1ee3p h\u01a1n nh\u01b0 1 lo\u1ea1i gel 3 pha [11]. H\u01a1n n\u1eefa, m\u1ed9t s\u1ed1 ch\u1ea5t l\u00e0m \u0111\u1ea7y HA th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i l\u00e0 ch\u1ea5t l\u00e0m \u0111\u1ea7y HA 1 pha nh\u01b0 Restylane Volyme v\u00e0 Restylane R\u00e8yne s\u1eed d\u1ee5ng c\u00f4ng ngh\u1ec7 OBT c\u0169ng cho th\u1ea5y k\u00edch th\u01b0\u1edbc h\u1ea1t g\u1ea7n nh\u01b0 \u0111\u1ed3ng nh\u1ea5t do qu\u00e1 tr\u00ecnh s\u00e0ng l\u1ecdc trong qui tr\u00ecnh s\u1ea3n xu\u1ea5t \u0111\u1ec3 c\u00f3 \u0111\u1ed9 \u0111\u1ed3ng nh\u1ea5t t\u1ed1i \u01b0u. Tuy nhi\u00ean, nh\u1eefng thu\u1eadt ng\u1eef n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng nh\u01b0 1 c\u00e1ch vi\u1ebft t\u1eaft \u0111\u1ec3 m\u00f4 t\u1ea3 \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a c\u00e1c ch\u1ea5t l\u00e0m \u0111\u1ea7y HA kh\u00e1c nhau nh\u1eb1m h\u1ed7 tr\u1ee3 th\u00f4ng tin cho c\u00e1c b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb. Do \u0111\u00f3, c\u1ea7n l\u01b0u \u00fd r\u1eb1ng c\u00e1c thu\u1eadt ng\u1eef \u201c1pha” hay \u201c2 pha\u201d nh\u01b0 \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp ch\u1ec9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho m\u1ee5c \u0111\u00edch thu\u1eadn ti\u1ec7n m\u00e0 th\u00f4i. Tuy nhi\u00ean, vi\u1ec7c m\u00f4 t\u1ea3 ch\u1ea5t l\u00e0m \u0111\u1ea7y HA \u0111\u1ec3 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i nh\u1ea5t cho l\u1ef1a ch\u1ecdn 1 ch\u1ea5t l\u00e0m \u0111\u1ea7y nh\u1ea5t \u0111\u1ecbnh cho 1 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng nh\u1ea5t \u0111\u1ecbnh n\u00ean s\u1eed d\u1ee5ng c\u00e1c x\u00e9t nghi\u1ec7m khoa h\u1ecdc nh\u01b0 ph\u00e9p \u0111o l\u01b0u bi\u1ebfn.<\/p>\n

      V\u1ec1 \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn c\u1ee7a ch\u00fang, ch\u1ea5t l\u00e0m \u0111\u1ea7y HA 2 pha c\u1ee9ng c\u00f3 xu h\u01b0\u1edbng th\u1ec3 hi\u1ec7n \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u00e0 \u0111\u1ed9 nh\u1edbt cao h\u01a1n HA 1 pha m\u1ec1m (b\u1ea3ng 2.2), cho ph\u00e9p gi\u1eef h\u00ecnh d\u1ea1ng t\u1ed1t h\u01a1n ch\u1ed1ng l\u1ea1i ngo\u1ea1i l\u1ef1c v\u00e0 kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y cao h\u01a1n [11]. Do \u0111\u00f3, HA 2 pha ph\u00f9 h\u1ee3p \u0111\u1ec3 \u0111\u01b0a v\u00e0o c\u00e1c m\u1eb7t ph\u1eb3ng s\u00e2u h\u01a1n, n\u01a1i ch\u00fang c\u00f3 th\u1ec3 l\u00e0m \u0111\u1ea7y c\u00e1c m\u00f4 s\u00e2u ho\u1eb7c h\u1ed7 tr\u1ee3 cho s\u1ef1 suy gi\u1ea3m th\u1ec3 t\u00edch v\u00f9ng m\u1eb7t nh\u01b0ng \u00edt ph\u00f9 h\u1ee3p h\u01a1n v\u1edbi ti\u00eam b\u1ec1 m\u1eb7t \u1edf l\u1edbp h\u1ea1 b\u00ec v\u00e0 kh\u00f4ng d\u1ec5 d\u00e0ng t\u1ea1o h\u00ecnh sau ti\u00eam.<\/p>\n

      Ng\u01b0\u1ee3c l\u1ea1i, HA 1 pha c\u00f3 xu h\u01b0\u1edbng c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u00e0 \u0111\u1ed9 nh\u1edbt th\u1ea5p h\u01a1n nh\u01b0ng th\u1ec3 hi\u1ec7n m\u1ee9c \u0111\u1ed9 g\u1eafn k\u1ebft cao h\u01a1n so v\u1edbi HA 2 pha t\u1ed3n t\u1ea1i d\u01b0\u1edbi d\u1ea1ng c\u00e1c h\u1ea1t gel ri\u00eang l\u1ebb, t\u1eadp h\u1ee3p l\u1ea1i v\u1edbi nhau nh\u01b0 c\u00e1c h\u1ea1t c\u00e1t. T\u00ednh li\u00ean k\u1ebft l\u00e0 1 y\u1ebfu t\u1ed1 l\u01b0u bi\u1ebfn quy\u1ebft \u0111\u1ecbnh quan tr\u1ecdng kh\u00e1c cho bi\u1ebft kh\u1ea3 n\u0103ng c\u1ee7a 1 s\u1ea3n ph\u1ea9m ch\u1ed1ng l\u1ea1i s\u1ef1 bi\u1ebfn d\u1ea1ng do ngo\u1ea1i l\u1ef1c b\u00ean ngo\u00e0i. \u0110\u00e1ng ch\u00fa \u00fd, trong nghi\u00ean c\u1ee9u c\u1ee7a Sundaram v\u00e0 nh\u1eefng ng\u01b0\u1eddi kh\u00e1c, th\u00ec Belotero Balance v\u00e0 Juvederm Ultra Plus ( c\u1ea3 2 \u0111\u1ec1u l\u00e0 HA 1 pha m\u1ec1m) cho th\u1ea5y \u0111i\u1ec3m s\u1ed1 g\u1eafn k\u1ebft cao nh\u1ea5t trong khi Restylane l\u00e0 ch\u1ea5t l\u00e0m \u0111\u1ea7y HA 2 pha cho th\u1ea5y \u0111\u1ed9 g\u1eafn k\u1ebft th\u1ea5p nh\u1ea5t ( B\u1ea3ng 2.2) [13]. Filler HA m\u1ec1m h\u01a1n v\u1edbi ch\u1ec9 s\u1ed1 G’ th\u1ea5p h\u01a1n v\u00e0 c\u00f3 \u0111\u1ed9 li\u00ean k\u1ebft cao h\u01a1n ph\u00f9 h\u1ee3p h\u01a1n filler c\u1ee9ng \u0111\u1ec3 ti\u00eam v\u00e0o nh\u1eefng v\u00f9ng da m\u1eb7t c\u1eed \u0111\u1ed9ng nhi\u1ec1u nh\u01b0 tr\u00e1n, r\u00e3nh m\u0169i m\u00e1, v\u00ec filler 1 pha c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i h\u00ecnh d\u1ea1ng ban \u0111\u1ea7u hi\u1ec7u qu\u1ea3 h\u01a1n m\u00e0 kh\u00f4ng b\u1ecb bi\u1ebfn d\u1ea1ng do c\u00e1c chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a c\u01a1 m\u1eb7t. Ngo\u00e0i ra, do c\u00f3 \u0111\u1ed9 nh\u1edbt th\u1ea5p h\u01a1n, filler HA 1 pha c\u00f3 th\u1ec3 t\u1ea1o ra hi\u1ec7u qu\u1ea3 d\u1ec5 d\u00e0ng ngay c\u1ea3 khi \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o b\u1ec1 m\u1eb7t l\u1edbp h\u1ea1 b\u00ec v\u00ec ch\u00fang d\u1ec5 d\u00e0ng lan truy\u1ec1n qua m\u1eb7t ph\u1eb3ng m\u00f4 v\u00e0 t\u1ea1o h\u00ecnh d\u1ec5 d\u00e0ng. [14]\n

      Do t\u00ednh \u01b0a n\u01b0\u1edbc, filler HA c\u00f3 th\u1ec3 t\u0103ng th\u1ec3 t\u00edch trong v\u00f2ng 2-4 tu\u1ea7n sau ti\u00eam v\u00e0 do \u0111\u00f3, c\u00f3 th\u1ec3 g\u00e2y t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n l\u00e0 v\u00f3n c\u1ee5c v\u00e0 kh\u00f4ng \u0111\u1ec1\u00f9. \u0110\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng v\u00f9ng c\u00f3 m\u00f4 m\u1ecfng bao ph\u1ee7 ph\u01b0 quanh h\u1ed1c m\u1eaft (h\u00ecnh 2.13). S\u1ef1 tr\u01b0\u01a1ng n\u1edf sau ti\u00eam do qu\u00e1 tr\u00ecnh hidrat h\u00f3a c\u00e1c ph\u00e2n t\u1eed HA d\u01b0\u1eddng nh\u01b0 x\u1ea3y ra nhi\u1ec1u h\u01a1n \u1edf filler HA m\u1ec1m 1 pha so v\u1edbi filler HA c\u1ee9ng 2 pha, trong khi c\u00e1c \u0111i\u1ec1u ki\u1ec7n kh\u00e1c nh\u01b0 n\u1ed3ng \u0111\u1ed9 HA c\u0169ng \u0111\u01b0\u1ee3c xem x\u00e9t (H\u00ecnh 2.14) [15]. \u0110\u1ed9 t\u0103ng th\u1ec3 t\u00edch c\u1ee7a HA sau ti\u00eam c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng ph\u00e9p \u0111o h\u1ec7 s\u1ed1 tr\u01b0\u01a1ng n\u1edf, \u0111\u00e2y l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a tr\u1ea1ng th\u00e1i hidrat h\u00f3a (b\u00e3o h\u00f2a) c\u1ee7a gel HA [17]. Khi g\u1ea7n b\u00e3o h\u00f2a (g\u1ea7n tr\u1ea1ng th\u00e1i c\u00e2n b\u1eb1ng) gel s\u1ebd kh\u00f4ng b\u1ecb t\u0103ng th\u1ec3 t\u00edch \u0111\u00e1ng k\u1ec3 sau ti\u00eam. D\u01b0\u1edbi m\u1ee9c c\u00e2n b\u1eb1ng (kh\u00f4ng b\u00e3o h\u00f2a) gel s\u1ebd s\u1eb5n s\u00e0ng l\u1ea5y n\u01b0\u1edbc t\u1eeb ch\u1ea5t l\u1ecfng xung quanh cho t\u1edbi khi n\u00f3 \u0111\u1ea1t \u0111\u1ebfn tr\u1ea1ng th\u00e1i c\u00e2n b\u1eb1ng hidrat h\u00f3a. \u0110\u1eb7c \u0111i\u1ec3m h\u1ea5p th\u1ee5 ch\u1ea5t l\u1ecfng c\u1ee7a gel kh\u00e1c nhau gi\u1eefa c\u00e1c s\u1ea3n ph\u1ea9m v\u00e0 ph\u1ee5 thu\u1ed9c v\u00e0o n\u1ed3ng \u0111\u1ed9 HA v\u00e0 b\u1ecb gi\u1edbi h\u1ea1n b\u1edfi m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o. Nh\u00ecn chung, khi m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o t\u0103ng l\u00ean trong filler HA c\u00f3 m\u1ee9c \u0111\u1ed9 G’ cao th\u00ec \u0111\u1ed9 tr\u01b0\u01a1ng n\u1edf s\u1ebd gi\u1ea3m. Ng\u01b0\u1ee3c l\u1ea1i, gel m\u1ec1m h\u01a1n v\u1edbi m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o th\u1ea5p h\u01a1n v\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 m\u1ee9c \u0111\u1ed9 G’ th\u1ea5p h\u01a1n s\u1ebd c\u00f3 h\u1ec7 s\u1ed1 tr\u01b0\u01a1ng n\u1edf cao h\u01a1n. C\u0169ng c\u00f3 th\u1ec3 gi\u1ea3 thi\u1ebft \u0111i\u1ec1u n\u00e0y 1 ph\u1ea7n l\u00e0 do xu h\u01b0\u1edbng lan r\u1ed9ng h\u01a1n c\u1ee7a HA 1 pha m\u1ec1m trong m\u00f4, khi\u1ebfn di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t gel ti\u1ebfp x\u00fac v\u1edbi n\u01b0\u1edbc trong m\u00f4 l\u1edbn h\u01a1n. \u0110i\u1ec1u n\u00e0y tr\u00e1i ng\u01b0\u1ee3c v\u1edbi c\u00e1c filler HA 2 pha \u00edt lan r\u1ed9ng h\u01a1n \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o m\u00f4 theo c\u00e1ch c\u00f3 m\u1ee5c ti\u00eau v\u00e0 do \u0111\u00f3 c\u00f3 di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t h\u1ea1n ch\u1ebf h\u01a1n trong m\u00f4. \u0110\u00e1ng ch\u00fa \u00fd, Juvederm Ultra Plus, d\u1ef1a tr\u00ean c\u00f4ng ngh\u1ec7 HYLACROSS v\u1edbi n\u1ed3ng \u0111\u1ed9 HA l\u00e0 24mg\/ml v\u00e0 Belotero Volume k\u1ebft h\u1ee3p c\u00f4ng ngh\u1ec7 CPMT v\u1edbi n\u1ed3ng \u0111\u1ed9 HA l\u00e0 26mg\/ml l\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m HA 1 pha \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 c\u00f3 kh\u1ea3 n\u0103ng t\u0103ng th\u1ec3 t\u00edch \u0111\u00e1ng k\u1ec3 sau ti\u00eam (B\u1ea3ng 2.2). Do v\u1eady, ch\u00fang kh\u00f4ng th\u00edch h\u1ee3p \u0111\u1ec3 ti\u00eam \u1edf nh\u1eefng v\u00f9ng da m\u1ecfng tr\u00ean m\u1eb7t, ngay c\u1ea3 khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ebb t\u1ea1o \u0111\u01b0\u1eddng n\u00e9t v\u00e0 t\u1ea1o
      \nh\u00ecnh, n\u00ean pha lo\u00e3ng s\u1ea3n ph\u1ea9m v\u1edbi n\u01b0\u1edbc mu\u1ed1i v\u1edbi t\u1ec9 l\u1ec7 6:4, v\u1edbi 6 ph\u1ea7n HA v\u00e0 4 ph\u1ea7n n\u01b0\u1edbc mu\u1ed1i t\u01b0\u01a1ng \u1ee9ng (xem ph\u1ea7n 3.1.3).<\/p>\n

      B\u1ea3ng 2.2: <\/strong>\u0110\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn, m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft, v\u00e0 kh\u1ea3 n\u0103ng t\u0103ng th\u1ec3 t\u00edch
      \ntrong l\u00e2m s\u00e0ng c\u1ee7a 9 lo\u1ea1i filler HA<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
      S\u1ea3n ph\u1ea9m<\/td>\nKh\u1ea3 n\u0103n g<\/p>\n

      l\u00e0m \u0111\u1ea7y<\/td>\n

      		Kh\u1ea3 n\u0103n g li\u00ean k\u1ebft<\/td>\nT\u00ednh su\u1ea5t 0.7 Hz<\/td>\nCh\u1ea5t c\u1eaft<\/td>\n\u1ee9ng \u1edf<\/td>\nKh\u1ea3 n\u0103ng n\u00e9n t\u0129nh \u1edf 1.5 mm<\/td>\nKh\u1ea3 \u0111\u1ed9ng<\/td>\nN\u0103ng \u1edf<\/td>\nN\u00e9n<\/p>\n

      0.7 Hz<\/td>\n

      		<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\nG’<\/td>\nG”<\/td>\nTan \u00f5<\/td>\nFn (N’)<\/td>\nE'(Pa)<\/td>\nE” (Pa)<\/td>\nTan \u00f5c<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\n(Pa)<\/td>\n(Pa)<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
      BELOTER<\/td>\n+<\/td>\n5<\/td>\n63 \u00b1<\/td>\n34\u00b12<\/td>\n0.54\u00b10.<\/td>\n0.51\u00b10.<\/td>\n31,457\u00b111<\/td>\n18,541\u00b14<\/td>\n0.59\u00b10.<\/td>\n<\/td>\n<\/tr>\n
      O<\/p>\n

      Balance<\/td>\n

      		<\/td>\n3<\/td>\n<\/td>\n04<\/td>\n02<\/td>\n32<\/td>\n72<\/td>\n03<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/tr>\n
      BELOTER<\/td>\n++<\/td>\n4<\/td>\n130\u00b1<\/td>\n52\u00b12<\/td>\n0.4\u00b10.0<\/td>\n1.06\u00b10.<\/td>\n59,150\u00b114<\/td>\n32,235\u00b16<\/td>\n0.54\u00b10.<\/td>\n<\/td>\n<\/tr>\n
      O Intense Lidocain<\/td>\n<\/td>\n<\/td>\n3<\/td>\n<\/td>\n2<\/td>\n03<\/td>\n69<\/td>\n22<\/td>\n02<\/td>\n<\/td>\n<\/tr>\n
      BELOTER<\/td>\n++<\/td>\n3<\/td>\n300\u00b1<\/td>\n57\u00b11<\/td>\n0.19\u00b10.<\/td>\n0.95\u00b10.<\/td>\n111,044\u00b12<\/td>\n58,047\u00b11<\/td>\n0.52\u00b10.<\/td>\n<\/td>\n<\/tr>\n
      O Volume Lidocain<\/td>\n+<\/td>\n5<\/td>\n<\/td>\n01<\/td>\n03<\/td>\n250<\/td>\n880<\/td>\n01<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/tr>\n
      JUVEDER<\/td>\n+<\/td>\n2<\/td>\n174\u00b1<\/td>\n28\u00b11<\/td>\n0.16\u00b10.<\/td>\n0.15\u00b10.<\/td>\n12,003\u00b140<\/td>\n25,270\u00b11<\/td>\n2.11\u00b10.<\/td>\n<\/td>\n<\/tr>\n
      M Volbela<\/td>\n<\/td>\n4<\/td>\n<\/td>\n01<\/td>\n01<\/td>\n0<\/td>\n015<\/td>\n08<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/tr>\n
      JUVEDER<\/td>\n++<\/td>\n2<\/td>\n279\u00b1<\/td>\n39\u00b12<\/td>\n0.14\u00b10.<\/td>\n0.22\u00b10.<\/td>\n21,994\u00b137<\/td>\n44,287\u00b11<\/td>\n2.01\u00b10.<\/td>\n<\/td>\n<\/tr>\n
      M<\/td>\n<\/td>\n6<\/td>\n<\/td>\n01<\/td>\n01<\/td>\n8<\/td>\n316<\/td>\n05<\/td>\n<\/td>\n<\/tr>\n
      Volift<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
      JUVEDER<\/td>\n++<\/td>\n2<\/td>\n314\u00b1<\/td>\n17\u00b11<\/td>\n0.06\u00b10.<\/td>\n0.33\u00b10.<\/td>\n41,747\u00b194<\/td>\n60,382\u00b11<\/td>\n1.45\u00b10.<\/td>\n<\/td>\n<\/tr>\n
      M<\/p>\n

      Voluma<\/td>\n

      		+<\/td>\n<\/td>\n5<\/td>\n<\/td>\n00<\/td>\n02<\/td>\n7<\/td>\n898<\/td>\n02<\/td>\n<\/td>\n<\/tr>\n
      RESTYLA<\/td>\n+<\/td>\n1<\/td>\n677\u00b1<\/td>\n136\u00b1<\/td>\n0.2\u00b10.0<\/td>\n0.23\u00b10.<\/td>\n8,456\u00b1256<\/td>\n32,469\u00b18<\/td>\n3.84\u00b10.<\/td>\n<\/td>\n<\/tr>\n
      NE lidocain<\/td>\n<\/td>\n13<\/td>\n3<\/td>\n1<\/td>\n01<\/td>\n<\/td>\n54<\/td>\n17<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/tr>\n
      RESTYLA<\/td>\n++<\/td>\n1<\/td>\n716\u00b1<\/td>\n110\u00b1<\/td>\n0.15\u00b10.<\/td>\n0.3\u00b10.0<\/td>\n9,507\u00b1216<\/td>\n35,184\u00b17<\/td>\n3.7\u00b10.0<\/td>\n<\/td>\n<\/tr>\n
      NE Lift lidocain<\/td>\n<\/td>\n9<\/td>\n4<\/td>\n01<\/td>\n1<\/td>\n<\/td>\n35<\/td>\n4<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/tr>\n
      JUVEDER<\/td>\n++<\/td>\n4<\/td>\n143\u00b1<\/td>\n36\u00b12<\/td>\n0.26\u00b10.<\/td>\n0.98\u00b10.<\/td>\n65,554\u00b118<\/td>\n23,856\u00b13<\/td>\n0.36\u00b10.<\/td>\n<\/td>\n<\/tr>\n
      M<\/td>\n<\/td>\n5<\/td>\n<\/td>\n02<\/td>\n02<\/td>\n91<\/td>\n30<\/td>\n02<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

      Ultraplu s XC<\/p>\n

      L\u1ef1a ch\u1ecdn ch\u1ea5t l\u00e0m \u0111\u1ea7y HA<\/h3>\n

      Ba y\u1ebfu t\u1ed1 ch\u00ednh c\u1ea7n xem x\u00e9t trong vi\u1ec7c l\u1ef1a ch\u1ecdn 1 s\u1ea3n ph\u1ea9m ch\u1ea5t l\u00e0m \u0111\u1ea7y l\u00e0 an to\u00e0n, tu\u1ed5i th\u1ecd v\u00e0 gi\u00e1 c\u1ea3 nh\u01b0 c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 th\u01b0\u1eddng xuy\u00ean nh\u1ea5n m\u1ea1nh trong c\u00e1c b\u00e0i thuy\u1ebft tr\u00ecnh t\u1eeb \u0111\u1ea7u nh\u1eefng n\u0103m 2000 (H\u00ecnh 2.15). Trong \u0111\u00f3, t\u00ednh an to\u00e0n \u0111\u01b0\u1ee3c \u01b0u ti\u00ean h\u00e0ng \u0111\u1ea7u, v\u00ec ch\u1ea5t l\u00e0m \u0111\u1ea7y v\u1ec1 c\u01a1 b\u1ea3n \u0111\u1ea1i di\u1ec7n cho c\u00e1c ch\u1ea5t b\u00ean ngo\u00e0i \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o c\u01a1 th\u1ec3 ng\u01b0\u1eddi. \u1ede \u0111i\u1ec3m n\u00e0y, HA l\u00e0m t\u1ed1t nh\u1ea5t trong t\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i ch\u1ea5t l\u00e0m \u0111\u1ea7y m\u00f4 m\u1ec1m kh\u00e1c hi\u1ec7n c\u00f3 tr\u00ean th\u1ecb tr\u01b0\u1eddng. Kh\u00f4ng ch\u1ec9 gi\u1ea3m thi\u1ec3u r\u1ee7i ro v\u1ec1 ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i, m\u00e0 filler HA \u0111\u01b0\u1ee3c ti\u00eam c\u00f2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n gi\u1ea3i d\u1ec5 d\u00e0ng khi ti\u00eam hyaluronodase n\u1ebfu c\u00f3 b\u1ea5t k\u1ef3 v\u1ea5n \u0111\u1ec1 n\u00e0o x\u1ea3y ra, gi\u00fap b\u1ec7nh nh\u00e2n tr\u1edf l\u1ea1i t\u00ecnh tr\u1ea1ng tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb 1 c\u00e1ch hi\u1ec7u qu\u1ea3. Tr\u01b0\u1edbc nh\u1eefng lo ng\u1ea1i g\u1ea7n \u0111\u00e2y v\u1ec1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam do ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn ch\u1eadm v\u1edbi ch\u1ea5t l\u00e0m \u0111\u1ea7y HA , th\u00ec t\u1ef7 l\u1ec7 qu\u00e1 m\u1eabn ch\u1eadm c\u0169ng tr\u1edf th\u00e0nh 1 ti\u00eau ch\u00ed an to\u00e0n \u0111\u00e1ng k\u1ec3 trong l\u1ef1a ch\u1ecdn s\u1ea3n ph\u1ea9m ch\u1ea5t l\u00e0m \u0111\u1ea7y HA.<\/p>\n

      Trong khi filler HA tr\u01b0\u1edbc \u0111\u00e2y \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 c\u00f3 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i t\u1eeb 6 th\u00e1ng – 1 n\u0103m sau khi ti\u00eam, theo quan s\u00e1t c\u1ee7a c\u00e1c t\u00e1c gi\u1ea3 cho th\u1ea5y th\u1eddi gian t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i h\u01a1n khung th\u1eddi gian \u0111\u1ec1 xu\u1ea5t n\u00e0y, th\u1eadm ch\u00ed k\u00e9o d\u00e0i t\u1eeb 5-10 n\u0103m v\u1edbi \u0111i\u1ec1u tr\u1ecb duy tr\u00ec l\u1eb7p l\u1ea1i 2-3 l\u1ea7n. Trong khi filler HA 1 pha Juvederm Voluma v\u00e0 BELOTERO Volume c\u00f3 xu h\u01b0\u1edbng t\u1ed3n t\u1ea1i l\u00e2u h\u01a1n HA 2 pha, c\u00e1c bi\u1ebfn th\u1ec3 d\u01b0\u1eddng nh\u01b0 t\u1ed3n t\u1ea1i s\u1ef1 kh\u00e1c nhau gi\u1eefa c\u00e1c b\u1ec7nh nh\u00e2n v\u00e0 gi\u1eefa c\u00e1c v\u00f9ng m\u1eb7t \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb kh\u00e1c nhau, kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 tu\u1ed5i th\u1ecd \u0111\u00e1ng k\u1ec3 gi\u1eefa c\u00e1c nh\u00e3n hi\u1ec7u filler HA kh\u00e1c nhau, mi\u1ec5n l\u00e0 ch\u00fang c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y t\u01b0\u01a1ng t\u1ef1 nhau. N\u1ebfu c\u00f3 b\u1ea5t k\u1ef3 v\u1ea5n \u0111\u1ec1 g\u00ec, th\u00ec c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 ch\u1ee9a qu\u00e1 nhi\u1ec1u li\u00ean k\u1ebft ch\u00e9o \u0111\u1ec3 t\u0103ng tu\u1ed5i th\u1ecd c\u00f3 y\u00eau c\u1ea7u x\u1eed l\u00fd c\u1ea9n th\u1eadn h\u01a1n v\u00ec ch\u00fang c\u00f3 kh\u1ea3 n\u0103ng ch\u1ed1ng b\u1ecb ph\u00e2n gi\u1ea3i b\u1edfi hyaluronidase cao h\u01a1n.<\/p>\n

      H\u00ecnh 2.13: S\u01b0ng t\u1ea5y sau ti\u00eam \u1edf m\u00e1ng l\u1ec7 xu\u1ea5t hi\u1ec7n b\u00ean ph\u1ea3i \u0111\u01b0\u1ee3c ti\u00eam v\u1edbi filler HA 1 pha (Juvederm Ultra), trong khi b\u00ean tr\u00e1i \u0111\u01b0\u1ee3c ti\u00eam v\u1edbi filler HA 2 pha cho th\u1ea5y kh\u00f4ng b\u1ecb s\u01b0ng t\u1ea5y.<\/p>\n

      H\u00ecnh 2.14: Xu h\u01b0\u1edbng th\u1eddi gian \u0111\u01b0\u1ee3c bi\u1ec3u th\u1ecb b\u1eb1ng h\u00ecnh 3D \u0111o l\u01b0\u1eddng theo c\u00e1c lo\u1ea1i filler. Kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 \u0111\u01b0\u1ee3c quan s\u00e1t gi\u1eefa filler B v\u00e0 J. Ph\u00e9p \u0111o 3D c\u1ee7a filler B lu\u00f4n l\u1edbn h\u01a1n c\u1ee7a filler R ngo\u1ea1i tr\u1eeb \u1edf 30p. H\u01a1n n\u1eefa, ph\u00e9p \u0111o 3D c\u1ee7a filler B lu\u00f4n l\u1edbn h\u01a1n c\u1ee7a filler Y \u1edf 2, 4, v\u00e0 24 tu\u1ea7n. (B: Belotero, J: Juvederm, R: Restylane, Y:YVOIRE) [15]\n

      Gi\u00e1 ch\u1eafc ch\u1eafn l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng \u0111\u1ed1i v\u1edbi b\u1ea5t k\u1ef3 ng\u01b0\u1eddi h\u00e0nh ngh\u1ec1 n\u00e0o quan t\u00e2m \u0111\u1ebfn l\u1ee3i nhu\u1eadn kinh doanh c\u1ee7a m\u00ecnh. Tuy nhi\u00ean, v\u1edbi s\u1ef1 s\u1ee5t gi\u1ea3m g\u00eda m\u1ed7i ml filler HA xu\u1ed1ng d\u01b0\u1edbi 1 n\u1eeda so v\u1edbi \u0111\u1ea7u nh\u1eefng n\u0103m 2000, gi\u00e1 filler HA \u0111\u00e3 gi\u1ea3m \u0111\u00e1ng k\u1ec3 v\u1edbi ng\u01b0\u1eddi h\u00e0nh ngh\u1ec1 b\u00ecnh th\u01b0\u1eddng. M\u1eb7c d\u00f9 v\u1eady, gi\u00e1 c\u1ee7a filler HA cho m\u1ed7i \u1ed1ng ti\u00eam v\u1eabn quan tr\u1ecdng trong tr\u01b0\u1eddng h\u1ee3p l\u00e0m \u0111\u1ea7y da m\u1eb7t c\u1ea7n \u00edt nh\u1ea5t 6-10ml \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong 1 l\u1ea7n. V\u1ec1 m\u1eb7t n\u00e0y, \u0111\u00e2y l\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n \u0111\u00e1ng hoan ngh\u00eanh do s\u1ef1 c\u1ea1nh tranh gay g\u1eaft tr\u00ean th\u1ecb tr\u01b0\u1eddng n\u1ed9i \u0111\u1ecba, c\u00e1c nh\u00e3n hi\u1ec7u filler HA c\u1ee7a H\u00e0n Qu\u1ed1c hi\u1ec7n c\u00f3 s\u1eb5n v\u1edbi gi\u00e1 th\u1eadm ch\u00ed l\u00e0 20-40USD cho m\u1ed7i \u1ed1ng ti\u00eam 1ml trong khi cho ch\u1ea5t l\u01b0\u1ee3ng t\u01b0\u01a1ng \u0111\u01b0\u01a1ng, v\u00ec gi\u00e1 c\u1ee7a ch\u00fang \u0111\u00e3 gi\u1ea3m xu\u1ed1ng c\u00f2n 1\/5-1\/10 gi\u00e1 nh\u1eadp kh\u1ea9u filler HA so v\u1edbi \u0111\u1ea7u nh\u1eefng n\u0103m 2000. \u0110i\u1ec1u n\u00e0y \u0111\u00e3 th\u00fac \u0111\u1ea9y filler HA \u0111\u01b0\u1ee3c so s\u00e1nh l\u00e0 thu\u1eadn l\u1ee3i h\u01a1n so v\u1edbi ph\u01b0\u01a1ng ph\u00e1p gh\u00e9p m\u1ee1 t\u1ef1 th\u00e2n \u1edf H\u00e0n Qu\u1ed1c, v\u00e0 cu\u1ed1i c\u00f9ng thay th\u1ebf m\u1ee1 t\u1ef1 th\u00e2n \u0111\u1ec3 l\u00e0m \u0111\u1ea7y v\u00f9ng m\u1eb7t.<\/p>\n

      Vi\u1ec7c quy\u1ebft \u0111\u1ecbnh gi\u1eefa h\u00e0ng lo\u1ea1t c\u00e1c s\u1ea3n ph\u1ea9m filler HA \u0111ang tr\u00e0n ng\u1eadp tr\u00ean th\u1ecb tr\u01b0\u1eddng c\u00f3 th\u1ec3 khi\u1ebfn ng\u01b0\u1eddi h\u00e0nh ngh\u1ec1 cho\u00e1ng ng\u1ee3p. Tuy nhi\u00ean, vi\u1ec7c l\u1ef1a ch\u1ecdn filler HA ph\u00f9 h\u1ee3p cho 1 quy tr\u00ecnh x\u00e9t v\u1ec1 nhi\u1ec1u kh\u00eda c\u1ea1nh c\u0169ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 vi\u1ec7c ch\u1ecdn \u0111\u00fang g\u1eady golf cho 1 c\u00fa \u0111\u00e1nh. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1ch 1 ng\u01b0\u1eddi \u0111\u00e1nh b\u00f3ng gi\u1ecfi kh\u00f4ng nh\u1ea5t thi\u1ebft ph\u1ea3i \u0111\u1eb7t b\u00f3ng n\u01a1i t\u1ed1t nh\u1ea5t, c\u00f3 1 ngh\u1ec7 thu\u1eadt \u0111\u1ec3 l\u1ef1a ch\u1ecdn filler HA ho\u00e0n h\u1ea3o v\u1edbi \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn ph\u00f9 h\u1ee3p \u0111\u1ec3 c\u00f3 ch\u1ec9 \u0111\u1ecbnh \u0111\u00fang. Ngo\u00e0i ra, gi\u1ed1ng nh\u01b0 1 chi\u1ebfc t\u00fai c\u1ee7a ng\u01b0\u1eddi ch\u01a1i golf th\u00f4ng th\u01b0\u1eddng ch\u01b0\u00e1 nhi\u1ec1u lo\u1ea1i g\u1eady \u0111\u00e1nh golf c\u1ee7a m\u1ed7i 1 th\u01b0\u01a1ng hi\u1ec7u kh\u00e1c nhau, ch\u1eb3ng h\u1ea1n nh\u01b0 g\u1eady s\u1eaft XXIO, g\u1eady \u0111i\u1ec1u khi\u1ec3n PING v\u00e0 g\u1eady g\u1ea1t b\u00f3ng Scotty Cameron, ng\u01b0\u1eddi h\u00e0nh ngh\u1ec1 c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p c\u00e1c s\u1ea3n ph\u1ea9m HA kh\u00e1c nhau t\u1eeb c\u00e1c nh\u00e0 s\u1ea3n xu\u1ea5t kh\u00e1c nhau, mi\u1ec5n l\u00e0 h\u1ecd c\u1ea3m th\u1ea5y tho\u1ea3i m\u00e1i nh\u1ea5t khi s\u1eed d\u1ee5ng. C\u00e1 nh\u00e2n t\u00f4i, trong h\u01a1n 10 n\u0103m \u0111\u1ea7u th\u1ef1c h\u00e0nh \u0111i\u1ec1u tr\u1ecb t\u00f4i h\u1ea7u nh\u01b0 y\u00eau th\u00edch nh\u1ea5t ch\u1ea5t l\u00e0m \u0111\u1ea7y m\u00f4 m\u1ec1m l\u00e0 Restylane. Trong v\u00f2ng 5-6 n\u0103m qua, filler HA Belotero \u0111\u00e3 \u0111\u01b0\u1ee3c th\u00eam v\u00e0o nh\u01b0 1 s\u1ef1 l\u1ef1a ch\u1ecdn \u01b0a chu\u1ed9ng c\u1ee7a t\u00f4i. V\u1ec1 c\u01a1 b\u1ea3n, s\u1ef1 l\u1ef1a ch\u1ecdn t\u1ed1t nh\u1ea5t v\u1ec1 filler HA \u0111\u1ec3 s\u1eed d\u1ee5ng l\u00e0 s\u1ef1 \u0111\u00e1nh gi\u00e1 c\u1ee7a m\u1ed7i ng\u01b0\u1eddi h\u00e0nh ngh\u1ec1 d\u1ef1a tr\u00ean m\u1ee9c \u0111\u1ed9 tho\u1ea3i m\u00e1i c\u1ee7a h\u1ecd v\u1edbi s\u1ea3n ph\u1ea9m, v\u00f9ng m\u1ee5c ti\u00eau, m\u1eb7t ph\u1eb3ng ti\u00eam v\u00e0 \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn c\u1ee7a s\u1ea3n ph\u1ea9m, t\u1ee9c l\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u00e0 t\u00ednh li\u00ean k\u1ebft c\u1ee7a HA v\u00e0 m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o (h\u00ecnh 2.16), vv. Do \u0111\u00f3, th\u01b0\u1eddng k\u1ebft h\u1ee3p c\u00e1c nh\u00e3n hi\u1ec7u filler HA kh\u00e1c nhau c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c v\u00f9ng m\u1eb7t kh\u00e1c nhau c\u1ee7a 1 b\u1ec7nh nh\u00e2n nh\u1ea5t \u0111\u1ecbnh. V\u00ed d\u1ee5, b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng Restylane cho m\u0169i ho\u1eb7c r\u00e3nh l\u1ec7 k\u1ebft h\u1ee3p v\u1edbi Bolotero Volume cho v\u00f9ng m\u00e1 tr\u01b0\u1edbc ho\u1eb7c m\u00e1 h\u00f3p. Ngo\u00e0i ra, c\u00e1c s\u1ea3n ph\u1ea9m HA kh\u00e1c nhau trong c\u00f9ng d\u00f2ng filler HA c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c tri\u1ec3n khai \u1edf c\u00e1c ti\u1ec3u \u0111\u01a1n v\u1ecb kh\u00e1c nhau c\u1ee7a 1 v\u00f9ng da m\u1eb7t nh\u1ea5t \u0111\u1ecbnh. 1 v\u00ed d\u1ee5 \u0111i\u1ec3n h\u00ecnh l\u00e0 vi\u1ec7c s\u1eed d\u1ee5ng Belotero Volume \u0111\u1ec3 l\u00e0m \u0111\u1ea7y ph\u1ea7n c\u00e1nh m\u00f4i v\u00e0 Belotero Balance \u0111\u1ec3 nh\u1ea5n v\u00f9ng vi\u1ec1n m\u00f4i.<\/p>\n

      L\u1ef1a ch\u1ecdn filler HA d\u1ef1a tr\u00ean khu v\u1ef1c m\u1eb7t: <\/strong>Theo nguy\u00ean t\u1eafc chung, vi\u1ec7c s\u1eed d\u1ee5ng filler HA 2 pha c\u1ee9ng v\u1edbi G’ cao h\u01a1n nh\u01b0 Restylane \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u00ean trong c\u00e1c v\u00f9ng da m\u1ecfng nh\u01b0 v\u00f9ng quanh m\u1eaft, bao g\u1ed3m cu\u1ed9n m\u00ed m\u1eaft d\u01b0\u1edbi, r\u00e3nh l\u1ec7, v\u00e0 m\u00ed m\u1eaft tr\u00ean, \u0111\u1ec3 tr\u00e1nh hi\u1ec7n t\u01b0\u1ee3ng s\u01b0ng ph\u1ed3ng sau ti\u00eam do c\u00e1c ph\u00e2n t\u1eed HA ng\u1eadm n\u01b0\u1edbc. V\u00ec l\u00fd do n\u00e0y, filler HA 2 pha c\u1ee9ng v\u1edbi G’ cao h\u01a1n c\u0169ng ph\u00f9 h\u1ee3p \u0111\u1ec3 n\u00e2ng cao s\u1ed1ng m\u0169i v\u00f9ng da m\u1ecfng. N\u00f3i chung, c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 G’ cao h\u01a1n, k\u00edch th\u01b0\u1edbc h\u1ea1t l\u1edbn h\u01a1n ho\u1eb7c c\u00f3 n\u1ed3ng \u0111\u1ed9 HA cao h\u01a1n th\u00edch h\u1ee3p cho c\u00e1c ch\u1ec9 \u0111\u1ecbnh l\u00e0m t\u0103ng th\u1ec3 t\u00edch v\u00ec ch\u00fang cung c\u1ea5p h\u1ed7 tr\u1ee3 c\u1ea5u tr\u00fac t\u1ed1t h\u01a1n b\u1ea5t k\u1ec3 ch\u00fang l\u00e0 filler m\u1ec1m hay c\u1ee9ng. M\u1eb7t kh\u00e1c, filler HA 1 pha m\u1ec1m v\u1edbi G’ cao h\u01a1n t\u01b0\u01a1ng \u0111\u1ed1i v\u00e0 \u0111\u1ed9 li\u00ean k\u1ebft cao h\u01a1n ch\u1eb3ng h\u1ea1n nh\u01b0 Belotero Volume, Juvederm Voluma v\u00e0 Restylane Volyme th\u01b0\u1eddng th\u00edch h\u1ee3p cho vi\u1ec7c t\u1eadp trung v\u00e0o c\u00e1c khu v\u1ef1c c\u00f3 t\u00ednh di \u0111\u1ed9ng cao nh\u01b0 v\u00f9ng g\u00f2 m\u00e1, r\u00e3nh c\u01b0\u1eddi, tr\u00e1n v\u00e0 th\u00e1i d\u01b0\u01a1ng n\u01a1i c\u00f3 l\u1ef1c t\u00e1c \u0111\u1ed9ng \u0111\u00e1ng k\u1ec3 do c\u00e1c chuy\u1ec3n \u0111\u1ed9ng c\u01a1 b\u00ean d\u01b0\u1edbi t\u00e1c \u0111\u1ed9ng. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb cho v\u00f9ng m\u00f4i c\u1ea7n c\u00f3 k\u1ebft c\u1ea5u m\u1ec1m m\u1ea1i, m\u01b0\u1ee3t m\u00e0 khi ch\u1ea1m v\u00e0o ch\u1ec9 n\u00ean th\u1ef1c hi\u1ec7n v\u1edbi c\u00e1c s\u1ea3n ph\u1ea9m filler 1 pha m\u1ec1m h\u01a1n v\u1edbi G’ th\u1ea5p h\u01a1n nh\u01b0 Belotero Intense, Restylane Kysse v\u00e0 Juvederm Ultra XC. Ng\u01b0\u1ee3c l\u1ea1i, filler HA 2 pha c\u1ee9ng h\u01a1n \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng \u1edf nh\u1eefng v\u00f9ng c\u1eb1m, s\u1ed1ng m\u0169i, n\u01a1i mong mu\u1ed1n c\u00f3 k\u1ebft c\u1ea5u r\u00f5 n\u00e9t.<\/p>\n

      L\u1ef1a ch\u1ecdn filler HA d\u1ef1a tr\u00ean ch\u1ea5t l\u01b0\u1ee3ng da: <\/strong>\u0110\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 l\u00e0n da m\u1ecfng, n\u01a1i c\u00f3 kh\u1ea3 n\u0103ng s\u1edd\/ nh\u00ecn th\u1ea5y s\u1ea3n ph\u1ea9m l\u00e0 y\u1ebfu t\u1ed1 quan tr\u1ecdng c\u1ea7n c\u00e2n nh\u1eafc, c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 gi\u00e1 tr\u1ecb G’ th\u1ea5p h\u01a1n th\u01b0\u1eddng l\u00e0 th\u00edch h\u1ee3p nh\u1ea5t. C\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 gi\u00e1 tr\u1ecb G’ th\u1ea5p h\u01a1n v\u00ed d\u1ee5 nh\u01b0 BELOTERO Intense, Restylane Define, Juvederm Volift, v\u00e0 Juvederm Ultra Plus XC th\u00ec m\u1ec1m h\u01a1n, v\u00e0 d\u1ec5 d\u00e0ng ph\u00e2n b\u1ed1 \u1edf trong m\u00f4.<\/p>\n

      L\u1ef1a ch\u1ecdn filler HA d\u1ef1a tr\u00ean m\u1eb7t ph\u1eb3ng ti\u00eam: <\/strong>Nh\u00ecn chung, c\u00e1c s\u1ea3n ph\u1ea9m c\u1ee9ng h\u01a1n c\u00f3 gi\u00e1 tr\u1ecb G’ cao h\u01a1n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh ti\u00eam \u1edf c\u00e1c m\u1eb7t ph\u1eb3ng s\u00e2u h\u01a1n v\u00e0 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng \u0111\u1ec3 h\u1ed7 tr\u1ee3 m\u1ee9c \u0111\u1ed9 \u0111i\u1ec1u ch\u1ec9nh t\u1ed1t h\u01a1n, trong khi c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 G’ th\u1ea5p h\u01a1n m\u1ec1m h\u01a1n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c m\u1eb7t ph\u1eb3ng s\u00e2u h\u01a1n v\u00e0 \u0111i\u1ec1u ch\u1ec9nh \u00edt nghi\u00eam ng\u1eb7t h\u01a1n. C\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 G’ cao h\u01a1n ph\u00f9 h\u1ee3p v\u1edbi c\u00e1c ch\u1ec9 \u0111\u1ecbnh y\u00eau c\u1ea7u t\u0103ng th\u1ec3 t\u00edch v\u00ec ch\u00fang cung c\u1ea5p h\u1ed7 tr\u1ee3 c\u1ea5u tr\u00fac t\u1ed1t h\u01a1n trong m\u00f4 s\u00e2u. C\u00e1c khu v\u1ef1c nh\u01b0 m\u00e1 sau, c\u1eb1m, jawline n\u01a1i c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 th\u1ec3 \u0111\u1eb7t tr\u00ean x\u01b0\u01a1ng, th\u00ec c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 G’ cao h\u01a1n nh\u01b0 BELOTERO Volume, Restylane Lift v\u00e0 Juvederm Voluma s\u1ebd mang l\u1ea1i l\u1ee3i th\u1ebf l\u1edbn h\u01a1n so v\u1edbi s\u1ea3n ph\u1ea9m c\u00f3 G’ th\u1ea5p h\u01a1n b\u1edfi v\u00ec n\u00f3 s\u1ebd c\u00f3 kh\u1ea3 n\u0103ng kh\u00e1ng l\u1ef1c l\u1edbn h\u01a1n v\u1edbi c\u00e1c l\u1ef1c n\u00e9n v\u1ed1n c\u00f3 \u1edf c\u00e1c m\u1eb7t ph\u1eb3ng s\u00e2u. Trong khi \u0111\u00f3, c\u00e1c s\u1ea3n ph\u1ea9m HA m\u1ec1m hone, m\u1ecfng h\u01a1n v\u1edbi G’ th\u1ea5p h\u01a1n nh\u01b0 BELOTERO Soft, Restylane Skinbooster Vital, Restylane Fyness, v\u00e0 Juvederm Volbella th\u00ec ph\u00f9 h\u1ee3p h\u01a1n \u0111\u1ec3 th\u1ef1c hi\u1ec7n \u0111i\u1ec1u ch\u1ec9nh trong da t\u1ed1t h\u01a1n ho\u1eb7c c\u00e1c \u0111i\u1ec1u tr\u1ecb tinh vi trong da. Xem L\u1ef1a ch\u1ecdn filler theo t\u1eebng ch\u1ec9 \u0111\u1ecbnh<\/em> \u0111\u1ec3 bi\u1ebft th\u00eam chi ti\u1ebft.<\/p>\n

      T\u00ednh ch\u1ea5t l\u01b0u bi\u1ebfn c\u1ee7a filler HA ( b\u1ea3ng 2.2)<\/h3>\n

      C\u00f3 c\u00e2u m\u1ed9t ng\u01b0\u1eddi th\u1ee3 th\u1ee7 c\u00f4ng k\u00e9m c\u1ecfi th\u01b0\u1eddng \u0111\u1ed5 l\u1ed7i cho c\u00f4ng c\u1ee5 c\u1ee7a m\u00ecnh,<\/em> tuy nhi\u00ean, c\u00f3 m\u1ed9t ph\u1ea7n \u0111\u1ec3 tr\u1edf th\u00e0nh 1 th\u1ee3 th\u1ee7 c\u00f4ng b\u1eadc th\u1ea7y l\u00e0 bi\u1ebft r\u00f5 c\u00e1c c\u00f4ng c\u1ee5 c\u1ee7a m\u00ecnh. Trong c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1eb1ng filler, vi\u1ec7c l\u1ef1a ch\u1ecdn s\u1eed d\u1ee5ng HA ph\u00f9 h\u1ee3p cho 1 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng nh\u1ea5t \u0111\u1ecbnh \u0111\u00e1nh d\u1ea5u \u0111i\u1ec3m kh\u1edfi \u0111\u1ea7u \u0111\u1ec3 t\u1ea1o ra k\u1ebft qu\u1ea3 th\u1ea9m m\u1ef9 tuy\u1ec7t v\u1eddi. Theo nhi\u1ec1u kh\u00eda c\u1ea1nh, vi\u1ec7c l\u1ef1a ch\u1ecdn HA l\u00fd t\u01b0\u1edfng c\u0169ng quan tr\u1ecdng gi\u1ed1ng nh\u01b0 ch\u1ecdn \u0111\u00fang g\u1eady golf cho 1 c\u00fa \u0111\u00e1nh. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1ch 1 v\u1eadn \u0111\u1ed9ng vi\u00ean tuy\u1ec7t v\u1eddi \u0111\u00e1nh b\u00f3ng kh\u00f4ng nh\u1ea5t thi\u1ebft ph\u1ea3i l\u1ef1a ch\u1ecdn n\u01a1i \u0111\u1eb7t b\u00f3ng thu\u1eadn l\u1ee3i nh\u1ea5t, c\u00f3 1 ngh\u1ec7 thu\u1eadt \u0111\u1ec3 l\u1ef1a ch\u1ecdn filler HA ho\u00e0n h\u1ea3o \u0111\u00f3 l\u00e0 \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn ph\u00f9 h\u1ee3p cho 1 ch\u1ec9 \u0111\u1ecbnh nh\u1ea5t \u0111\u1ecbnh. C\u00e1c v\u00f9ng kh\u00e1c hau tr\u00eang\u01b0\u01a1ng m\u1eb7t c\u00f3 \u0111\u1ed9 d\u00e0y, \u0111\u1ed9 c\u0103ng, ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u01a1 v\u00e0 m\u1eadt \u0111\u1ed9 m\u00f4 kh\u00e1c nhau, m\u1ed7i lo\u1ea1i filler c\u00f3 v\u1ecb tr\u00ed ri\u00eang. V\u1ec1 m\u1eb7t n\u00e0y, s\u1ef1 hi\u1ec3u bi\u1ebft v\u1ec1 c\u00e1c thu\u1ed9c t\u00ednh l\u01b0u bi\u1ebfn c\u1ee7a t\u1eebng lo\u1ea1i filler l\u00e0 ch\u00eca kh\u00f3a \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh s\u1eed d\u1ee5ng lo\u1ea1i filler n\u00e0o v\u00e0 v\u1ecb tr\u00ed s\u1eed d\u1ee5ng ch\u00fang \u1edf \u0111\u00e2u. L\u01b0u bi\u1ebfn h\u1ecdc li\u00ean quan \u0111\u1ebfn d\u00f2ng ch\u1ea3y c\u1ee7a v\u1eadt ch\u1ea5t, \u0111\u1eb7c bi\u1ec7t th\u00edch h\u1ee3p v\u1edbi c\u00e1c qui tr\u00ecnh s\u1eed d\u1ee5ng ch\u1ea5t l\u00e0m \u0111\u1ea7y v\u00ed d\u1ee5 gel HA 2 pha th\u1ec3 hi\u1ec7n \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a c\u1ea3 ch\u1ea5t l\u1ecfng v\u00e0 ch\u1ea5t r\u1eafn t\u1ea1i c\u00f9ng 1 th\u1eddi \u0111i\u1ec3m.<\/p>\n

      L\u01b0u bi\u1ebfn h\u1ecdc \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 nghi\u00ean c\u1ee9u c\u00e1c \u0111\u1eb7c t\u00ednh li\u00ean quan \u0111\u1ebfn d\u00f2ng ch\u1ea3y, s\u1ef1 hi\u1ec3u bi\u1ebft v\u1ec1 c\u00e1c \u0111\u1eb7c t\u00ednh n\u00e0y r\u1ea5t quan tr\u1ecdng \u0111\u1ed1i v\u1edbi vi\u1ec7c s\u1ea3n xu\u1ea5t v\u00e0 s\u1eed l\u00fd v\u1eadt li\u1ec7u trong nhi\u1ec1u ng\u00e0nh c\u00f4ng nghi\u1ec7p kh\u00e1c nhau, t\u1eeb s\u01a1n, m\u1ef1c in, thu\u1ed1c m\u1ee1, \u0111\u1ebfn ch\u1ea5t k\u1ebft d\u00ednh, th\u1ec3 hi\u1ec7n \u0111\u1ed9 nh\u1edbt c\u1ee7a ch\u1ea5t l\u1ecfng v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i c\u1ee7a ch\u1ea5t r\u1eafn. Filler HA l\u00e0 lo\u1ea1i gel \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh t\u1eeb v\u1eadt li\u1ec7u 2 pha bao g\u1ed3m c\u1ea3 th\u00e0nh ph\u1ea7n l\u1ecfng v\u00e0 r\u1eafn. Do v\u1eady, nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u00e3 c\u1ed1 g\u1eafng nghi\u00ean c\u1ee9u t\u00ednh ch\u1ea5t l\u01b0u bi\u1ebfn c\u1ee7a c\u00e1c lo\u1ea1i filler kh\u00e1c nhau \u0111\u1ec3 \u0111\u01b0a ra c\u00e1c h\u00e0nh vi l\u00e2m s\u00e0ng c\u1ee7a ch\u00fang v\u00e0 so s\u00e1nh \u0111i\u1ec3m m\u1ea1nh v\u00e0 \u0111i\u1ec3m y\u1ebfu t\u01b0\u01a1ng \u0111\u1ed1i c\u1ee7a ch\u00fang trong vi\u1ec7c \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 th\u1ea9m m\u1ef9 mong mu\u1ed1n. Th\u1ef1c s\u1ef1, hi\u1ec3u \u0111\u01b0\u1ee3c c\u00e1c \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn n\u00e0y c\u00f3 th\u1ec3 gi\u00fap d\u1ef1 \u0111o\u00e1n ho\u1ea1t \u0111\u1ed9ng c\u1ee7a filler HA kh\u00e1c nhau trong v\u00e0 sau khi c\u1ea5y v\u00e0o m\u00f4, do \u0111\u00f3 cho ph\u00e9p l\u1ef1a ch\u1ecdn filler HA t\u1ed1i \u01b0u cho 1 \u1ee9ng d\u1ee5ng l\u00e2m s\u00e0ng nh\u1ea5t \u0111\u1ecbnh, do \u0111\u00f3 d\u1eabn \u0111\u1ebfn vi\u1ec7c h\u00ecnh th\u00e0nh thu\u1eadt ng\u1eef \u201c\u0111i\u1ec1u ch\u1ec9nh l\u01b0u bi\u1ebfn\u201d.[11]\n

      C\u1ea3 trong v\u00e0 sau khi \u0111\u01b0\u1ee3c c\u1ea5y v\u00e0o m\u00f4, HA ph\u1ea3i ch\u1ecbu 1 lo\u1ea1t c\u00e1c l\u1ef1c ph\u1ee9c t\u1ea1p, m\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m kh\u00e1c nhau ho\u1ea1t \u0111\u1ed9ng kh\u00e1c nhau t\u00f9y theo \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn n\u1ed9i t\u1ea1i c\u1ee7a ch\u00fang. Trong qu\u00e1 tr\u00ecnh ti\u00eam, filler HA c\u00f3 th\u1ec3 b\u1ecb bi\u1ebfn d\u1ea1ng c\u1eaft do n\u00f3 \u0111\u01b0\u1ee3c \u0111\u1ea9y ra kh\u1ecfi \u1ed1ng ti\u00eam qua kim nh\u1ecf ho\u1eb7c cannula. Sau khi \u0111\u01b0\u1ee3c c\u1ea5y v\u00e0o m\u00f4, s\u1ea3n ph\u1ea9m ti\u1ebfp x\u00fac v\u1edbi c\u00e1c \u1ee9ng su\u1ea5t c\u01a1 h\u1ecdc c\u1ee7a c\u00e1c vector l\u1ef1c v\u1edbi c\u01b0\u1eddng \u0111\u1ed9 kh\u00e1c nhau nh\u01b0 tr\u1ecdngtr\u1ecdn, l\u1ef1c c\u1eaft do chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a c\u01a1 m\u1eb7t v\u00e0 bi\u1ebfn d\u1ea1ng n\u00e9n do m\u00f4 da b\u00ean tr\u00ean t\u00e1c \u0111\u1ed9ng. Trong \u0111\u00f3, l\u1ef1c c\u1eaft ngang c\u00f3 th\u1ec3 x\u1ea3y ra trong 2 t\u00ecnh hu\u1ed1ng. \u0110\u1ea7u ti\u00ean l\u00e0 khi filler HA \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o gi\u1eefa 2 l\u1edbp m\u00f4 gi\u1ea3i ph\u1eabu kh\u00e1c nhau, v\u00ed d\u1ee5 gi\u1eefa l\u1edbp m\u1ee1 s\u00e2u v\u00e0 m\u1eb7t ph\u1eb3ng c\u01a1 nh\u01b0 trong tr\u01b0\u1eddng h\u1ee3p ti\u00eam s\u00e2u cho h\u00f5m m\u00e1. Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y, m\u1ed7i l\u1edbp n\u1eb1m ngang ti\u1ebfp x\u00fac v\u1edbi HA c\u00f3 th\u1ec3 ch\u1ecbu 1 m\u1ee9c \u0111\u1ed9 \u1ee9ng su\u1ea5t c\u1eaft kh\u00e1c nhau tr\u00ean filler HA \u0111\u01b0\u1ee3c c\u1ea5y gh\u00e9p. Th\u1ee9 2 l\u00e0 khi ch\u1ea5t l\u00e0m \u0111\u1ea7y HA \u0111\u01b0\u1ee3c ti\u00eam trong c\u00f9ng 1 l\u1edbp m\u00f4 theo gi\u1ea3i ph\u1eabu, nh\u01b0ng ph\u1ea7n HA n\u1eb1m g\u1ea7n b\u1ec1 m\u1eb7t c\u01a1 h\u01a1n s\u1ebd b\u1ecb c\u1eaft nhi\u1ec1u h\u01a1n c\u00e1c ph\u1ea7n kh\u00e1c. Trong khi \u0111\u00f3, l\u1ef1c n\u00e9n \u0111\u1ea1i di\u1ec7n cho 1 l\u1ef1c l\u00e0m bi\u1ebfn d\u1ea1ng d\u1ecdc t\u00e1c d\u1ee5ng l\u00ean filler HA kh\u00f4ng ch\u1ec9 khi khu\u00f4n m\u1eb7t \u1edf tr\u1ea1ng th\u00e1i ngh\u1ec9 (t\u1ee9c l\u00e0 tr\u1ea1ng th\u00e1i t\u0129nh) b\u1edfi c\u00e1c m\u00f4 da b\u00ean tr\u00ean m\u00e0 c\u00f2n trong qu\u00e1 tr\u00ecnh chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a g\u01b0\u01a1ng m\u1eb7t (t\u1ee9c l\u00e0 tr\u1ea1ng th\u00e1i \u0111\u1ed9ng) b\u1edfi c\u00e1c c\u01a1 m\u1eb7t. L\u1ef1c n\u00e9n t\u00e1c \u0111\u1ed9ng l\u00ean HA \u0111\u01b0\u1ee3c ti\u00eam v\u00e0o c\u00e1c m\u1eb7t ph\u1eb3ng s\u00e2u nh\u01b0 l\u1edbp tr\u00ean m\u00e0ng x\u01b0\u01a1ng ho\u1eb7c l\u1edbp b\u00ean d\u01b0\u1edbi da s\u00e2u h\u01a1n tr\u00ean b\u1ec1 m\u1eb7t da. Kh\u1ea3 n\u0103ng ch\u1ed1ng l\u1ea1i c\u00e1c l\u1ef1c g\u00e2y bi\u1ebfn d\u1ea1ng kh\u00e1c nhau v\u00e0 gi\u1eef d\u01b0\u1ee3c h\u00ecnh d\u1ea1ng ban \u0111\u1ea7u m\u00e0 kh\u00f4ng b\u1ecb d\u1ecbch chuy\u1ec3n kh\u1ecfi v\u1ecb tr\u00ed c\u1ea5y gh\u00e9p l\u00e0 y\u1ebfu t\u1ed1 thi\u1ebft y\u1ebfu c\u1ee7a filler l\u00e0m \u0111\u1ea7y HA.<\/p>\n

      Kh\u1ea3 n\u0103ng \u0111\u00e0n h\u1ed3i<\/h4>\n

      T\u00ednh \u0111\u00e0n h\u1ed3i th\u1ec3 hi\u1ec7n kh\u1ea3 n\u0103ng kh\u00f4i ph\u1ee5c h\u00ecnh d\u1ea1ng ban \u0111\u1ea7u c\u1ee7a gel sau khi b\u1ecb bi\u1ebfn d\u1ea1ng, \u0111\u00e2y l\u00e0 \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn quan tr\u1ecdng nh\u1ea5t \u0111\u1ed1i v\u1edbi filler. V\u00ed d\u1ee5, n\u00fat tai d\u00f9ng 1 l\u1ea7n \u0111\u01b0\u1ee3c l\u00e0m b\u1eb1ng polyurethane c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m l\u00e0 c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao, trong khi m\u1eadt ong th\u00ec kh\u00f4ng. Ngo\u00e0i ra, trong khi c\u1ea3 2 \u0111\u1ec1u l\u00e0 gel, gelatine \u0111\u00fac th\u1ec3 hi\u1ec7n \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao h\u01a1n so v\u1edbi b\u00e1nh pudding chocolate c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i th\u1ea5p h\u01a1n (H\u00ecnh 2.17). \u0110\u1ed9 \u0111\u00e0n h\u1ed3i c\u1ee7a filler HA c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c bi\u1ec3u th\u1ecb b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng c\u00e1c th\u00f4ng s\u1ed1’ l\u01b0u bi\u1ebfn kh\u00e1c nhau t\u00f9y theo lo\u1ea1i l\u1ef1c bi\u1ebfn d\u1ea1ng \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng. T\u00ednh \u0111\u00e0n h\u1ed3i c\u1ee7a gel d\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a \u1ee9ng su\u1ea5t c\u1eaft (t\u1ee9c l\u00e0 \u1ee9ng su\u1ea5t c\u1eaft ngang) \u0111\u01b0\u1ee3c bi\u1ec3u th\u1ecb b\u1eb1ng modun \u0111\u00e0n h\u1ed3i (G’), \u0111o \u0111\u1ed9 c\u1ee9ng c\u1ee7a gel v\u00e0 do \u0111\u00f3 n\u00f3 c\u00f3 kh\u1ea3 n\u0103ng ch\u1ed1ng l\u1ea1i s\u1ef1 bi\u1ebfn d\u1ea1ng d\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a l\u1ef1c c\u1eaft (H\u00ecnh 2.18a). M\u1eb7t kh\u00e1c, \u0111\u1ed9 \u0111\u00e0n h\u1ed3i c\u1ee7a gel b\u1ecb n\u00e9n (t\u1ee9c l\u00e0 \u1ee9ng su\u1ea5t th\u1eb3ng \u0111\u1ee9ng) \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng l\u1ef1c b\u00ecnh th\u01b0\u1eddng (FN<\/sub>) \u1edf ch\u1ebf \u0111\u1ed9 t\u0129nh v\u00e0 b\u1eb1ng modun \u0111\u00e0n h\u1ed3i E’ trong qu\u00e1 tr\u00ecnh chuy\u1ec3n \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng c\u1ee7a c\u01a1 m\u1eb7t, ngh\u0129a l\u00e0 \u1edf ch\u1ebf \u0111\u1ed9 \u0111\u1ed9ng [12] (H\u00ecnh 2.18b). M\u1ee9c \u0111\u1ed9 l\u1ef1c khi chuy\u1ec3n \u0111\u1ed9ng g\u00f3p ph\u1ea7n v\u00e0o s\u1ef1 bi\u1ebfn d\u1ea1ng c\u1ee7a filler HA \u0111\u01b0\u1ee3c c\u1ea5y v\u00e0o m\u00f4 l\u00e0 kh\u00e1c nhau t\u00f9y thu\u1ed9c v\u00e0o m\u1eb7t ph\u1eb3ng ti\u00eam. Trong khi l\u1ef1c c\u1eaft m\u1ea1nh h\u01a1n \u1edf m\u1eb7t ph\u1eb3ng b\u00ean ngo\u00e0i (h\u1ea1 b\u00ec) v\u00e0 l\u1edbp c\u01a1, l\u1ef1c n\u00e9n tr\u1edf n\u00ean nghi\u00eam tr\u1ecdng h\u01a1n \u1edf m\u1eb7t ph\u1eb3ng s\u00e2u h\u01a1n (l\u1edbp m\u1ee1 s\u00e2u v\u00e0 l\u1edbp tr\u00ean m\u00e0ng x\u01b0\u01a1ng) (h\u00ecnh 2.18). C\u00e1c y\u1ebfu r\u00f4 kh\u00e1c nhau c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn G’ v\u00e0 E’ c\u1ee7a filler HA, bao g\u1ed3m n\u1ed3ng \u0111\u1ed9 HA, m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o, t\u1ef7 l\u1ec7 BDPE li\u00ean k\u1ebft \u0111\u00f4i\/li\u00ean k\u1ebft \u0111\u01a1n trong gel, t\u1ef7 l\u1ec7 HA d\u1ea1ng t\u1ef1 do trong gel v\u00e0 qui tr\u00ecnh s\u1ea3n xu\u1ea5t \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. N\u00f3i chung, gel HA c\u00f3 n\u1ed3ng \u0111\u1ed9 HA cao h\u01a1n v\u00e0 m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o cao h\u01a1n th\u00ec c\u00f3 G’ cao h\u01a1n, trong khi nh\u1eefng lo\u1ea1i gel c\u00f3 th\u00e0nh ph\u1ea7n BDPE li\u00ean k\u1ebft \u0111\u01a1n ho\u1eb7c HA d\u1ea1ng t\u1ef1 do cao h\u01a1n trong gel th\u00ec c\u00f3 G’ th\u1ea5p h\u01a1n. Ngo\u00e0i ra, v\u1edbi k\u00edch th\u01b0\u1edbc h\u1ea1t b\u1eb1ng nhau th\u00ec gel HA 2 pha th\u01b0\u1eddng c\u00f3 G’ cao h\u01a1n so v\u1edbi HA 1 pha (h\u00ecnh 2.19). V\u1ec1 \u00fd ngh\u0129a l\u00e2m s\u00e0ng, c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 modun \u0111\u00e0n h\u1ed3i G’ cao kh\u00f4ng th\u00edch h\u1ee3p cho nh\u1eefng v\u00f9ng da c\u1ea7n c\u1ea3m gi\u00e1c m\u1ec1m m\u1ecbn, th\u1eadm ch\u00ed c\u1ea3m nh\u1eadn gi\u1ed1ng nh\u01b0 m\u00f4i v\u00ec k\u1ebft c\u1ea5u gel c\u1ee9ng. Ng\u01b0\u1ee3c l\u1ea1i, c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 G’ cao c\u00f3 th\u1ec3 mang l\u1ea1i hi\u1ec7u qu\u1ea3 cao h\u01a1n, \u0111\u1ebfn m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 h\u01a1n do xu h\u01b0\u1edbng kh\u00f4ng lan r\u1ed9ng v\u00e0 gi\u1eef nguy\u00ean h\u00ecnh d\u1ea1ng ban \u0111\u1ea7u trong v\u00f9ng \u0111\u01b0\u1ee3c c\u1ea5y gh\u00e9p (h\u00ecnh 2.20). Do v\u1eady, ch\u00fang th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh th\u1ec3 t\u00edch \u1edf m\u1eb7t ph\u1eb3ng m\u00f4 s\u00e2u. T\u00f3m l\u1ea1i, G’ cao t\u01b0\u01a1ng quan v\u1edbi v\u1eadt li\u1ec7u c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y t\u1ed1t h\u01a1n nh\u01b0 \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e2m s\u00e0ng trong nghi\u00ean c\u1ee9u ph\u00e2n chia v\u00f9ng m\u1eb7t c\u00f3 ki\u1ec3m so\u00e1t c\u1ee7a Monhei v\u00e0 c\u1ed9ng s\u1ef1 th\u1ef1c hi\u1ec7n tr\u00ean 140 b\u1ec7nh nh\u00e2n [17]. C\u00e1c quan s\u00e1t t\u01b0\u01a1ng t\u1ef1 c\u0169ng thu \u0111\u01b0\u1ee3c \u0111\u1ed1i v\u1edbi c\u00e1c th\u00f4ng s\u1ed1 n\u00e9n Fn v\u00e0 E’ v\u1edbi c\u00e1c gi\u00e1 tr\u1ecb cao h\u01a1n t\u01b0\u01a1ng quan v\u1edbi c\u00f4ng su\u1ea5t l\u00e0m \u0111\u1ea7y cao h\u01a1n [12]. \u0110i\u1ec1u \u0111\u00f3 n\u00f3i l\u00ean, c\u1ea7n l\u01b0u \u00fd r\u1eb1ng c\u00e1c s\u1ea3n ph\u1ea9m c\u1ee9ng h\u01a1n c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao h\u01a1n y\u00eau c\u1ea7u l\u1ef1c \u0111\u1ea9y l\u1edbn h\u01a1n trong qu\u00e1 tr\u00ecnh ti\u00eam, c\u0169ng nh\u01b0 vi\u1ec7c s\u1eed d\u1ee5ng kim ho\u1eb7c cannula l\u1edbn h\u01a1n v\u00e0 d\u00e0y h\u01a1n. Ngo\u00e0i ra, v\u00ec nh\u1eefng s\u1ea3n ph\u1ea9m n\u00e0y kh\u00f4ng d\u1ec5 n\u1eafn ch\u1ec9nh v\u00e0 kh\u00f4ng lan r\u1ed9ng d\u1ec5 d\u00e0ng, n\u00ean ch\u00fang \u0111\u01b0\u1ee3c \u0111\u1eb7t trong c\u00e1c m\u1eb7t ph\u1eb3ng m\u00f4 s\u00e2u h\u01a1n l\u00e0 \u1edf l\u1edbp b\u1ec1 m\u1eb7t.<\/p>\n

      \u0110\u1ed9 nh\u1edbt<\/h4>\n

      \u0110\u1ed9 nh\u1edbt \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 kh\u1ea3 n\u0103ng ch\u1ed1ng l\u1ea1i s\u1ef1 bi\u1ebfn d\u1ea1ng ho\u1eb7c xu h\u01b0\u1edbng k\u1ebft d\u00ednh l\u1ea1i v\u1edbi nhau m\u00e0 kh\u00f4ng b\u1ecb ph\u00e2n m\u1ea3nh d\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a \u1ee9ng su\u1ea5t c\u1ee7a ch\u1ea5t l\u1ecfng. V\u00ed d\u1ee5, b\u01a1 trong t\u1ee7 l\u1ea1nh ho\u1eb7c b\u01a1 \u0111\u1eadu ph\u1ed9ng c\u00f3 \u0111\u1ed9 nh\u1edbt cao v\u00e0 do \u0111\u00f3 kh\u00f4ng d\u1ec5 d\u00e0ng ph\u1ebft l\u00ean b\u00e1nh m\u00ec n\u01b0\u1edbng, trong khi b\u01a1 \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng c\u00f3 \u0111\u1ed9 nh\u1edbt th\u1ea5p v\u00e0 do \u0111\u00f3 d\u1ec5 d\u00e0ng l\u01b0\u1edbt d\u1ecdc theo b\u1ec1 m\u1eb7t \u0111\u01b0\u1ee3c ph\u1ebft (h\u00ecnh 2.21). \u0110\u1ed9 nh\u1edbt \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng modun nh\u1edbt (G\u201d) ho\u1eb7c \u0111\u1ed9 nh\u1edbt ph\u1ee9c (\u25a1) v\u1ec1 kh\u1ea3 n\u0103ng bi\u1ebfn d\u1ea1ng c\u1eaft v\u00e0 b\u1eb1ng modun nh\u1edbt (E\u201d) v\u1ec1 bi\u1ebfn d\u1ea1ng n\u00e9n. \u0110\u1ed9 nh\u1edbt k\u1ebft h\u1ee3p (o) m\u00f4 t\u1ea3 kh\u1ea3 n\u0103ng c\u1ee7a gel ch\u1ed1ng l\u1ea1i bi\u1ebfn d\u1ea1ng c\u1eaft b\u00ean ngo\u00e0i, hay n\u00f3i c\u00e1ch kh\u00e1c l\u00e0 kh\u1ea3 n\u0103ng ch\u1ed1ng l\u1ea1i vi\u1ec7c b\u1ecb lan r\u1ed9ng. Khi l\u1ef1c c\u1eaft n\u1eb1m trong 1 ph\u1ea1m vi nh\u1ea5t \u0111\u1ecbnh (trong ph\u1ea1m vi \u0111\u00e0n h\u1ed3i tuy\u1ebfn t\u00ednh), 0 gi\u1ea3m t\u01b0\u01a1ng \u1ee9ng v\u1edbi s\u1ef1 gia t\u0103ng t\u00e1c \u0111\u1ed9ng c\u1ee7a \u1ee9ng su\u1ea5t c\u1eaft [11]. Modun nh\u1edbt (G\u201d) l\u00e0 th\u01b0\u1edbc \u0111o kh\u1ea3 n\u0103ng ti\u00eau t\u00e1n n\u0103ng l\u01b0\u1ee3ng c\u1ee7a gel khi t\u00e1c d\u1ee5ng l\u1ef1c c\u1eaft (h\u00ecnh 2.22). Trong ph\u1ea1m vi nh\u1edbt \u0111\u00e0n h\u1ed3i tuy\u1ebfn t\u00ednh, G” \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 t\u01b0\u01a1ng \u1ee9ng, n\u1ebfu kh\u00f4ng ho\u00e0n to\u00e0n gi\u1ed1ng nhau v\u1edbi ph\u1ee9c \u0111\u1ed9 nh\u1edbt (\u25a1). Tuy nhi\u00ean, \u0111\u1ed1i v\u1edbi filler 2 pha, 0 \u0111\u01b0\u1ee3c coi l\u00e0 ch\u1ec9 s\u1ed1 ch\u00ednh x\u00e1c h\u01a1n G” \u0111\u1ec3 d\u1ef1 \u0111o\u00e1n tr\u00ean l\u00e2m s\u00e0ng v\u00e0 do \u0111\u00f3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i h\u01a1n [11].<\/p>\n

      Trong khi filler HA c\u00f3 \u0111\u1ed9 nh\u1edbt cao h\u01a1n n\u00ean \u0111\u00f2i h\u1ecfi l\u1ef1c \u0111\u1ea9y l\u1edbn h\u01a1n v\u00ec ti\u00eam ch\u00fang kh\u00f4ng tr\u01a1n tru, khi \u0111\u01b0\u1ee3c c\u1ea5y v\u00e0o m\u00f4, ch\u00fang c\u00f3 th\u1ec3 ch\u1ed1ng l\u1ea1i<\/p>\n

        \n
      • l\u1ef1c \u1ee9ng su\u1ea5t c\u1eaft l\u1edbn m\u00e0 kh\u00f4ng b\u1ecb lan ra, do v\u1eady gi\u1eef \u0111\u01b0\u1ee3c h\u00ecnh d\u1ea1ng v\u00e0 c\u1ea5u tr\u00fac to\u00e0n v\u1eb9n. \u0110i\u1ec1u n\u00e0y l\u00e0m cho ch\u00fang tr\u1edf n\u00ean l\u00fd t\u01b0\u1edfng \u0111\u1ec3 ti\u00eam v\u00e0o nh\u1ee9ng v\u00f9ng c\u01a1 m\u1eb7t chuy\u1ec3n \u0111\u1ed9ng nhi\u1ec1u ho\u1eb7c v\u00e0o m\u1eb7t ph\u1eb3ng \u1edf c\u00e1c m\u00f4 s\u00e2u. Ng\u01b0\u1ee3c l\u1ea1i, filler HA l\u1ecfng h\u01a1n c\u00f3 \u0111\u1ed9 nh\u1edbt th\u1ea5p h\u01a1n s\u1ebd ti\u00eam v\u00e0 ch\u1ea3y qua m\u00f4 1 c\u00e1ch d\u1ec5 d\u00e0ng v\u00e0 do \u0111\u00f3 th\u00edch h\u1ee3p h\u01a1n v\u1edbi l\u1edbp n\u00f4ng c\u1ee7a m\u00f4 da. Trong nghi\u00ean c\u1ee9u c\u1ee7a Rosamilia v\u00e0 c\u00e1c c\u1ed9ng s\u1ef1 [18] d\u1ef1a tr\u00ean c\u00e1c d\u00f2ng filler HA Belotero, Belotero Soft, 1 s\u1ea3n ph\u1ea9m m\u1ec1m h\u01a1n v\u1edbi \u0111\u1ed9 nh\u1edbt th\u1ea5p h\u01a1n, \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 d\u1ec5 d\u00e0ng \u0111\u01b0a v\u00e0o m\u00f4 h\u01a1n so v\u1edbi Belotero Volume, 1 s\u1ea3n ph\u1ea9m \u00edt l\u1ecfng h\u01a1n v\u1edbi \u0111\u1ed9 nh\u1edbt cao h\u01a1n. Trong khi \u0111\u00f3, HA<\/li>\n
      • pha \u1edf d\u1ea1ng h\u1ea1t \u0111\u01b0\u1ee3c bi\u1ebft th\u01b0\u1eddng c\u00f3 \u0111\u1ed9 nh\u1edbt cao h\u01a1n HA 1 pha [19]. D\u1ef1a tr\u00ean s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u00ednh ch\u1ea5t l\u01b0u bi\u1ebfn, khi \u0111\u01b0\u1ee3c ti\u00eam trong da \u1edf l\u1edbp h\u1ea1 b\u00ec, Belotero Balance d\u01b0\u1edbi d\u1ea1ng HA 1 pha \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 kh\u1ea3 n\u0103ng t\u00edch h\u1ee3p \u0111\u1ed3ng nh\u1ea5t \u1edf trong m\u00f4 h\u01a1n so v\u1edbi Restylane 2 pha v\u1edbi \u0111\u1ed9 nh\u1edbt cao h\u01a1n [14].<\/li>\n<\/ul>\n

        H\u00ecnh 2.17<\/strong>: Kh\u1ed1i gelatin th\u1ec3 hi\u1ec7n \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao h\u01a1n so v\u1edbi pudding chocolate c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i th\u1ea5p h\u01a1n<\/p>\n

        H\u00ecnh 2.18<\/strong>: (a) Modul \u0111\u00e0n h\u1ed3i (G’). T\u00ednh \u0111\u00e0n h\u1ed3i c\u1ee7a gel d\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a \u1ee9ng su\u1ea5t c\u1eaft (t\u1ee9c l\u00e0 \u1ee9ng su\u1ea5t ngang) \u0111\u01b0\u1ee3c bi\u1ec3u th\u1ecb b\u1eb1ng modul \u0111\u00e0n h\u1ed3i (G’).<\/p>\n

        (b) T\u00ednh \u0111\u00e0n h\u1ed3i c\u1ee7a gel ch\u1ecbu n\u00e9n (t\u1ee9c l\u00e0 \u1ee9ng su\u1ea5t d\u1ecdc) \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng l\u1ef1c b\u00ecnh th\u01b0\u1eddng (Fn) \u1edf tr\u1ea1ng th\u00e1i t\u0129nh.<\/p>\n

        (c) C\u00e1c l\u1ef1c \u0111\u1ed9ng g\u00f3p ph\u1ea7n l\u00e0m bi\u1ebfn d\u1ea1ng c\u00e1c s\u1ea3n ph\u1ea9m filler HA \u0111\u01b0\u1ee3c c\u1ea5y v\u00e0o b\u1ec1 m\u1eb7t (l\u1edbp h\u1ea1 b\u00ec) v\u00e0 m\u1eb7t ph\u1eb3ng s\u00e2u (l\u1edbp m\u1ee1 s\u00e2u v\u00e0 tr\u00ean m\u00e0ng x\u01b0\u01a1ng) c\u1ee7a m\u00f4 m\u1ec1m.<\/p>\n

        H\u00ecnh 2.19<\/strong>: Gel HA 2 pha c\u00f3 \u0111\u1ed9 G’ cao h\u01a1n so v\u1edbi HA 1 pha ( a – NASHA: gel HA 2 pha, b – OBT: gel HA 1 pha).<\/p>\n

        H\u00ecnh 2.20<\/strong>: Modul \u0111\u00e0n h\u1ed3i (G’) c\u1ee7a 9 lo\u1ea1i filler HA c\u1ee9ng (\u0111\u01b0\u1ee3c s\u1eeda \u0111\u1ed5i t\u1eeb Merz Institute of Advanced Aesthetics).<\/p>\n

        H\u00ecnh 2.21<\/strong>: B\u01a1 \u0111\u1eadu ph\u1ed9ng c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao v\u00e0 do \u0111\u00f3 kh\u00f3 ph\u1ebft tr\u00ean b\u1ec1 m\u1eb7t b\u00e1nh m\u00ec n\u01b0\u1edbng, khi \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng b\u01a1 c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i th\u1ea5p v\u00e0 do \u0111\u00f3 d\u1ec5 d\u00e0ng ph\u1ebft d\u1ecdc theo b\u1ec1 m\u1eb7t b\u00e1nh m\u00ec.<\/p>\n

        H\u00ecnh 2.22<\/strong>: Modul \u0111\u1ed9 nh\u1edbt (G”) c\u1ee7a 9 lo\u1ea1i filler HA.<\/p>\n

        Tan Delta (\u00f5)<\/h4>\n

        V\u00ec filler l\u00e0 v\u1eadt li\u1ec7u th\u1ec3 hi\u1ec7n \u0111\u1eb7c t\u00ednh c\u1ee7a c\u1ea3 \u0111\u1ed9 nh\u1edbt v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i, ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ch\u00fang kh\u00f4ng th\u1ec3 x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c khi ch\u1ec9 d\u1ef1a tr\u00ean 1 tham s\u1ed1 m\u00f4 t\u1ea3 \u0111\u1eb7c t\u00ednh c\u1ee7a ch\u1ea5t r\u1eafn ho\u1eb7c ch\u1ea5t l\u1ecfng \u0111\u01a1n thu\u1ea7n. \u0110i\u1ec1u n\u00e0y \u0111\u00e3 \u0111\u1ec1 xu\u1ea5t ra c\u00e1c ph\u00e9p t\u00ednh l\u01b0u bi\u1ebfn th\u1ee9 c\u1ea5p kh\u00e1c nhau xu\u1ea5t ph\u00e1t t\u1eeb c\u00e1c th\u00f4ng s\u1ed1’ l\u01b0u bi\u1ebfn ch\u00ednh. Trong s\u1ed1’ n\u00e0y Tan Delta (\u00f4) l\u00e0 1 modul \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng kh\u00e1 ph\u1ed5 bi\u1ebfn, n\u00f3 \u0111o t\u1ec9 l\u1ec7 gi\u1eefa modul nh\u1edbt G” tr\u00ean modul \u0111\u00e0n h\u1ed3i G’ (G”\/G’) trong 1 v\u1eadt li\u1ec7u nh\u1ea5t \u0111\u1ecbnh [11]. N\u00f3i c\u00e1ch kh\u00e1c Tan l\u00e0 1 modul ph\u1ee9c t\u1ea1p xem x\u00e9t \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u00e0 \u0111\u1ed9 nh\u1edbt c\u1ee7a 1 gel HA nh\u1ea5t \u0111\u1ecbnh. Gi\u00e1 tr\u1ecb c\u1ee7a Tan \u00f4 nh\u1ecf h\u01a1n 1 denote bi\u1ec3u th\u1ecb r\u1eb1ng s\u1ea3n ph\u1ea9m \u0111\u00e0n h\u1ed3i h\u01a1n nh\u1edbt, trong khi Tan \u00f4 l\u1edbn h\u01a1n 1 bi\u1ec3u th\u1ecb \u0111\u1ed9 nh\u1edbt l\u1edbn h\u01a1n \u0111\u00e0n h\u1ed3i. V\u00ec h\u1ea7u h\u1ebft filler HA c\u00f3 xu h\u01b0\u1edbng th\u1ec3 hi\u1ec7n t\u00ednh \u0111\u00e0n h\u1ed3i h\u01a1n so v\u1edbi 1 ch\u1ea5t l\u1ecfng n\u00ean gi\u00e1 tr\u1ecb Tan \u00f4 th\u01b0\u1eddng nh\u1ecf h\u01a1n 1, v\u1edbi 1 s\u1ed1’ filler c\u1ee9ng h\u01a1n, \u0111\u00e0n h\u1ed3i h\u01a1n cho th\u1ea5y gi\u00e1 tr\u1ecb Tan \u00f4 th\u1eadm ch\u00ed nh\u1ecf h\u01a1n 0.2. Th\u1eadm ch\u00ed trong c\u00f9ng 1 d\u00f2ng s\u1ea3n ph\u1ea9m filler HA, c\u00e1c s\u1ea3n ph\u1ea9m \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh th\u1ec3 t\u00edch s\u00e2u c\u00f3 xu h\u01b0\u1edbng bi\u1ec3u th\u1ecb gi\u00e1 tr\u1ecb Tan \u00f4 th\u1ea5p h\u01a1n. Trong khi \u0111\u00f3, Tan \u00d4C (E”\/E’) l\u00e0 modul \u0111\u00e0n h\u1ed3i nh\u1edbt t\u01b0\u01a1ng \u1ee9ng m\u00f4 t\u1ea3 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a gel d\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a l\u1ef1c n\u00e9n [12]. Tuy nhi\u00ean, gi\u00e1 tr\u1ecb Tan \u00d4C (E”\/E’) d\u01b0\u1eddng nh\u01b0 l\u1ec7ch kh\u1ecfi Tan \u00f4 (G”\/G’) trong \u0111\u00f3 Tan \u00d4c nh\u1ecf h\u01a1n 1 \u0111\u1ed1i v\u1edbi d\u00f2ng s\u1ea3n ph\u1ea9m Belotero v\u00e0 Hylacross – d\u1ef1a tr\u00ean Juvederm Ultra, t\u1ee9c l\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 gi\u00e1 tr\u1ecb Tan \u00f4 cao, 1-2 v\u1edbi c\u00e1c s\u1ea3n ph\u1ea9m d\u1ef1a tr\u00ean VYCROSS, v\u00e0 >3 \u0111\u1ed1i v\u1edbi d\u00f2ng s\u1ea3n ph\u1ea9m Restylane, Tan \u00f4 nh\u1ecf nh\u1ea5t v\u1edbi c\u00e1c s\u1ea3n ph\u1ea9m \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m ( ngh\u0129a l\u00e0 <0.22). T\u1eeb \u0111\u00e2y, HA ho\u1ea1t \u0111\u1ed9ng kh\u00e1c nhau d\u01b0\u1edbi \u1ee9ng su\u1ea5t c\u1eaft h\u01a1n so v\u1edbi d\u01b0\u1edbi n\u00e9n \u0111\u1ed9ng [11]. C\u0169ng c\u1ea7n l\u01b0u \u00fd r\u1eb1ng HA \u0111\u1eb7t trong m\u00f4 s\u00e2u kh\u00f4ng ch\u1ec9 ti\u1ebfp x\u00fac v\u1edbi \u1ee9ng su\u1ea5t c\u1eaft m\u00e0 c\u00f2n ch\u1ecbu l\u1ef1c n\u00e9n, v\u1edbi l\u1ef1c n\u00e9n \u1edf m\u1eb7t ph\u1eb3ng s\u00e2u l\u1edbn h\u01a1n \u1edf b\u1ec1 m\u1eb7t.<\/p>\n

        S\u1ef1 li\u00ean k\u1ebft<\/h4>\n

        T\u00ednh li\u00ean k\u1ebft m\u00f4 t\u1ea3 xu h\u01b0\u1edbng kh\u00f4ng ph\u00e2n t\u00e1n c\u1ee7a v\u1eadt li\u1ec7u do l\u1ef1c h\u00fat c\u1ee7a c\u00e1c ph\u00e2n t\u1eed v\u1edbi nhau. V\u00ed d\u1ee5, m\u1eadt ong l\u00e0 1 v\u1eadt li\u1ec7u c\u00f3 t\u00ednh li\u00ean k\u1ebft cao, trong khi c\u00e1c h\u1ea1t c\u00e1t \u00edt li\u00ean k\u1ebft v\u1edbi nhau h\u01a1n (h\u00ecnh 2.23). T\u00ednh li\u00ean k\u1ebft c\u1ee7a filler HA th\u1ec3 hi\u1ec7n m\u1ee9c \u0111\u1ed9 m\u00e0 n\u00f3 v\u1eabn c\u00f2n nguy\u00ean v\u1eb9n, kh\u00f4ng b\u1ecb ph\u00e2n t\u00e1n sau khi \u0111\u01b0\u1ee3c c\u1ea5y gh\u00e9p. \u0110\u1ec3 c\u00f3 1 quy tr\u00ecnh \u0111\u00e1nh gi\u00e1 kh\u00e1ch quan, \u0111\u1ed9 li\u00ean k\u1ebft c\u1ee7a filler HA \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng thang \u0111i\u1ec3m tr\u1ef1c quan, ti\u00eau chu\u1ea9n h\u00f3a 5 \u0111i\u1ec3m \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 thang \u0111o li\u00ean k\u1ebft Gavard-Sundaram (\u201cthang \u0111o li\u00ean k\u1ebft GS”). [13] Thang \u0111o li\u00ean k\u1ebft GS c\u00f3 gi\u00e1 tr\u1ecb t\u1eeb 1 (ph\u00e2n t\u00e1n ho\u00e0n to\u00e0n) \u0111\u1ebfn 5 (li\u00ean k\u1ebft ho\u00e0n to\u00e0n) (h\u00ecnh 2.242). Nh\u00ecn chung, v\u1edbi k\u00edch th\u01b0\u1edbc h\u1ea1t b\u1eb1ng nhau, filler HA 2 pha c\u00f3 xu h\u01b0\u1edbng \u00edt li\u00ean k\u1ebft h\u01a1n filler HA 1 pha. Th\u00ec ra, Restylane d\u01b0\u1edbi d\u1ea1ng HA 2 pha c\u00f3 \u0111i\u1ec3m tr\u00ean thang \u0111o \u0111\u1ed9 li\u00ean k\u1ebft GS l\u00e0 1, trong khi Belotero Balance 1 pha c\u00f3 \u0111\u1ed9 g\u1eafn k\u1ebft cao nh\u1ea5t l\u00e0 5 [12,13]. Ngay c\u1ea3 trong s\u1ed1’ c\u00e1c filler HA 1 pha, v\u1eabn c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 v\u1ec1 \u0111i\u1ec3m s\u1ed1 GS c\u1ee7a ch\u00fang, ph\u1ea3n \u00e1nh s\u1ef1 kh\u00e1c bi\u1ec7t trong qui tr\u00ecnh s\u1ea3n xu\u1ea5t c\u01a1 b\u1ea3n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. V\u00ed d\u1ee5, trong d\u00f2ng s\u1ea3n ph\u1ea9m filler HA Juvederm c\u00f3 Juvederm Ultra Plus (Juvederm Ultra 3) s\u1ea3n xu\u1ea5t d\u01b0\u1edbi c\u00f4ng ngh\u1ec7 HYLACROSS c\u00f3 \u0111i\u1ec3m li\u00ean k\u1ebft l\u00e0 4, trong khi Juvederm Voluma s\u1ea3n xu\u1ea5t d\u01b0\u1edbi c\u00f4ng ngh\u1ec7 VYCROSS c\u00f3 \u0111i\u1ec3m li\u00ean k\u1ebft kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 l\u00e0 1 [12].<\/p>\n

        \u00dd ngh\u0129a l\u00e2m s\u00e0ng \u0111\u00e1ng ch\u00fa \u00fd nh\u1ea5t c\u1ee7a t\u00ednh li\u00ean k\u1ebft n\u1eb1m \u1edf kh\u1ea3 n\u0103ng \u0111\u00f3ng g\u00f3p v\u00e0o kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y c\u0169ng nh\u01b0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i c\u1ee7a filler HA. \u0110i\u1ec1u n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c l\u00e0m s\u00e1ng t\u1ecf trong nghi\u00ean c\u1ee9u so s\u00e1nh kh\u1ea3 n\u0103ng \u0111i\u1ec1u tr\u1ecb r\u00e3nh c\u01b0\u1eddi c\u1ee7a Belotero Intense v\u00e0 Restylane Lift \u1edf 20 \u0111\u1ed1i t\u01b0\u1ee3ng [20]. Kh\u00f4ng c\u1ea7n ph\u1ea3i n\u00f3i, \u0111\u1ed9 \u0111\u00e0n h\u1ed3i l\u00e0 y\u1ebfu t\u1ed1 quan tr\u1ecdng \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y c\u1ee7a filler HA. Nh\u01b0 v\u1eady, nghi\u00ean c\u1ee9u tr\u00ean r\u1ea5t \u0111\u00e1ng ch\u00fa \u00fd \u1edf ch\u1ed7 n\u00f3 \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng Belotero v\u1edbi G’ ch\u1ec9 111 Pa (0.7 Hz) c\u00f3 th\u1ec3 mang l\u1ea1i hi\u1ec7u \u1ee9ng l\u00e0m \u0111\u1ea7y t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi Restylane c\u00f3 G’ l\u00e0 549 Pa. Do \u0111\u00f3, c\u00f3 th\u1ec3 th\u1eeba nh\u1eadn r\u1eb1ng, m\u1eb7c d\u00f9 c\u00f3 G’ th\u1ea5p h\u01a1n nh\u01b0ng Belotero v\u1eabn c\u00f3 th\u1ec3 thu h\u1eb9p kho\u1ea3ng c\u00e1ch v\u1edbi Restylane Lift 1 c\u00e1ch hi\u1ec7u qu\u1ea3 nh\u1edd \u0111\u1ed9 g\u1eafn k\u1ebft cao h\u01a1n \u0111\u00e1ng k\u1ec3 l\u00e0 4 \u0111i\u1ec3m so v\u1edbi 1 \u0111i\u1ec3m c\u1ee7a Restylane Lift. \u1ea2nh h\u01b0\u1edfng c\u1ee7a t\u00ednh li\u00ean k\u1ebft l\u00ean kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y c\u1ee7a filler c\u00f3 li\u00ean quan \u0111\u1eb7c bi\u1ec7t khi \u0111i\u1ec1u tr\u1ecb c\u00e1c khu v\u1ef1c c\u00f3 t\u00ednh di \u0111\u1ed9ng cao nh\u01b0 r\u00e3nh m\u0169i m\u00e1, n\u1ebfp kh\u00f3e mi\u1ec7ng v\u00e0 v\u00f9ng tr\u00e1n. Theo kinh nghi\u1ec7m c\u1ee7a t\u00e1c gi\u1ea3, c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 \u0111\u1ed9 li\u00ean k\u1ebft th\u1ea5p nh\u01b0 Restylane SubQ th\u01b0\u1eddng d\u1ec5 b\u1ecb v\u00f3n c\u1ee5c ho\u1eb7c t\u00e1ch l\u1edbp khi ch\u1ecbu t\u00e1c \u0111\u1ed9ng c\u1ee7a ho\u1ea1t \u0111\u1ed9ng c\u01a1 m\u1ea1nh, trong khi Belotero Volume c\u00f3 xu h\u01b0\u1edbng gi\u1eef nguy\u00ean v\u1ecb tr\u00ed v\u00e0 h\u00ecnh d\u1ea1ng ban \u0111\u1ea7u hi\u1ec7u qu\u1ea3 h\u01a1n. C\u00f3 th\u1ec3 h\u00ecnh dung, nh\u1eefng kh\u00e1c bi\u1ec7t nh\u01b0 v\u1eady c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u00fd gi\u1ea3i cho s\u1ef1 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1ec1 kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y gi\u1eefa Belotero Intense v\u00e0 Restylane Lift, m\u1eb7 d\u00f9 modul \u0111\u00e0n h\u1ed3i G’ c\u1ee7a d\u00f2ng s\u1ea3n ph\u1ea9m Belotero th\u1ea5p h\u01a1n nhi\u1ec1u.<\/p>\n

        H\u00ecnh 2.23<\/strong>: M\u1eadt ong l\u00e0 v\u1eadt li\u1ec7u c\u00f3 \u0111\u1ed9 li\u00ean k\u1ebft cao, trong khi c\u00e1t c\u00f3 \u0111\u1ed9 li\u00ean k\u1ebft th\u1ea5p h\u01a1n nhi\u1ec1u.<\/p>\n

        H\u00ecnh 2.24<\/strong>: Thang \u0111o \u0111\u1ed9 li\u00ean k\u1ebft GS, (a) Restylane 1 \u0111i\u1ec3m t\u1ea1i 90s, (b) Belotero 5 \u0111i\u1ec3m t\u1ea1i 90s.<\/p>\n

        B\u1ea3ng 2.3<\/strong>: \u00dd ngh\u0129a l\u00e2m s\u00e0ng c\u1ee7a c\u00e1c \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn (xem x\u00e9t m\u1ed7i d\u1ea5u hi\u1ec7u).<\/p>\n\n\n\n\n\n\n\n\n
        D\u1ea5u hi\u1ec7u<\/td>\nKhu v\u1ef1c<\/td>\nT\u00ednh ch\u1ea5t l\u01b0u bi\u1ebfn th\u00edch h\u1ee3p<\/td>\nG\u1ee3i \u00fd<\/td>\n<\/tr>\n
        L\u00e0m \u0111\u1ea7y b\u00ean d\u01b0\u1edbi da m\u1ecfng<\/td>\nR\u00e3nh l\u1ec7<\/p>\n

        R\u00e3nh mi m\u1eaft m\u00e1<\/td>\n

        		2 pha, \u0111\u1ed9 nh\u1edbt, \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u1eeba ph\u1ea3i<\/td>\nRestylane, Restylane Skinbooster
        \nVital<\/td>\n<\/tr>\n
        K\u1ef9 thu\u1eadt ti\u00eam
        \ntrong da
        \nHydrolifting
        \nFern<\/td>\n        		Khu v\u1ef1c da d\u00e0y<\/td>\n1 pha ho\u1eb7c 2
        \npha c\u00f3 \u0111\u1ed9 nh\u1edbt
        \nth\u1ea5p<\/td>\n        		Belotero
        \nBalance,
        \nRestylane
        \nSkinbooster
        \nVital,
        \nJuvederm
        \nVolbella<\/td>\n<\/tr>\n
        Khu v\u1ef1c da
        \nm\u1ecfng (khu v\u1ef1c
        \nquanh m\u1eaft v\u00e0
        \nc\u1ed5)<\/td>\n        		1 pha v\u1edbi \u0111\u1ed9
        \nnh\u1edbt th\u1ea5p<\/td>\n        		Belotero Soft<\/td>\n<\/tr>\n
        L\u00e0m \u0111\u1ea7y v\u00e0 l\u00e0m
        \ncho l\u1ed3i ra<\/td>\n        		Khu v\u1ef1c th\u00e1i
        \nd\u01b0\u01a1ng<\/td>\n        		Gi\u00e1 tr\u1ecb G\u2019 cao
        \nnh\u1ea5t trong m\u1ed7i
        \nd\u00f2ng s\u1ea3n ph\u1ea9m<\/td>\n        		Restylane Lift,
        \nRestylane
        \nVolym,
        \nBelotero
        \nVolume,
        \nJuvederm
        \nVoluma,
        \nJuvederm
        \nVolux<\/td>\n<\/tr>\n
        Khu v\u1ef1c ho\u1ea1t
        \n\u0111\u1ed9ng nhi\u1ec1u
        \nv\u00f9ng tr\u01b0\u1edbc tr\u00e1n,
        \nr\u00e3nh m\u0169i m\u00e1,
        \nn\u1ebfp kh\u00f3e
        \nmi\u1ec7ng, c\u1eb1m<\/td>\n        		1 pha v\u1edbi \u0111\u1ed9 \u0111\u00e0n
        \nh\u1ed3i v\u00e0 \u0111\u1ed9 nh\u1edbt
        \ncao<\/td>\n        		Belotero
        \nVolume,
        \nJuvederm
        \nVoluma,
        \nJuvederm
        \nVolux<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n
        <\/td>\nJawline, v\u00e0 g\u00f2 m\u00e1<\/td>\n2 pha ho\u1eb7c 1 pha v\u1edbi \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao<\/td>\nRestylane Lift, Restylane Volym, Belotero Volume, Juvederm Voluma,<\/td>\n<\/tr>\n
        2 l\u1edbp<\/td>\nL\u1edbp s\u00e2u<\/td>\n2 pha v\u1edbi \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao<\/td>\nRestylane Lift<\/td>\n<\/tr>\n
        L\u1edbp n\u00f4ng<\/td>\n1 pha v\u1edbi \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao<\/td>\nBelotero Volume<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        \u00dd ngh\u0129a l\u00e2m s\u00e0ng<\/h4>\n

        So s\u00e1nh tr\u1ef1c ti\u1ebfp t\u00ednh ch\u1ea5t l\u01b0u bi\u1ebfn gi\u1eefa c\u00e1c c\u00f4ng th\u1ee9c s\u1ea3n ph\u1ea9m \u0111\u00e3 \u0111\u01b0\u1ee3c t\u1ea1o ra b\u1eb1ng c\u00e1c quy tr\u00ecnh s\u1ea3n xu\u1ea5t kh\u00e1c nhau l\u00e0 r\u1ea5t kh\u00f3. Th\u1eadt v\u1eady, c\u00f9ng 1 s\u1ea3n ph\u1ea9m th\u01b0\u1eddng \u0111\u01b0\u1ee3c t\u00ecm ra c\u00e1c gi\u00e1 tr\u1ecb l\u01b0u bi\u1ebfn l\u00e0 kh\u00e1c nhau trong c\u00e1c nghi\u00ean c\u1ee9u kh\u00e1c nhau n\u00f3 t\u00f9y thu\u1ed9c v\u00e0o c\u00e1c th\u00f4ng s\u1ed1 th\u1eed nghi\u1ec7m c\u01a1 b\u1ea3n \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng. Do v\u1eady, khi \u0111\u00e1nh gi\u00e1 gi\u00e1 tr\u1ecb l\u01b0u bi\u1ebfn c\u1ee7a c\u00e1c lo\u1ea1i gel HA kh\u00e1c nhau, th\u00ec ph\u00f9 h\u1ee3p h\u01a1n khi so s\u00e1nh c\u00e1c s\u1ea3n ph\u1ea9m trong c\u00f9ng 1 d\u00f2ng h\u01a1n l\u00e0 gi\u1eefa c\u00e1c d\u00f2ng kh\u00e1c nhau. Gi\u00e1 tr\u1ecb l\u01b0u bi\u1ebfn c\u1ee7a c\u00e1c s\u1ea3n ph\u1ea9m thu\u1ed9c v\u1ec1 c\u00e1c nh\u00e3n hi\u1ec7u kh\u00e1c nhau c\u00f3 th\u1ec3 h\u1eefu \u00edch ch\u1ec9 trong ph\u1ea1m vi ch\u00fang c\u00f3 th\u1ec3 gi\u00fap l\u00e0m s\u00e1ng t\u1ecf xu h\u01b0\u1edbng ho\u1eb7c ki\u1ec3u m\u1eabu chung.<\/p>\n

        Filler d\u00e0y, c\u1ee9ng h\u01a1n v\u1edbi \u0111\u1ed9 nh\u1edbt v\u00e0 \u0111\u00e0n h\u1ed3i cao h\u01a1n th\u01b0\u1eddng kh\u00f3 ti\u00eam h\u01a1n v\u00e0 do \u0111\u00f3 c\u1ea7n s\u1eed d\u1ee5ng kim ho\u1eb7c cannula d\u00e0y h\u01a1n. V\u00ed d\u1ee5, m\u1eb7c d\u00f9 Belotero Volume d\u01b0\u1edbi d\u1ea1ng gel 1 pha c\u00f3 th\u1ec3 \u0111i qua kim 30G v\u00ec l\u1ef1c \u0111\u1ea9y HA 1 pha kh\u00f4ng b\u1ecb h\u1ea1n ch\u1ebf b\u1edfi k\u00edch th\u01b0\u1edbc c\u1ee7a d\u1ee5ng c\u1ee5 ti\u00eam, nh\u01b0ng s\u1ea3n ph\u1ea9m d\u01b0\u1eddng nh\u01b0 c\u1ea3m th\u1ea5y c\u1ee9ng h\u01a1n nhi\u1ec1u khi \u0111\u1ea9y qua kim 25G so v\u1edbi khi \u0111\u1ea9y qua cannula 23G d\u00e0y h\u01a1n.<\/p>\n

        C\u00e1c s\u1ea3n ph\u1ea9m m\u1ec1m, l\u1ecfng v\u1edbi \u0111\u1ed9 nh\u1edbt v\u00e0 \u0111\u00e0n h\u1ed3i th\u1ea5p nh\u01b0 Restylane Vital, Belotero Soft v\u00e0 Juvederm Volbella th\u00ec ph\u00f9 h\u1ee3p h\u01a1n v\u1edbi ti\u00eam \u1edf b\u1ec1 m\u1eb7t trong da v\u00e0 ch\u00fang s\u1ebd d\u00e0n tr\u1ea3i qua m\u00f4 d\u1ec5 d\u00e0ng. N\u00f3i chung, filler HA 1 pha m\u1ec1m c\u00f3 G’ th\u1ea5p h\u01a1n nh\u01b0 Belotero Soft v\u00e0 Juvederm Volbella d\u00e0n tr\u1ea3i \u0111\u1ec1u h\u01a1n v\u00e0 t\u00edch h\u1ee3p \u0111\u1ed3ng nh\u1ea5t v\u00e0o m\u00f4, do \u0111\u00f3 t\u1ea1o ra \u00edt b\u1ea5t th\u01b0\u1eddng ho\u1eb7c r\u1ed1i lo\u1ea1n trong k\u1ebft c\u1ea5u h\u01a1n HA 2 pha d\u00e0y, c\u1ee9ng h\u01a1n. M\u1eb7t kh\u00e1c, kh\u1ea3 n\u0103ng d\u00e0n tr\u1ea3i cao c\u00f3 ngh\u0129a l\u00e0 filler HA 1 pha m\u1ec1m c\u00f3 di\u1ec7n t\u00edch ti\u1ebfp x\u00fac v\u1edbi enzyme hyaluronidase n\u1ed9i sinh nhi\u1ec1u h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi HA 2 pha c\u1ee9ng, d\u1eabn \u0111\u1ebfn s\u1ef1 tho\u00e1i h\u00f3a nhanh h\u01a1n. Th\u1eadt v\u1eady, theo kinh nghi\u1ec7m c\u1ee7a t\u00e1c gi\u1ea3, khi s\u1eed d\u1ee5ng Restylane v\u00e0 Belotero trong \u0111i\u1ec1u tr\u1ecb r\u00e3nh c\u01b0\u1eddi (b\u1eb1ng k\u1ef9 thu\u1eadt d\u01b0\u01a1ng x\u1ec9) ho\u1eb7c tr\u00ean da m\u1eb7t (b\u1eb1ng k\u1ef9 thu\u1eadt hydro lifting), Restylane g\u1ea7n nh\u01b0 c\u00f3 tu\u1ed5i th\u1ecd k\u00e9o d\u00e0i h\u01a1n, cho h\u01a1n 1 n\u0103m trong khi Belotero Balance t\u1ed3n t\u1ea1i trong kho\u1ea3ng th\u1eddi gian ng\u1eafn h\u01a1n. Quan s\u00e1t n\u00e0y ph\u00f9 h\u1ee3p v\u1edbi nh\u1eefng ph\u00e1t hi\u1ec7n c\u1ee7a Tran v\u00e0 c\u1ed9ng s\u1ef1 , khi so s\u00e1nh s\u1ef1 t\u00edch h\u1ee3p sinh h\u1ecdc c\u1ee7a c\u00e1c lo\u1ea1i filler HA kh\u00e1c nhau trong l\u1edbp h\u1ea1 b\u00ec d\u01b0\u1ea1 tr\u00ean \u0111\u1eb7c t\u00ednh \u0111\u1ed9 nh\u1edbt v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i c\u1ee7a ch\u00fang. Theo nghi\u00ean c\u1ee9u , trong khi Belotero Balance \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 cho s\u1ef1 t\u00edch h\u1ee3p \u0111\u1ed3ng nh\u1ea5t h\u01a1n trong m\u00f4, nh\u01b0ng n\u00f3 t\u1ed3n t\u1ea1i trong m\u00f4 \u00edt h\u01a1n Restylane 118 ng\u00e0y [14].<\/p>\n

        Do \u0111\u00f3, c\u00e1ch ti\u1ebfp c\u1eadn \u01b0a th\u00edch c\u1ee7a t\u00e1c gi\u1ea3 khi th\u1ef1c hi\u1ec7n ph\u01b0\u01a1ng ph\u00e1p hidro lifting l\u00e0 s\u1eed d\u1ee5ng Belotero Balance \u1edf b\u1ec7nh nh\u00e2n c\u00f3 da m\u1ecfng, s\u00e1ng ho\u1eb7c \u1edf nh\u1ee9ng v\u00f9ng da m\u1eb7t c\u00f3 m\u00f4 m\u1ecfng bao ph\u1ee7 nh\u01b0 quanh m\u1eaft v\u00e0 Restylane ho\u1eb7c Restylane Vital d\u00f9ng cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ed9 d\u00e0y da b\u00ecnh th\u01b0\u1eddng.<\/p>\n

        Trong khi \u0111\u00f3, v\u1edbi m\u1ee5c \u0111\u00edch l\u00e0 l\u00e0m \u0111\u1ea7y v\u00e0 ch\u1ec9nh h\u00ecnh, b\u1ea1n n\u00ean ch\u1ecdn filler HA d\u00e0y h\u01a1n, c\u1ee9ng h\u01a1n nh\u01b0 Restylane Lift, Belotero Volume v\u00e0 Juvederm Voluma c\u00f3 gi\u00e1 tr\u1ecb G’ cao nh\u1ea5t trong ph\u1ea1m vi c\u00e1c d\u00f2ng s\u1ea3n ph\u1ea9m. Restylane Lift l\u00e0 filler HA 2 pha c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao, v\u00e0 do \u0111\u00f3 k\u1ebft c\u1ea5u gel kh\u00e1 c\u1ee9ng, ph\u00f9 h\u1ee3p h\u01a1n khi \u0111\u1eb7t \u1edf nh\u1eefng v\u00f9ng x\u01b0\u01a1ng n\u1eb1m ngay d\u01b0\u1edbi da, \u0111\u1ec3 kh\u00f4ng tr\u1edf th\u00e0nh v\u1ea5n \u0111\u1ec1 khi s\u1edd th\u1ea5y s\u1ea3n ph\u1ea9m c\u1ee9ng. 1 \u0111i\u1ec3m c\u1ea7n c\u00e2n nh\u1eafc th\u00eam khi s\u1eed d\u1ee5ng Restylane Lift l\u00e0 do \u0111\u1ed9 li\u00ean k\u1ebft t\u01b0\u01a1ng \u0111\u00f4\u00ed th\u1ea5p c\u1ee7a d\u00f2ng filler HA c\u1ee7a Restylane, n\u00ean n\u00f3 th\u01b0\u1eddng ph\u00f9 h\u1ee3p h\u01a1n khi \u0111\u1eb7t \u1edf nh\u1eefng khu v\u1ef1c c\u00f3 \u00edt t\u00ednh di \u0111\u1ed9ng, v\u00ed d\u1ee5 s\u1ed1ng m\u0169i, jawline, v\u00e0 g\u00f2 m\u00e1 n\u01a1i m\u00e0 s\u1ea3n ph\u1ea9m kh\u00f4ng ch\u1ecbu t\u00e1c \u0111\u1ed9ng m\u1ea1nh c\u1ee7a c\u00e1c c\u01a1 xung quanh. L\u01b0u \u00fd, v\u00f9ng th\u00e1i d\u01b0\u01a1ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng HA 2 pha ho\u1eb7c 1 pha, b\u1ea5t ch\u1ea5p s\u1ef1 co l\u1eb7p \u0111i l\u1eb7p l\u1ea1i c\u1ee7a c\u00e1c c\u01a1 v\u00f9ng th\u00e1i d\u01b0\u01a1ng, v\u00ec v\u00f9ng th\u00e1i d\u01b0\u01a1ng d\u00e0y, bao ph\u1ee7 filler \u0111\u01b0\u1ee3c c\u1ea5y gh\u00e9p, ng\u0103n c\u1ea3n nh\u00ecn th\u1ea5y c\u00e1c b\u1ea5t th\u01b0\u1eddng c\u00f3 th\u1ec3 x\u1ea3y ra. Trong khi \u0111\u00f3, HA 1 pha c\u1ee9ng v\u1edbi \u0111\u1ed9 li\u00ean k\u1ebft cao nh\u01b0 Belotero Volume th\u01b0\u1eddng th\u00edch h\u1ee3p nh\u1ea5t v\u1edbi c\u00e1c v\u00f9ng ho\u1ea1t \u0111\u1ed9ng nhi\u1ec1u nh\u01b0 tr\u00e1n, m\u00e1, r\u00e3nh c\u01b0\u1eddi v\u00e0 m\u00e1 tr\u01b0\u1edbc.<\/p>\n

        Filler HA 1 pha, l\u00e0 filler m\u1ec1m v\u1edbi \u0111\u1ed9 c\u1ee9ng v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i th\u1ea5p h\u01a1n, r\u1ea5t l\u00fd t\u01b0\u1edfng \u0111\u1ec3 \u0111\u1eb7t v\u00e0o c\u00e1c v\u00f9ng nh\u01b0 m\u00f4i, m\u00e1 ph\u1ea3i c\u00f3 c\u1ea3m gi\u00e1c m\u1ec1m v\u00e0 m\u1ecbn. M\u1eb7t khM\u1eb7, filler HA 2 pha c\u1ee9ng h\u01a1n v\u00e0 \u0111\u00e0n h\u1ed3i h\u01a1n, ph\u00f9 h\u1ee3p h\u01a1n \u0111\u1ec3 c\u1ea5y gh\u00e9p v\u00e0o nh\u1eefng v\u00f9ng m\u00e0 x\u01b0\u01a1ng b\u00ean d\u01b0\u1edbi c\u00f3 th\u1ec3 s\u1edd th\u1ea5y tr\u1ef1c ti\u1ebfp, nh\u01b0 s\u1ed1ng m\u0169i, jawline, v\u00e0 x\u01b0\u01a1ng h\u00e0m. Trong khi, m\u1edf r\u1ed9ng ra, v\u00f9ng tr\u00e1n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem x\u00e9t l\u00e0 khu v\u1ef1c ph\u00f9 h\u1ee3p v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng HA 2 pha, nh\u01b0ng trong th\u1ef1c t\u1ebf th\u00ec kh\u00f4ng ph\u1ea3i nh\u01b0 v\u1eady. Thay v\u00e0o \u0111\u00f3, do khu v\u1ef1c n\u00e0y c\u00f3 c\u00e1c c\u01a1 ho\u1ea1t \u0111\u1ed9ng nhi\u1ec1u v\u00e0 kh\u00f4ng gian \u0111\u1ec3 \u0111\u01b0a ch\u1ea5t l\u00e0m \u0111\u1ea7y v\u00e0o h\u1ea1n ch\u1ebf, n\u00ean HA 1 pha m\u1ec1m h\u01a1n, v\u1edbi \u0111\u1ed9 li\u00ean k\u1ebft cao h\u01a1n v\u00e0 t\u00edch h\u1ee3p v\u00e0o m\u00f4 \u0111\u1ed3ng nh\u1ea5t h\u01a1n, l\u00e0 1 l\u1ef1a ch\u1ecdn t\u1ed1t h\u01a1n \u0111\u1ec3 l\u00e0m \u0111\u1ea7y v\u00f9ng tr\u00e1n. M\u1eb7t kh\u00e1c filler HA 2 pha ph\u00f9 h\u1ee3p h\u01a1n \u0111\u1ec3 \u0111\u01b0a v\u00e0o nh\u1eefng khu v\u1ef1c c\u00f3 da m\u1ecfng nh\u01b0 quanh m\u1eaft, bao g\u1ed3m cu\u1ed9n d\u01b0\u1edbi mi m\u1eaft v\u00e0 r\u00e3nh l\u1ec7, do xu h\u01b0\u1edbng c\u1ee7a HA 1 pha v\u1edbi G’ th\u1ea5p h\u01a1n \u0111\u1ec3 gi\u1eef n\u01b0\u1edbc khi c\u1ea5y v\u00e0o nh\u1eefng v\u00f9ng n\u00e0y.<\/p>\n

        Trong khi \u0111\u00f3, khi filler HA \u0111\u01b0\u1ee3c ti\u00eam bolus v\u00e0o l\u1edbp h\u1ea1 b\u00ec ho\u1eb7c b\u00ean d\u01b0\u1edbi da, n\u00f3 c\u00f3 th\u1ec3 t\u1ea1o ra hi\u1ec7u \u1ee9ng Tyndall (h\u00ecnh 2.25), 1 s\u1ef1 \u0111\u1ed5i m\u00e0u h\u01a1i xanh c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y b\u1eb1ng m\u1eaft th\u01b0\u1eddng do s\u1ef1 t\u00e1n x\u1ea1 \u00e1nh s\u00e1ng b\u1edfi filler HA \u0111\u01b0\u1ee3c c\u1ea5y v\u00e0o b\u1ec1 m\u1eb7t. Hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y ch\u00ednh x\u00e1c h\u01a1n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u201ct\u00e1n x\u1ea1 Rayleigh”, x\u1ea3y ra do \u00e1nh s\u00e1ng truy\u1ec1n qua kh\u00f4ng kh\u00ed ho\u1eb7c ch\u1ea5t l\u1ecfng b\u1ecb t\u00e1n x\u1ea1 b\u1edfi kh\u00f4ng kh\u00ed ho\u1eb7c n\u01b0\u1edbc c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf h\u01a1n b\u01b0\u1edbc s\u00f3ng \u00e1nh s\u00e1ng [21]. Khi \u0111i\u1ec1u n\u00e0y x\u1ea3y ra, \u00e1nh s\u00e1ng c\u00f3 b\u01b0\u1edbc s\u00f3ng ng\u1eafn h\u01a1n b\u1ecb t\u00e1n x\u1ea1 m\u1ea1nh h\u01a1n nhi\u1ec1u, do \u0111\u00f3, \u00e1nh s\u00e1ng xanh lam c\u00f3 b\u01b0\u1edbc s\u00f3ng ng\u1eafn \u0111\u01b0\u1ee3c \u01b0u ti\u00ean ph\u1ea3n x\u1ea1 l\u1ea1i m\u1eaft. \u0110i\u1ec1u n\u00e0y gi\u1ea3i th\u00edch t\u1ea1i sao b\u1ea7u tr\u1eddi c\u00f3 m\u00e0u xanh lam, c\u0169ng gi\u1ed1ng nh\u01b0 n\u01b0\u1edbc trong ao. \u0110\u1ec3 so s\u00e1nh, theo \u0111\u00fang ngh\u0129a hi\u1ec7u \u1ee9ng Tyndall l\u00e0 hi\u1ec7u \u1ee9ng \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y khi \u00e1nh s\u00e1ng t\u1ea1o ra ch\u00f9m tia nh\u00ecn th\u1ea5y \u0111\u01b0\u1ee3c khi truy\u1ec1n qua 1 ch\u1ea5t keo c\u00f3 k\u00edch th\u01b0\u1edbc h\u1ea1t \u0111\u01b0\u1eddng k\u00ednh t\u1eeb 1-1000 nm [22]. Ch\u00ednh v\u00ec l\u00fd do \u0111\u00f3 m\u00e0 \u0111\u00e8n pha oto khi \u0111i v\u00e0o s\u01b0\u01a1ng m\u00f9 s\u1ebd t\u1ea1o ra ch\u00f9m s\u00e1ng. Do \u0111\u00f3, trong khi t\u00e1n x\u1ea1 Rayleigh n\u00ean l\u00e0 thu\u1eadt ng\u1eef th\u00edch h\u1ee3p, nh\u01b0ng v\u00ec Tyndall \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u01b0\u1eddng xuy\u00ean h\u01a1n \u0111\u1ec3 m\u00f4 t\u1ea3 m\u00e0u h\u01a1i xanh xu\u1ea5t hi\u1ec7n sau khi ti\u00eam filler, n\u00ean ch\u00fang ta s\u1ebd g\u1ecdi hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y l\u00e0 hi\u1ec7u \u1ee9ng Tyndall \u0111\u1ec3 ti\u1ebfp t\u1ee5c th\u1ea3o lu\u1eadn. Hi\u1ec7u \u1ee9ng Tyndal th\u01b0\u1eddng xuy\u00ean x\u1ea3y ra n\u1ebfu filler HA \u0111\u01b0\u1ee3c \u0111\u1eb7t qu\u00e1 n\u00f4ng \u1edf l\u1edbp th\u01b0\u1ee3ng b\u00ec ho\u1eb7c s\u1ed1’ l\u01b0\u1ee3ng nhi\u1ec1u \u1edf nh\u1eefng v\u00f9ng c\u00f3 da m\u1ecfng nh\u01b0 cu\u1ed9n tr\u01b0\u1edbc m\u00ed m\u1eaft ho\u1eb7c m\u00e1ng l\u1ec7. M\u1eb7c d\u00f9 v\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y ng\u01b0\u1eddi ta \u0111\u00e3 \u0111\u1ec1 xu\u1ea5t r\u1eb1ng Belotero c\u00f3 xu h\u01b0\u1edbng t\u1ea1o ra \u00edt hi\u1ec7u \u1ee9ng Tyndall h\u01a1n khi \u0111\u01b0\u1ee3c c\u1ea5y v\u00e0o v\u00f9ng quanh \u1ed5 m\u1eaft c\u00f3 da m\u1ecfng nh\u01b0 cu\u1ed9n m\u00ed m\u1eaft d\u01b0\u1edbi v\u00e0 m\u00e1ng l\u1ec7, nh\u01b0ng v\u1eabn c\u1ea7n s\u1ef1 quan t\u00e2m \u0111\u1ea3m b\u1ea3o ch\u1ee9ng th\u1ef1c v\u1ec1 ph\u00e1t hi\u1ec7n n\u00e0y. Gi\u1ea3 thuy\u1ebft c\u01a1 b\u1ea3n cho ph\u00e1t hi\u1ec7n n\u00e0y l\u00e0 kh\u00f4ng gr\u00f4ng nh\u01b0 HA 2 pha, c\u00f3 m\u00f4 h\u00ecnh ph\u00e2n b\u1ed1 mocrobolus khi \u0111\u01b0\u1ee3c ti\u00eam v\u00e0o m\u00f4 da, Belotero c\u00f3 \u0111\u1ed9 nh\u1edbt th\u1ea5p v\u00e0 m\u1ec1m cho ph\u00e9p n\u00f3 d\u00e0n tr\u1ea3i qua l\u1edbp h\u1ea1 b\u00ec \u1edf d\u1ea1ng l\u1ecfng, \u0111\u1ed3ng nh\u1ea5t, kh\u00f4ng c\u00f3 c\u00e1c h\u1ea1t r\u1eddi r\u1ea1c c\u00f3 nguy c\u01a1 g\u00e2y ra s\u1ef1 t\u00e1n x\u1ea1 c\u1ee7a \u00e1nh s\u00e1ng xanh [11]. Tuy nhi\u00ean, \u0111i\u1ec1u n\u00e0y ch\u1ec9 ra r\u1eb1ng trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng l\u00e0m \u0111\u1ea7y r\u00e3nh l\u1ec7 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1eb1ng c\u00e1ch \u0111\u1eb7t 1 l\u1edbp m\u1ecfng d\u01b0\u1edbi da b\u1eb1ng k\u1ef9 thu\u1eadt retrograde, tr\u00e1i ng\u01b0\u1ee3c v\u1edbi ti\u00eam trong da \u1edf l\u1edbp th\u01b0\u1ee3ng b\u00ec. Tr\u00ean c\u01a1 s\u1edf n\u00e0y, kh\u00f3 c\u00f3 th\u1ec3 k\u1ebft lu\u1eadn Belotero mang l\u1ea1i l\u1ee3i \u00edch c\u1ee5 th\u1ec3 n\u00e0o \u0111\u00f3 so v\u1edbi c\u00e1c s\u1ea3n ph\u1ea9m kh\u00e1c trong vi\u1ec7c ch\u1ec9nh s\u1eeda r\u00e3nh l\u1ec7. \u0110i\u1ec1u t\u01b0\u01a1ng t\u1ef1 c\u0169ng \u00e1p d\u1ee5ng cho tr\u01b0\u1eddng h\u1ee3p n\u00f3 \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 n\u00e2ng s\u1ed1ng m\u0169i, th\u1ec3 t\u00edch th\u1ef1c s\u1ef1 \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o d\u01b0\u1edbi da trong qu\u00e1 tr\u00ecnh r\u00fat kim.<\/p>\n

        Thay v\u00e0o \u0111\u00f3, trong th\u1ef1c t\u1ebf c\u1ee7a ri\u00eang t\u00f4i, t\u00f4i \u0111\u00e3 quan s\u00e1t \u0111\u01b0\u1ee3c c\u00e1c tr\u01b0\u1eddng h\u1ee3p x\u1ea3y ra hi\u1ec7u \u1ee9ng Tyndall sau khi ti\u00eam Belotero Volume v\u1edbi th\u1ec3 t\u00edch l\u01a1n (>1ml) v\u00e0o d\u00e1i tai. D\u1ef1a tr\u00ean kinh nghi\u1ec7m l\u00e2m s\u00e0ng nh\u01b0 v\u1eady, t\u00e1c gi\u1ea3 cho r\u1eb1ng kh\u00f4ng c\u00f3 s\u1ea3n ph\u1ea9m n\u00e0o c\u00f3 th\u1ec3 ho\u00e0n to\u00e0n kh\u00f4ng c\u00f3 nguy c\u01a1 x\u1ea3y ra hi\u1ec7u \u1ee9ng Tyndall khi \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o nh\u1eefng v\u00f9ng c\u00f3 m\u00f4 m\u1ecfng bao ph\u1ee7 ho\u1eb7c th\u1ec3 t\u00edch l\u1edbn \u1edf d\u01b0\u1edbi da. \u0110\u00fang v\u1eady, Belotero \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 t\u1ea1o ra hi\u1ec7u \u1ee9ng Tyndall \u00edt h\u01a1n trong l\u1edbp h\u1ea1 b\u00ec. Tuy nhi\u00ean, khi n\u00f3i \u0111\u1ebfn l\u00e0m \u0111\u1ea7y r\u00e3nh l\u1ec7 hay cu\u1ed9n mi m\u1eaft d\u01b0\u1edbi, th\u00ec \u0111\u1ed9 s\u00e2u m\u1ee5c ti\u00eau c\u1ee7a m\u0169i ti\u00eam kh\u00f4ng n\u1eb1m \u1edf l\u1edbp h\u1ea1 b\u00ec b\u1ec1 ngo\u00e0i. N\u1ebfu c\u00f3 b\u1ea5t k\u1ef3 \u0111i\u1ec1u g\u00ec x\u1ea3y ra, th\u00ec t\u00ednh \u01b0a n\u01b0\u1edbc c\u1ee7a HA 1 pha c\u00f3 th\u1ec3 ch\u1ec9 g\u00f3p ph\u1ea7n v\u00e0o nguy c\u01a1 x\u1ea3y ra hi\u1ec7u \u1ee9ng Tyndall \u1edf nh\u1eefng khu v\u1ef1c n\u00e0y, v\u00e0 nh\u01b0 v\u1eady, filler HA 2 pha c\u00f3 th\u1ec3 \u0111\u1ea1i di\u1ec7n cho 1 l\u1ef1a ch\u1ecdn t\u1ed1t h\u01a1n, m\u1eb7c d\u00f9 \u0111i\u1ec3m n\u00e0y v\u1eabn l\u00e0 1 ch\u1ee7 \u0111\u1ec1 c\u1ea7n nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng trong t\u01b0\u01a1ng lai.<\/p>\n

        Restylane, 1 HA 2 pha, c\u00f3 k\u1ebft c\u1ea5u gel c\u1ee9ng ph\u1ea3n \u00e1nh \u0111\u1ed9 nh\u1edbt v\u00e0 G’ cao, \u0111\u1ed3ng th\u1eddi c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y t\u1ed1t nh\u01b0 1 kh\u1ed1i v\u1eefng ch\u1eafc, \u00edt d\u00e0n tr\u1ea3i, m\u1eb7c d\u00f9 \u0111\u1ed9 nh\u1edbt cao c\u1ee7a n\u00f3 ng\u0103n c\u1ea3n d\u00f2ng ch\u1ea3y c\u1ee7a qu\u00e1 tr\u00ecnh ti\u00eam v\u00e0 \u0111\u1ed9 d\u00e0n tr\u1ea3i c\u1ee7a gel th\u1ea5p l\u00e0m cho n\u00f3 kh\u00f3 n\u1eafn ch\u1ec9nh khi ti\u00eam, nh\u01b0ng kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y cao c\u1ee7a n\u00f3 l\u00e0m cho s\u1ea3n ph\u1ea9m l\u00fd t\u01b0\u1edfng \u0111\u1ec3 \u0111\u1eb7t trong m\u1eb7t ph\u1eb3ng m\u00f4 s\u00e2u, n\u01a1i n\u00f3 c\u00f3 th\u1ec3 cho c\u1ea5u tr\u00fac v\u00e0 \u0111i\u1ec1u ch\u1ec9nh t\u1ed1t.<\/p>\n

        Khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho k\u1ef9 thu\u1eadt ph\u00e2n l\u1edbp k\u00e9p, HA 2 pha nh\u01b0 Restylane c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p v\u1edbi \u0111\u1eb7t HA 1 pha l\u00ean l\u1edbp tr\u00ean b\u1ec1 m\u1eb7t \u0111\u1ec3 cho k\u1ebft qu\u1ea3 t\u1ed1i \u01b0u. Filler HA 1 pha cung c\u1ea5p \u0111\u1ed9 d\u1ebbo t\u1ed1t h\u01a1n v\u00e0 do \u0111\u00f3 l\u00fd t\u01b0\u1edfng cho l\u1edbp b\u1ec1 m\u1eb7t. V\u00ed d\u1ee5, khi l\u00e0m \u0111\u1ea7y v\u00f9ng g\u00f2 m\u00e1 tr\u01b0\u1edbc, \u0111\u1ea7u ti\u00ean c\u00f3 th\u1ec3 \u0111\u1eb7t HA 2 pha v\u00e0o m\u1eb7t ph\u1eb3ng m\u00f4 s\u00e2u \u0111\u1ec3 l\u00e0m t\u0103ng th\u1ec3 t\u00edch v\u00e0 \u0111i\u1ec1u ch\u1ec9nh b\u1ea5t k\u1ef3 ch\u1ed7 l\u00f5m tr\u00ean b\u1ec1 m\u1eb7t c\u00f2n l\u1ea1i b\u1eb1ng HA 1 pha trong m\u1eb7t ph\u1eb3ng b\u1ec1 m\u1eb7t (b\u1ea3ng 2.4).<\/p>\n

        B\u1ea3ng 2.4<\/strong>: L\u00e0m \u0111\u1ea7y b\u1eb1ng filler HA v\u1edbi kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y cao h\u01a1n<\/p>\n\n\n\n\n
        T\u00ean th\u01b0\u01a1ng m\u1ea1i<\/td>\nRestylane Lift<\/td>\nRestylane Volyme<\/td>\nJuvederm VOLUMA<\/td>\nJuvederm Volux<\/td>\nBetolero Volume<\/td>\n<\/tr>\n
        C\u00f4ng ty<\/td>\nGalderma (Sweden)<\/td>\nGalderma (Sweden)<\/td>\nAllergan (France)<\/td>\nAllergan (France)<\/td>\nMerz (Switzerland)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n\n\n
        C\u00f4ng ngh\u1ec7 s\u1ea3n xu\u1ea5t<\/td>\nNASHA<\/td>\nOBT<\/td>\nVYCROSS<\/td>\nVYCROSS<\/td>\nCPM<\/td>\n<\/tr>\n
        1 pha hay 2 pha<\/td>\n2 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n<\/tr>\n
        N\u1ed3ng \u0111\u1ed9<\/p>\n

        HA<\/td>\n

        		20mg\/ml<\/td>\n20mg\/ml<\/td>\n20mg\/ml<\/td>\n25mg\/ml<\/td>\n26mg\/ml<\/td>\n<\/tr>\n
        MoD<\/p>\n

        (%)<\/td>\n

        		<1%<\/td>\n6-8%<\/td>\n4%<\/td>\n6-7%<\/td>\n5.1%<\/td>\n<\/tr>\n
        Kim<\/td>\n29G<\/td>\n27G<\/td>\n27G<\/td>\n27G<\/td>\n27G,30G<\/td>\n<\/tr>\n
        M\u1ee9c \u0111\u1ed9 ti\u00eam<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng\/ h\u1ea1 b\u00ec s\u00e2u<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng\/ h\u1ea1 b\u00ec s\u00e2u<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng\/ h\u1ea1 b\u00ec s\u00e2u<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

         <\/p>\n\n\n\n\n\n\n\n\n\n\n\n
        T\u00ean th\u01b0\u01a1ng m\u1ea1i<\/td>\nYVOIRE Y- Solution 720<\/td>\nYVOIRE Contour<\/td>\nNeuramis<\/p>\n

        Volume<\/td>\n

        		E.P.T.Q<\/p>\n

        S500<\/td>\n<\/tr>\n

        C\u00f4ng ty<\/td>\nLG Chem (Korea)<\/td>\nLG Chem (Korea)<\/td>\nMedytox (Korea)<\/td>\nJETEMA (Korea)<\/td>\n<\/tr>\n
        C\u00f4ng ngh\u1ec7 s\u1ea3n xu\u1ea5t<\/td>\nS-HICE<\/td>\nHICE<\/td>\nSHAPE<\/td>\nJetema<\/p>\n

        (Korea)<\/td>\n<\/tr>\n

        1 pha\/2 pha<\/td>\n2 pha<\/td>\n2 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n<\/tr>\n
        N\u1ed3ng \u0111\u1ed9 HA<\/td>\n20mg\/ml<\/td>\n22mg\/ml<\/td>\n20mg\/ml<\/td>\n24mg\/ml<\/td>\n<\/tr>\n
        MoD (%)<\/td>\n3.3%<\/td>\n2.0%<\/td>\nkh\u00f4ng c\u00f4ng b\u1ed1<\/td>\n1.89%<\/td>\n<\/tr>\n
        Kim<\/td>\n27G<\/td>\n23G<\/td>\n27G<\/td>\n27G<\/td>\n<\/tr>\n
        M\u1ee9c \u0111\u1ed9 ti\u00eam<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean<\/td>\n<\/tr>\n
        <\/td>\n<\/td>\n<\/td>\n<\/td>\nm\u00e0ng x\u01b0\u01a1ng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        C\u00e1c s\u1ea3n ph\u1ea9m filler HA ch\u00ednh<\/h2>\n

        Restylane: ti\u00eau chu\u1ea9n v\u00e0ng c\u1ee7a filler HA<\/h3>\n

        Restylane (Galderma, Sweden) l\u00e0 loaik filler HA \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn b\u1edfi FDA Hoa K\u1ef3 n\u0103m 2003, sau khi n\u00f3 \u0111\u01b0\u1ee3c ch\u1ee9ng nh\u1eadn CE \u1edf ch\u00e2u \u00c2u n\u0103m 1996. Ng\u00e0y nay, Restylane \u0111\u01b0\u1ee3c xem l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng c\u1ee7a c\u00e1c lo\u1ea1i filler HA d\u1ef1a tr\u00ean an to\u00e0n \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp tr\u00ean to\u00e0n c\u1ea7u v\u00e0 ti\u1ec3u s\u1eed hi\u1ec7u qu\u1ea3 c\u1ee7a n\u00f3. Trong n\u0103m 2020, c\u00f3 h\u01a1n 40 tri\u1ec7u case \u0111i\u1ec1u tr\u1ecb s\u1eed d\u1ee5ng Restylane tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. \u0110\u00e1ng ch\u00fa \u00fd, Restylane \u0111\u1ea1i di\u1ec7n cho filler HA \u0111\u1ea7u ti\u00ean \u1ee9ng d\u1ee5ng c\u00f4ng ngh\u1ec7 acid hyaluronic \u1ed5n \u0111\u1ecbnh (NASHA) kh\u00f4ng c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb \u0111\u1ed9ng v\u1eadt. M\u1eb7c d\u00f9 vi\u1ec7c s\u1eed d\u1ee5ng HA kh\u00f4ng t\u1eeb \u0111\u1ed9ng v\u1eadt kh\u00f4ng c\u00f2n l\u00e0 1 \u0111i\u1ec3m \u0111\u1ec3 ph\u00e2n bi\u1ec7t gi\u1eefa c\u00e1c filler HA th\u01b0\u01a1ng m\u1ea1i hi\u1ec7n c\u00f3 ng\u00e0y nay, v\u00ec h\u1ea7u h\u1ebft \u0111\u1ec1u d\u1ef1a tr\u00ean HA c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb nu\u00f4i c\u1ea5y vi khu\u1ea9n , tr\u1edf l\u1ea1i khi Restylane l\u1ea7n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ra m\u1eaft, NASHA \u0111\u00e3 th\u1ef1c s\u1ef1 mang t\u00ednh c\u1ea3i ti\u1ebfn, ch\u1eb3ng h\u1ea1n nh\u01b0 n\u00f3 \u0111\u00e3 \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p v\u00e0o t\u00ean s\u1ea3n ph\u1ea9m, nh\u01b0 c\u00e1c gel HA hi\u1ec7n c\u00f3 \u0111\u1ec1u d\u1ef1a tr\u00ean ch\u1ea5t chi\u1ebft su\u1ea5t t\u1eeb m\u00e0o g\u00e0 tr\u1ed1ng. Trong khi \u0111\u00f3, thu\u1eadt ng\u1eef \u201c\u1ed5n \u0111\u1ecbnh\u201d trong NASHA bi\u1ec3u th\u1ecb c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a Restylane l\u00e0 gel HA c\u1ee9ng v\u1edbi m\u1ee9c \u0111\u1ed9 bi\u1ebfn \u0111\u1ed5i th\u1ea5p ch\u1ec9 bao g\u1ed3m c\u00e1c h\u1ea1t gel c\u00f3 c\u00f9ng k\u00edch th\u01b0\u1edbc.<\/p>\n

        Vi\u1ec7c s\u1eed d\u1ee5ng c\u00f4ng ngh\u1ec7 NASHA \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ea5p b\u1eb1ng s\u00e1ng ch\u1ebf \u0111\u1ec3 \u1ed5n \u0111\u1ecbnh gel HA thay v\u00ec li\u00ean k\u1ebft ch\u00e9o h\u00f3a h\u1ecdc v\u1edbi BDDE cho ph\u00e9p Restylane \u0111\u1ea1t \u0111\u01b0\u1ee3c \u00edt h\u01a1n 1% MoD (m\u1ee9c \u0111\u1ed9 bi\u1ebfn \u0111\u1ed5i) trong s\u1ea3n ph\u1ea9m cu\u1ed1i c\u00f9ng (h\u00ecnh 2.7). do \u0111\u00f3, n\u00f3 c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u c\u00e1c bi\u1ebfn ch\u1ee9ng ti\u1ec1m \u1ea9n ph\u00e1t sinh t\u1eeb vi\u1ec7c bi\u1ebfn \u0111\u1ed5i HA b\u1edfi ch\u1ea5t x\u00fac t\u00e1c li\u00ean k\u1ebft ch\u00e9o v\u00e0 \u0111\u1ea3m b\u1ea3o t\u00ednh t\u01b0\u01a1ng th\u00edch sinh h\u1ecdc t\u1ed1i \u01b0u. Trong khi \u0111\u00f3, m\u1ed7i s\u1ea3n ph\u1ea9m trong d\u00f2ng s\u1ea3n ph\u1ea9m Restylane \u0111\u1ea1i di\u1ec7n cho 1 filler HA 2 pha \u0111\u00e0n h\u1ed3i, v\u00e0 ch\u1ee9a c\u00e1c h\u1ea1t gel c\u00f3 k\u00edch th\u01b0\u1edbc \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh ri\u00eang (h\u00ecnh 2.2). Theo th\u1ee9 t\u1ef1 k\u00edch th\u01b0\u1edbc h\u1ea1t gel t\u0103ng d\u1ea7n l\u00e0 Restylane Skinbooster Vital Light, Restylane, v\u00e0<\/p>\n

        Restylane Lift ( tr\u01b0\u1edbc \u0111\u00e2y l\u00e0 Restylane Perlane) (b\u1ea3ng 2.5). trong khi \u0111\u00f3, Restylane SubQ c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o danh s\u00e1ch, c\u00f3 k\u00edch th\u01b0\u1edbc h\u1ea1t l\u1edbn nh\u1ea5t, sau \u0111\u00f3 \u0111\u00e3 b\u1ecb ng\u1eebng s\u1ea3n xu\u1ea5t v\u00e0o n\u0103m 2018. Trong khi \u0111\u00f3, c\u0169ng c\u1ea7n l\u01b0u \u00fd r\u1eb1ng Restylane \u0111\u00e3 ch\u1ea5p nh\u1eadn kh\u00e1i ni\u1ec7m \u201cph\u00f9 h\u1ee3p v\u1edbi m\u00f4\u201d, theo \u0111\u00f3, c\u00e1c s\u1ea3n ph\u1ea9m \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh cho ph\u00f9 h\u1ee3p v\u1edbi c\u00e1c ch\u1ec9 \u0111\u1ecbnh tr\u00ean l\u00e2m s\u00e0ng v\u00e0 \u0111\u1ed9 s\u00e2u ti\u00eam kh\u00e1c nhau ngay t\u1eeb \u0111\u1ea7u nh\u1eefng n\u0103m 2000 trong th\u1eddi gian m\u1edbi ra \u0111\u1eddi, k\u1ec3 t\u1eeb \u0111\u00f3 tr\u1edf th\u00e0nh t\u00ednh n\u0103ng ti\u00eau chu\u1ea9n c\u1ee7a h\u1ea7u h\u1ebft c\u00e1c th\u01b0\u01a1ng hi\u1ec7u filler hi\u1ec7n nay. Theo \u0111\u00f3, Restylane Booster Vital, bao g\u1ed3m c\u00e1c h\u1ea1t gel nh\u1ecf h\u01a1n, \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 ti\u00eam b\u1ec1 m\u1eb7t trong l\u1edbp h\u1ea1 b\u00ec \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c n\u1ebfp nh\u0103n v\u00e0 m\u1ea5t \u0111\u1ed9 \u0111\u00e0n h\u1ed3i, Restylane Lift v\u1edbi k\u00edch th\u01b0\u1edbc h\u1ea1t gel l\u1edbn h\u01a1n th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ti\u00eam s\u00e2u tr\u00ean m\u00e0ng x\u01b0\u01a1ng ho\u1eb7c trong m\u00f4 b\u00ean d\u01b0\u1edbi da \u0111\u1ec3 ph\u1ee5c h\u1ed3i t\u00ecnh tr\u1ea1ng thi\u1ebfu h\u1ee5t th\u1ec3 t\u00edch, Restylane Skinbooster Vital Light c\u00f3 k\u00edch th\u01b0\u1edbc h\u1ea1t nh\u1ecf nh\u1ea5t \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 s\u1eed d\u1ee5ng cho c\u00e1c v\u00f9ng da m\u1ecfng, m\u1ecbn, bao g\u1ed3m c\u1ea3 v\u00f9ng quanh m\u1eaft v\u00e0 c\u1ed5. Trong khi \u0111\u00f3, Restylane c\u1ed5 \u0111i\u1ec3n c\u00f3 k\u00edch th\u01b0\u1edbc h\u1ea1t trung b\u00ecnh, l\u00e0m cho n\u00f3 c\u00f3 th\u1ec3 ph\u00f9 h\u1ee3p \u0111\u1ec3 ti\u00eam v\u00e0o l\u1edbp h\u1ea1 b\u00ec s\u00e2u \u0111\u1ec3 ch\u1ec9nh s\u1eeda c\u00e1c n\u1ebfp g\u1ea5p trung b\u00ecnh. V\u00e0o n\u0103m 2009, c\u00e1c s\u1ea3n ph\u1ea9m Restylanr b\u1ed5 sung s\u1eb5n 0.3 % lodocain, \u0111\u1ea3m b\u1ea3o s\u1ef1 tho\u1ea3i m\u00e1i h\u01a1n cho b\u1ec7nh nh\u00e2n. V\u00e0o n\u0103m 2010, d\u00f2ng ch\u1ea5t l\u00e0m \u0111\u1ea7y HA c\u1ee7a Emervel k\u1ebft h\u1ee3p c\u00f4ng ngh\u1ec7 OBT (c\u00f4ng ngh\u1ec7 c\u00e2n b\u1eb1ng t\u1ed1i \u01b0u) \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t \u1edf ch\u00e2u \u00c2u, v\u00e0o n\u0103m 2016 c\u00f4ng ngh\u1ec7 n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ed5i t\u00ean v\u00e0 t\u00edch h\u1ee3p th\u00e0nh th\u01b0\u01a1ng hi\u1ec7u Restylane, do \u0111\u00f3 m\u1edf r\u1ed9ng ph\u1ea1m vi v\u00e0 t\u00ednh linh ho\u1ea1t c\u1ee7a d\u00f2ng s\u1ea3n ph\u1ea9m Restylane (h\u00ecnh 2.8). S\u1ea3n ph\u1ea9m OBT l\u00e0 filler HA m\u1ec1m 1 pha c\u00f3 c\u00f9ng n\u1ed3ng \u0111\u1ed9 HA l\u00e0 20mg\/ml, nh\u01b0ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 m\u1ee9c \u0111\u1ed9 v\u00e0 lo\u1ea1i li\u00ean k\u1ebft ch\u00e9o c\u0169ng nh\u01b0 k\u00edch th\u01b0\u1edbc h\u1ea1t. MoD c\u1ee7a filler OBT n\u1eb1m trong kho\u1ea3ng 6-8% v\u00e0 thay \u0111\u1ed5i t\u00f9y thu\u1ed9c v\u00e0o t\u1eebng s\u1ea3n ph\u1ea9m. Trong khi c\u00e1c s\u1ea3n ph\u1ea9m s\u1eed d\u1ee5ng c\u00f4ng ngh\u1ec7 OBT \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i l\u00e0 HA m\u1ec1m 1 pha, ch\u00fang c\u0169ng \u0111\u01b0\u1ee3c ch\u1ee9ng minh c\u00f3 k\u00edch th\u01b0\u1edbc h\u1ea1t g\u1ea7n nh\u01b0 kh\u00f4ng \u0111\u1ed5i do k\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh s\u00e0ng l\u1ecdc \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t \u0111\u1ec3 c\u00f3 \u0111\u1ed9 \u0111\u1ed3ng nh\u1ea5t t\u1ed1i \u01b0u. C\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 k\u00edch th\u01b0\u1edbc h\u1ea1t nh\u1ecf v\u00e0 c\u00f3 \u00edt li\u00ean k\u1ebft ch\u00e9o \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 ti\u00eam b\u1ec1 m\u1eb7t (v\u00ed d\u1ee5 Restylane Ffyness, trong khi c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 k\u00edch th\u01b0\u1edbc h\u1ea1t l\u1edbn h\u01a1n v\u00e0 c\u00f3 nhi\u1ec1u li\u00ean k\u1ebft ch\u00e9o \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 ti\u00eam s\u00e2u h\u01a1n v\u00e0 l\u00e0m \u0111\u1ea7y (v\u00ed d\u1ee5 Restylane Voyme). \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a ch\u00fang l\u00e0 c\u00f3 k\u1ebft c\u1ea5u gel m\u1ec1m h\u01a1n v\u00e0 linh ho\u1ea1t h\u01a1n c\u00e1c s\u1ea3n ph\u1ea9m t\u00edch h\u1ee3p c\u00f4ng ngh\u1ec7 OBT bao g\u1ed3m Restylane Fyness, Restylane Kysse, Restylane Refyne, Restylane Defyne, v\u00e0 Restylane Volyme.<\/p>\n

        T\u1eeb filler HA r\u1ea5t m\u1ec1m \u0111\u1ebfn r\u1ea5t c\u1ee9ng, d\u00f2ng s\u1ea3n ph\u1ea9m Restylane c\u1ef1c k\u1ef3 linh ho\u1ea1t v\u00e0 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong h\u1ea7u h\u1ebft c\u00e1c ch\u1ec9 \u0111\u1ecbnh. S\u1ea3n ph\u1ea9m NASHA Restylane Lift c\u1ee9ng c\u1ee7a h\u00e3ng s\u1edf h\u1eefu kh\u1ea3 n\u0103ng n\u00e2ng m\u00f4 cao h\u01a1n, ph\u00f9 h\u1ee3p cho vi\u1ec7c ph\u1ee5c h\u1ed3i th\u1ec3 t\u00edch. Nh\u1edd kh\u1ea3 n\u0103ng gi\u1ea3m s\u01b0ng t\u1ea5y sau ti\u00eam, s\u1ea3n ph\u1ea9m NASHA Restylane c\u0169ng tr\u1edf th\u00e0nh filler \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn trong l\u00e0m \u0111\u1ea7y r\u00e3nh m\u0169i m\u00e1, r\u00e3nh l\u1ec7 v\u00e0 c\u00e1c v\u00f9ng \u0111\u01b0\u1ee3c bao ph\u1ee7 b\u1edfi l\u1edbp da m\u1ecfng kh\u00e1c c\u1ee7a khu\u00f4n m\u1eb7t. M\u1eb7t kh\u00e1c, s\u1ea3n ph\u1ea9m OBT Restylane Refyne m\u1ec1m t\u1ed1i \u01b0u h\u00f3a \u0111\u1ec3 s\u1eed d\u1ee5ng \u1edf l\u1edbp h\u1ea1 b\u00ec b\u1ec1 m\u1eb7t \u0111\u1ec3 tr\u00e1nh c\u00e1c b\u1ea5t th\u01b0\u1eddng ti\u1ec1m \u1ea9n do t\u00ednh d\u1ec5 thay \u0111\u1ed5i h\u00ecnh d\u1ea1ng v\u00e0 kh\u1ea3 n\u0103ng d\u00e0n tr\u1ea3i c\u1ee7a n\u00f3. Ngo\u00e0i ra, c\u00e1c s\u1ea3n ph\u1ea9m OBT Restylane Lift c\u1ee9ng \u0111\u1ec3 s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb c\u00e1c khu v\u1ef1c c\u00f3 t\u00ednh di \u0111\u1ed9ng cao nh\u01b0 \u0111\u01b0\u1eddng marionette v\u00e0 v\u00f9ng tr\u00e1n.<\/p>\n

        B\u1ea3ng 2.5: C\u00e1c s\u1ea3n ph\u1ea9m Restylane<\/p>\n\n\n\n\n\n\n\n\n\n\n
        T\u00ean th\u01b0\u01a1 ng m\u1ea1i<\/td>\nRestyla ne Lift<\/td>\nRestyla ne Lidocai n<\/td>\nRestylan e Skinboo ster Vital<\/td>\nRestylan e Skinboo ster Vital Light<\/td>\nRestyla ne Fyness<\/td>\nRestyla ne Refyne<\/td>\nRestyla ne<\/p>\n

        Defyne<\/td>\n

        		Restyla ne Volym e<\/td>\nRestyla ne Kyssr<\/td>\n<\/tr>\n
        C\u00f4ng ngh\u1ec7 s\u1ea3n xu\u1ea5t<\/td>\nNASHA<\/td>\nNASHA<\/td>\nNASHA<\/td>\nNASHA<\/td>\nOBT<\/td>\nOBT<\/td>\nOBT<\/td>\nOBT<\/td>\nOBT<\/td>\n<\/tr>\n
        1\u00a0 hay<\/p>\n

        2\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0pha<\/td>\n

        		1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n<\/tr>\n
        N\u1ed3ng \u0111\u1ed9 HA<\/td>\n20mg\/ ml<\/td>\n20mg\/ ml<\/td>\n20mg\/m l<\/td>\n12mg\/m l<\/td>\n20mg\/ ml<\/td>\n20mg\/ ml<\/td>\n20mg\/ ml<\/td>\n20mg\/ ml<\/td>\n20mg\/ ml<\/td>\n<\/tr>\n
        Kh\u1ea3 n\u0103ng n\u00e2ng \u0111\u1ee1 m\u00f4<\/td>\n+++<\/td>\n++<\/td>\n+<\/td>\n+<\/td>\n+<\/td>\n++<\/td>\n+++<\/td>\n++++<\/td>\n+++<\/td>\n<\/tr>\n
        Kim<\/td>\n29G<\/td>\n29G<\/td>\n29G<\/td>\n29G<\/td>\n30G<\/td>\n30G<\/td>\n27G<\/td>\n27G<\/td>\n30G<\/td>\n<\/tr>\n
        M\u1ee9c \u0111\u1ed9 ti\u00eam<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng \/ h\u1ea1 b\u00ec s\u00e2u<\/td>\nH\u1ea1 b\u00ec gi\u1eefa \u0111\u1ebfn s\u00e2u<\/td>\nH\u1ea1 b\u00ec n\u00f4ng \u0111\u1ebfn gi\u1eefa<\/td>\nH\u1ea1 b\u00ec n\u00f4ng \u0111\u1ebfn gi\u1eefa<\/td>\nTr\u00ean h\u1ea1 b\u00ec<\/td>\nH\u1ea1 b\u00ec gi\u1eefa \u0111\u1ebfn s\u00e2u<\/td>\nH\u1ea1 b\u00ec s\u00e2u\/ d\u01b0\u1edbi da<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\nTr\u00ean h\u1ea1 b\u00ec<\/td>\n<\/tr>\n
        K\u00edch th\u01b0\u1edb c h\u1ea1t<\/td>\n650^m<\/td>\n300|1<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        OBT<\/p>\n

        Juvederm: filler HA m\u1ec1m \u0111\u1ea7u ti\u00ean (h\u00ecnh 2.28)<\/h3>\n

        Juvederm (Allergan, Ph\u00e1p) \u0111\u00e3 \u0111\u01b0\u1ee3c CE ph\u00ea duy\u1ec7t t\u1ea1i ch\u00e2u \u00c2u n\u0103m 2004 v\u00e0 \u0111\u01b0\u1ee3c FDA Hoa K\u1ef3 ph\u00ea duy\u1ec7t n\u0103m 2006. Juvederm l\u00e0 filler HA m\u1ec1m (1 pha) \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ph\u00e1t ti\u1ec3n b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng c\u00f4ng ngh\u1ec7 HYLACROSS \u0111\u1ec3 c\u1ea1nh tranh l\u1ea1i v\u1edbi filler HA c\u1ee9ng l\u00e0 d\u00f2ng s\u1ea3n ph\u1ea9m NASHA (b\u1ea3ng 2.6). Trong khi Restylane l\u00e0 filler HA c\u1ee9ng (2 pha), l\u00e0 1 lo\u1ea1i gel th\u1ec3 hi\u1ec7n t\u00ednh nh\u1ea5t qu\u00e1n d\u1ea1ng h\u1ea1t, th\u00ec Juvederm c\u00f3 k\u1ebft c\u1ea5u gel m\u1ecbn, \u0111\u1eb7c tr\u01b0ng c\u1ee7a HA 1 pha. L\u00e0 1 filler m\u1ec1m m\u1ecbn, c\u00f3 t\u00ednh d\u00e0n tr\u1ea3i v\u1edbi \u0111\u1ed9 nh\u1edbt v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i th\u1ea5p, n\u00ean Juvederm cho kh\u1ea3 n\u0103ng d\u1ec5 ti\u00eam v\u00e0 d\u1ec5 n\u1eafn ch\u1ec9nh h\u01a1n, \u0111i\u1ec1u n\u00e0y \u0111\u1eb7c bi\u1ec7t th\u00edch h\u1ee3p \u0111\u1ec3 ti\u00eam v\u00e0o m\u1eb7t ph\u1eb3ng n\u00f4ng tr\u00ean b\u1ec1 m\u1eb7t. M\u1eb7c d\u00f9 c\u00f3 \u0111\u1ed9 nh\u1edbt v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i th\u1ea5p nh\u01b0ng Juvederm c\u0169ng r\u1ea5t l\u00fd t\u01b0\u1edfng \u0111\u1ec3 t\u1ea1o \u0111\u1ed9 ph\u1ed3ng v\u00e0 t\u1ea1o \u0111\u01b0\u1eddng n\u00e9t nh\u1edd t\u00ednh li\u00ean k\u1ebft cao. Trong d\u00f2ng s\u1ea3n ph\u1ea9m Juvederm, th\u00ec Juvederm Ultra v\u00e0 Juvederm Ultra Plus \u0111\u01b0\u1ee3c b\u00e0o ch\u1ebf b\u1eb1ng c\u00f4ng ngh\u1ec7 HYLACROSS v\u1edbi c\u00f9ng n\u1ed3ng \u0111\u1ed9 HA l\u00e0 24mg\/ml, m\u1eb7c d\u00f9 c\u00f3 t\u1ef7 l\u1ec7 li\u00ean k\u1ebft ch\u00e9o kh\u00e1c nhau, v\u1edbi 6% cho Juvederm Ultra v\u00e0 8% cho Juvederm Ultra Plus. Do t\u1ec9 l\u1ec7 li\u00ean k\u1ebft ch\u00e9o cao h\u01a1n, Juvederm Ultra Plus cho kh\u1ea3 n\u0103ng li\u00ean k\u1ebft v\u00e0 n\u00e2ng m\u00f4 cao h\u01a1n, do \u0111\u00f3 th\u01b0\u1eddng \u0111\u1ec3 t\u0103ng th\u1ec3 t\u00edch trong m\u1eb7t ph\u1eb3ng s\u00e2u [9].<\/p>\n

        Tuy nhi\u00ean, do n\u1ed3ng \u0111\u1ed9 HA cao (24mg\/ml) v\u00e0 s\u1eed d\u1ee5ng HA tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed cao, n\u00ean c\u00e1c s\u1ea3n ph\u1ea9m HYLACROSS d\u1ec5 b\u1ecb hydrat h\u00f3a h\u01a1n nhi\u1ec1u (t\u1ee9c l\u00e0 gel tr\u01b0\u01a1ng n\u1edf) v\u00e0 c\u00f3 th\u1ec3 h\u00fat n\u01b0\u1edbc g\u1ea5p \u0111\u00f4i so v\u1edbi c\u00e1c s\u1ea3n ph\u1ea9m \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng tr\u00ean c\u00f4ng ngh\u1ec7 VYCROSS [9]. Do \u0111\u00f3, v\u00f3n c\u1ee5c v\u00e0 kh\u00f4ng \u0111\u1ec1u \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 ph\u1ed5 bi\u1ebfn c\u1ee7a c\u00e1c s\u1ea3n ph\u1ea9m HYLACROSS do s\u01b0ng sau ti\u00eam.<\/p>\n

        \u0110\u1ec3 gi\u1ea3i quy\u1ebft nh\u01b0\u1ee3c \u0111i\u1ec3m n\u00e0y, VYCROSS \u0111\u00e3 \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u nh\u01b0 1 c\u1ea3i ti\u1ebfn \u0111\u1ec3 gi\u00fap gi\u1ea3m \u0111\u1ed9 s\u01b0ng ph\u1ed3ng v\u00e0 t\u0103ng c\u01b0\u1eddng \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh. \u0110\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111i\u1ec1u n\u00e0y, VYCROSS k\u1ebft h\u1ee3p c\u1ea3 HA tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed cao v\u00e0 th\u1ea5p \u0111\u1ec3 t\u1ea1o ra ma tr\u1eadn gel HA t\u00edch h\u1ee3p hi\u1ec7u qu\u1ea3 h\u01a1n v\u00e0o m\u00f4 \u1edf n\u1ed3ng \u0111\u1ed9 HA th\u1ea5p h\u01a1n (h\u00ecnh 2.29). C\u00f3 s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a HA tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p (chu\u1ed7i ng\u1eafn) v\u00e0 HA tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed cao (chu\u1ed7i d\u00e0i) trong qu\u00e1 tr\u00ecnh li\u00ean k\u1ebft ch\u00e9o c\u00f3 th\u1ec3 t\u1ea1o ra 1 li\u00ean k\u1ebft ch\u1eb7t ch\u1ebd h\u01a1n v\u00e0 hi\u1ec7u qu\u1ea3 h\u01a1n gi\u1eefa c\u00e1c ph\u00e2n t\u1eed HA so v\u1edbi khi ch\u1ec9 d\u1ef1a tr\u00ean vi\u1ec7c s\u1eed d\u1ee5ng HA tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed cph. Hi\u1ec7u qu\u1ea3 c\u1ee7a c\u00f4ng ngh\u1ec7 li\u00ean k\u1ebft ch\u00e9o VYCROSS c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c minh h\u1ecda r\u00f5 r\u00e0ng nh\u1ea5t b\u1eb1ng c\u00e1ch t\u01b0\u01a1ng t\u1ef1 nh\u01b0 vi\u1ec7c tr\u1ed9n 1 b\u00e1t m\u00ec cay (bimbim-myeon gi\u1ed1ng bibibap (c\u01a1m tr\u1ed9n H\u00e0n Qu\u1ed1c nh\u01b0ng v\u1edbi m\u00ec l\u1ea1nh) sau khi \u0111\u1ed5 n\u01b0\u1edbc s\u1ed1t l\u00ean tr\u00ean. \u1ede \u0111\u00e2y, ng\u01b0\u1eddi ta s\u1ebd th\u1ea5y r\u1eb1ng vi\u1ec7c c\u1eaft c\u00e1c ph\u1ea7n m\u00ec b\u1eb1ng k\u00e9o s\u1ebd cho ph\u00e9p n\u01b0\u1edbc s\u1ed1t h\u00f2a quy\u1ec7n v\u00e0o nhau 1 c\u00e1ch k\u1ef9 l\u01b0\u1ee1ng v\u00e0 \u0111\u1ed3ng \u0111\u1ec1u h\u01a1n v\u00e0o c\u00e1c s\u1ee3i m\u00ec. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 v\u1eady, VYCROSS l\u00e0 1 ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7u qu\u1ea3 \u0111\u1ec3 t\u1ea1o ra c\u00e1c ph\u00e2n t\u1eed HA li\u00ean k\u1ebft ch\u00e9o v\u00e0 d\u00e0y \u0111\u1eb7c h\u01a1n, mang l\u1ea1i s\u1ef1u \u1ed5n \u0111\u1ecbnh cao h\u01a1n v\u1edbi m\u1ee9c hydrat h\u00f3a t\u1ed1i thi\u1ec3u.<\/p>\n

        C\u0169ng nh\u01b0 c\u00e1c d\u00f2ng filler HA ch\u00ednh kh\u00e1c, d\u00f2ng s\u1ea3n ph\u1ea9m VYCROSS c\u0169ng bao g\u1ed3m h\u1ed7n h\u1ee3p s\u1ea3n ph\u1ea9m b\u1ed5 sung \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 ph\u00f9 h\u1ee3p v\u1edbi t\u1eebng ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng kh\u00e1c nhau d\u1ef1a tr\u00ean c\u00e1c \u0111\u1eb7c t\u00ednh kh\u00e1c nhau c\u1ee7a gel.<\/p>\n

        Juvederm Voluma, 20mg\/ml, \u0111\u1ea1i di\u1ec7n cho s\u1ea3n ph\u1ea9m \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c b\u00e0o ch\u1ebf b\u1eb1ng c\u00f4ng ngh\u1ec7 VYCROSS, c\u00f3 n\u1ed3ng \u0111\u1ed9 HA cao nh\u1ea5t (20mg\/ml) v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i trong ph\u1ea1m vi c\u1ee7a VYCROSS cho ph\u00e9p n\u00f3 cung c\u1ea5p kh\u1ea3 n\u0103ng n\u00e2ng m\u00f4 t\u1ed1i \u0111a khi \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o c\u00e1c m\u1eb7t ph\u1eb3ng m\u00f4 s\u00e2u nh\u01b0 1 filler HA kh\u00f4i ph\u1ee5c th\u1ec3 t\u00edch. V\u00e0o n\u0103m 2013, Juvederm Voluma \u0111\u00e3 \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh s\u1ef1 thi\u1ebfu h\u1ee5t th\u1ec3 t\u00edch v\u00f9ng gi\u1eefa m\u1eb7t. \u0110\u01b0\u1ee3c ch\u00fa \u00fd v\u00ec kh\u1ea3 n\u0103ng t\u1ea1o ra k\u1ebft qu\u1ea3 l\u00e2u d\u00e0i, Juvederm Voluma c\u0169ng tr\u1edf th\u00e0nh filler HA \u0111\u1ea7u ti\u00ean nh\u1eadn \u0111\u01b0\u1ee3c s\u1ef1 ch\u1ea5p thu\u1eadn c\u1ee7a FDA trong th\u1eddi gian hi\u1ec7u ch\u1ec9nh 24 th\u00e1ng. Juvederm Volift c\u00f3 n\u1ed3ng \u0111\u1ed9 th\u1ea5p h\u01a1n l\u00e0 17.5mg\/ml, c\u00f3 \u0111\u1eb7c t\u00ednh l\u01b0u bi\u1ebfn trung gian n\u1eb1m gi\u1eefa c\u00e1c \u0111\u1eb7c t\u00ednh c\u1ee7a Juvederm Voluma v\u00e0 Juvederm Volbella v\u00e0 cho th\u1ea5y kh\u1ea3 n\u0103ng ng\u1eadm n\u01b0\u1edbc <30% so v\u1edbi v Voluma [9].<\/p>\n

        Juvederm Volift th\u00edch h\u1ee3p \u0111\u1ec3 ti\u00eam v\u00e0o l\u1edbp h\u1ea1 b\u00ec s\u00e2u ho\u1eb7c m\u1eb7t ph\u1eb3ng d\u01b0\u1edbi da, kh\u00f4ng ch\u1ec9 l\u00e0m \u0111\u1ea7y c\u00e1c r\u00e3nh v\u00e0 n\u1ebfp nh\u0103n nh\u01b0 n\u1ebfp g\u1ea5p m\u0169i v\u00e0 c\u00e1c \u0111\u01b0\u1eddng quanh mi\u1ec7ng m\u00e0 c\u00f2n \u0111\u1ec3 t\u0103ng th\u1ec3 t\u00edch c\u00e1c v\u00f9ng nh\u01b0 tr\u01b0\u1edbc tr\u00e1n. Trong khi \u0111\u00f3, Juvederm Volbella l\u00e0 filler m\u1ec1m v\u1edbi n\u1ed3ng \u0111\u1ed9 HA l\u00e0 15mg\/ml, do \u0111\u00f3 c\u00f3 \u0111\u1ed9 li\u00ea k\u1ebft v\u00e0 \u0111\u1ed9 nh\u1edbt th\u1ea5p nh\u1ea5t trong c\u00e1c d\u00f2ng s\u1ea3n ph\u1ea9m.<\/p>\n

        Juvederm Volbella th\u00edch h\u1ee3p \u0111\u1ec3 ti\u00eam v\u00e0o l\u1edbp h\u1ea1 b\u00ec \u0111\u1ec3 l\u00e0m m\u1ec1m c\u00e1c n\u1ebfp nh\u0103n b\u1ec1 m\u1eb7t v\u00e0 r\u00e3nh l\u1ec7 b\u1ecb m\u1ea5t th\u1ec3 t\u00edch c\u0169ng nh\u01b0 t\u0103ng \u0111\u1ed9 c\u0103ng m\u1ecdng cho m\u00f4i.<\/p>\n

        T\u1ea5t c\u1ea3 c\u00e1c s\u1ea3n ph\u1ea9m trong d\u00f2ng Juvederm kh\u00f4ng ch\u1ec9 bao g\u1ed3m Juvederm Ultra v\u00e0 Juvederm Ultra Plus m\u00e0 c\u00f2n to\u00e0n b\u1ed9 d\u00f2ng s\u1ea3n ph\u1ea9m VYCROSS, \u0111\u1ec1u hi\u1ec7n c\u00f3 s\u1eb5n 0.3% lidocain \u0111\u1ec3 mang l\u1ea1i s\u1ef1 tho\u1ea3i m\u00e1i trong qu\u00e1 tr\u00ecnh \u0111\u1ec1u tr\u1ecb v\u1edbi m\u1ed7i c\u00f4ng th\u1ee9c \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn b\u1edfi FDA Hoa K\u1ef3. Juvederm Ultra l\u00e0 Juvederm Utra XC kh\u00f4ng c\u00f3 lidocain v\u00e0 Juvederm Ultra Plus l\u00e0 Juvederm Ultra Plus XC kh\u00f4ng c\u00f3 lidocain.<\/p>\n

        B\u1ea3ng 2.6<\/strong>: C\u00e1c s\u1ea3n ph\u1ea9m Juvederm<\/p>\n\n\n\n\n\n\n\n\n\n
        T\u00ean th\u01b0\u01a1ng m\u1ea1i<\/td>\nJuvederm VOLITE<\/td>\nJuvederm VOLBELLA<\/td>\nJuvederm VOLIFT<\/td>\nJuvederm VOLUMA<\/td>\nJuvederm VOLUX<\/td>\n<\/tr>\n
        C\u00f4ng ngh\u1ec7 s\u1ea3n xu\u1ea5t<\/td>\nVycross<\/td>\nVycross<\/td>\nVycross<\/td>\nVycross<\/td>\nVycross<\/td>\n<\/tr>\n
        1 hay 2 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n<\/tr>\n
        N\u1ed3ng \u0111\u1ed9 HA<\/td>\n12mg\/ml<\/td>\n15mg\/ml<\/td>\n17.5mg\/ml<\/td>\n20mg\/ml<\/td>\n25mg\/ml<\/td>\n<\/tr>\n
        Kh\u1ea3 n\u0103ng n\u00e2ng \u0111\u1ee1 m\u00f4<\/td>\n+<\/td>\n++<\/td>\n+++<\/td>\n++++<\/td>\n++++<\/td>\n<\/tr>\n
        Kim<\/td>\n32G<\/td>\n30G<\/td>\n30G<\/td>\n27G<\/td>\n27G<\/td>\n<\/tr>\n
        M\u1ee9c \u0111\u1ed9 ti\u00eam<\/td>\nTrong da<\/td>\nB\u1ec1 m\u1eb7t\/ trong da\/ ni\u00eam m\u1ea1c m\u00f4i<\/td>\nH\u1ea1 b\u00ec s\u00e2u\/ ni\u00eam m\u1ea1c m\u00f4i<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng\/ h\u1ea1 b\u00ec s\u00e2u<\/td>\nD\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

         <\/p>\n\n\n\n\n\n\n\n\n\n
        T\u00ean th\u01b0\u01a1ng m\u1ea1i<\/td>\nJuvederm Ultra XC<\/td>\nJuvederm Ultra Plus XC<\/td>\n<\/tr>\n
        C\u00f4ng ngh\u1ec7 s\u1ea3n xu\u1ea5t<\/td>\nHylacross<\/td>\nHylacross<\/td>\n<\/tr>\n
        1 hay 2 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n<\/tr>\n
        N\u1ed3ng \u0111\u1ed9 HA<\/td>\n24mg\/ml<\/td>\n24mg\/ml<\/td>\n<\/tr>\n
        M\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o<\/td>\n6%<\/td>\n8%<\/td>\n<\/tr>\n
        Kim<\/td>\n30G<\/td>\n27G<\/td>\n<\/tr>\n
        M\u1ee9c \u0111\u1ed9 ti\u00eam<\/td>\nTrung b\u00ec<\/td>\nTrung b\u00ec v\u00e0 \/ ho\u1eb7c h\u1ea1 b\u00ec s\u00e2u<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        Belotero: filler HA v\u1edbi s\u1ef1 n\u1ed5i ti\u1ebfng v\u1ec1 an to\u00e0n (h\u00ecnh 2.30)<\/h3>\n

        D\u00f2ng s\u1ea3n ph\u1ea9m Belotero \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t v\u00e0 ti\u1ebfp th\u1ecb b\u1edfi Merz Pharmaceutical GmbH (\u0110\u1ee9c) v\u00e0 \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n b\u1edfi Anteis S.A, Th\u1ee5y S\u0129, v\u1edbi t\u00ean th\u01b0\u01a1ng m\u1ea1i l\u00e0 Esth\u00e9lis (b\u1ea3ng 2.7). Belotero \u0111\u1ea1t ch\u1ee9ng nh\u1eadn CE v\u00e0o n\u0103m 2005 v\u00e0 \u0111\u01b0\u1ee3c FDA Hoa K\u1ef3 ph\u00ea duy\u1ec7t v\u00e0o n\u0103m 2011. M\u1eb7c d\u00f9 ra \u0111\u1eddi t\u01b0\u01a1ng \u0111\u1ed1i mu\u1ed9n tr\u00ean th\u1ecb tr\u01b0\u1eddng, Belotero v\u1eabn \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn r\u1ed9ng r\u00e3i trong nh\u1eefng n\u0103m qua nh\u1edd t\u00ednh an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 c\u1ee7a filler HA 1 pha. D\u00f2ng s\u1ea3n ph\u1ea9m Belotero \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng d\u1ef1a tr\u00ean c\u00f4ng ngh\u1ec7 Cohesive Polydensified Matrix (CPM) li\u00ean quan \u0111\u1ebfn \u1ee9ng d\u1ee5ng th\u1ee9 2 c\u1ee7a ph\u00e2n t\u1eed HA \u0111\u1ec3 t\u1ea1o li\u00ean k\u1ebft ch\u00e9o v\u1edbi BDDE d\u01b0 c\u00f2n l\u1ea1i sau ph\u1ea3n \u1ee9ng t\u1ea1o li\u00ean k\u1ebft ch\u00e9o ban \u0111\u1ea7u. \u0110i\u1ec1u n\u00e0y d\u1eabn \u0111\u1ebfn 1 ma tr\u1eadn gel l\u1ecfng nh\u01b0ng c\u00f3 \u0111\u1ed9 li\u00ean k\u1ebft cao ch\u1ec9 c\u00f3 \u1edf Belotero, c\u00f3 c\u00e1c m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o kh\u00e1c nhau c\u00f9ng t\u1ed3n t\u1ea1i trong c\u00f9ng 1 ch\u1ea5t gel (h\u00ecnh 2.31). S\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a v\u00f9ng c\u00f3 m\u1eadt \u0111\u1ed9 gel cao mang l\u1ea1i kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y v\u00e0 tu\u1ed5i th\u1ecd cao h\u01a1n cho s\u1ea3n ph\u1ea9m trong khi m\u1eadt \u0111\u1ed9 gel th\u1ea5p \u00edt d\u1ebbo h\u01a1n gi\u00fap d\u1ec5 ti\u00eam h\u01a1n v\u00e0 ph\u00e2n ph\u1ed1i\/ t\u00edch h\u1ee3p s\u1ea3n ph\u1ea9m \u0111\u1ed3ng nh\u1ea5t h\u01a1n v\u00e0o m\u00f4. Ch\u1ee9a 1 s\u1ed1 c\u1ea5p \u0111\u1ed9 m\u1eadt \u0111\u1ed9 trong c\u00f9ng 1 s\u1ea3n ph\u1ea9m c\u0169ng cho ph\u00e9p duy tr\u00ec kh\u1ea3 n\u0103ng \u0111\u00e0n h\u1ed3i t\u1ed1t h\u01a1n v\u00e0 gi\u00fap ch\u1ed1ng l\u1ea1i l\u1ef1c t\u00e1c d\u1ee5ng b\u1edfi c\u01a1 m\u1eb7t sau khi ti\u00eam. C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y, c\u00e1c s\u1ea3n ph\u1ea9m s\u1eed d\u1ee5ng c\u00f4ng ngh\u1ec7 CPM c\u00f3 t\u00ednh li\u00ean k\u1ebft cao h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi c\u00e1c s\u1ea3n ph\u1ea9m d\u1ef1a tr\u00ean c\u00f4ng ngh\u1ec7 VYCROSS ho\u1eb7c NASHA [13]. C\u00e1c s\u1ea3n ph\u1ea9m CPM c\u0169ng \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 modul \u0111\u00e0n h\u1ed3i E’ v\u00e0 l\u1ef1c b\u00ecnh th\u01b0\u1eddng Fn cao h\u01a1n c\u00e1c s\u1ea3n ph\u1ea9m VYCROSS ho\u1eb7c NASHA d\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a l\u1ef1c n\u00e9n [15]. V\u00ec nh\u1eefng l\u00fd do n\u00e0y m\u00e0 Belotero c\u00f3 th\u1ec3 ch\u1ee9ng minh kh\u1ea3 n\u0103ng l\u00e0m \u0111\u1ea7y t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi c\u00e1c s\u1ea3n ph\u1ea9m c\u1ee7a NASHA, m\u1eb7c d\u00f9 c\u00f3 G’ th\u1ea5p h\u01a1n \u0111\u00e1ng k\u1ec3. \u0110\u00e1ng ch\u00fa \u00fd l\u00e0 t\u00ednh li\u00ean k\u1ebft \u0111\u00f3ng 1 vai tr\u00f2 quan tr\u1ecdng trong t\u00e1c d\u1ee5ng l\u00e0m t\u0103ng \u0111\u1ed9 ph\u1ed3ng c\u1ee7a filler HA v\u00ec n\u00f3 cho ph\u00e9p s\u1ea3n ph\u1ea9m duy tr\u00ec th\u1ec3 t\u00edch v\u00e0 h\u00ecnh d\u1ea1ng ngay c\u1ea3 \u1edf nh\u1eefng v\u00f9ng di \u0111\u1ed9ng nhi\u1ec1u nh\u01b0 r\u00e3nh c\u01b0\u1eddi, r\u00e3nh marionette v\u00e0 v\u00f9ng tr\u00e1n.<\/p>\n

        Ngo\u00e0i hi\u1ec7u qu\u1ea3 \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh, 1 \u01b0u \u0111i\u1ec3m kh\u00e1c c\u1ee7a Belotero n\u1eb1m \u1edf t\u00ednh an to\u00e0n v\u00e0 kh\u1ea3 n\u0103ng dung n\u1ea1p t\u1ed1t. Nh\u1edd \u0111\u1ed9 nh\u1edbt th\u1ea5p, Belotero d\u1ec5 d\u00e0ng \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o l\u1edbp h\u1ea1 b\u00ec theo c\u00e1ch ph\u00e2n b\u1ed1 v\u00e0 khu\u1ebfch t\u00e1n h\u01a1n, cho ph\u00e9p t\u1ea1o ra k\u1ebft qu\u1ea3 m\u1ecbn m\u00e0ng, \u0111\u1ec1u, \u00edt x\u1ea3y ra hi\u1ec7u \u1ee9ng Tyndall h\u01a1n. \u0110\u00e1ng ch\u00fa \u00fd nh\u1ea5t l\u00e0 kh\u00f4ng c\u00f3 tr\u01b0\u1eddng h\u1ee3p b\u1ecb u h\u1ea1t n\u00e0o \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o do ti\u00eam Belotero k\u1ec3 t\u1eeb khi ch\u00fang \u0111\u01b0\u1ee3c tung ra th\u1ecb tr\u01b0\u1eddng v\u00e0o n\u0103m 2005. N\u00f3 c\u0169ng li\u00ean quan \u0111\u1ebfn t\u1ef7 l\u1ec7 bi\u1ebfn ch\u1ee9ng mi\u1ec5n d\u1ecbch ch\u1eadm th\u1ea5p nh\u1ea5t trong s\u1ed1 c\u00e1c filler HA hi\u1ec7n c\u00f3 cho \u0111\u1ebfn nay.<\/p>\n

        D\u00f2ng s\u1ea3n ph\u1ea9m Betolero c\u0169ng bao g\u1ed3m 1 lo\u1ea1t c\u00e1c s\u1ea3n ph\u1ea9m ph\u00f9 h\u1ee3p v\u1edbi ch\u1ec9 \u0111\u1ecbnh v\u00e0 \u0111\u1ed9 s\u00e2u ti\u00eam kh\u00e1c nhau. Betolero Volume c\u00f3 n\u1ed3ng \u0111\u1ed9 HA cao nh\u1ea5t (26mg\/ml) v\u00e0 c\u00f3 m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o cao nh\u1ea5t trong c\u00e1c s\u1ea3n ph\u1ea9m CPM, v\u00e0 do \u0111\u00f3 c\u00f3 modul c\u1eaft G v\u00e0 modul \u0111\u00e0n h\u1ed3i E’ cao nh\u1ea5t. Do \u0111\u00f3 n\u00f3 ph\u00f9 h\u1ee3p \u0111\u1ec3 \u0111\u01b0a v\u00e0o c\u00e1c m\u1eb7t ph\u1eb3n s\u00e2u \u0111\u1ec3 kh\u00f4i ph\u1ee5c th\u1ec3 t\u00edch v\u00f9ng m\u1eb7t. Betolero Intense c\u00f3 n\u1ed3ng \u0111\u1ed9 HA l\u00e0 25.5mg\/ml v\u00e0 c\u00f3 \u0111\u1ed9 nh\u1edbt v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i n\u1eb1m gi\u1eefa Betolero Volume v\u00e0 Betolero Balance. D\u00f9 sao th\u00ec n\u00f3 v\u1eabn l\u00fd t\u01b0\u1edfng \u0111\u1ec3 kh\u00f4i ph\u1ee5c th\u1ec3 t\u00edch v\u00f9ng m\u1eb7t v\u00ec Fn (\u00e1p l\u1ef1c th\u01b0\u1eddng) v\u00e0 kh\u1ea3 n\u0103ng li\u00ean k\u1ebft cao h\u01a1n so v\u1edbi Betolero Volume. Do \u0111\u00f3, n\u00f3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 ti\u00eam v\u00e0o l\u1edbp h\u1ea1 b\u00ec s\u00e2u ho\u1eb7c m\u00f4 d\u01b0\u1edbi da \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh c\u00e1c n\u1ebfp nh\u0103n s\u00e2u h\u01a1n (v\u00ed d\u1ee5 r\u00e3nh m\u0169i m\u00e1) ho\u1eb7c \u0111\u1ec3 t\u0103ng th\u00eam th\u1ec3 t\u00edch \u1edf m\u00f4i v\u00e0 tr\u00e1n. Betolero Balance c\u00f3 n\u1ed3ng \u0111\u1ed9 HA l\u00e0 22.5mg\/ml , \u0111\u1ed9 nh\u1edbt v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i th\u1ea5p nh\u01b0ng c\u00f3 \u0111\u1ed9 li\u00ean k\u1ebft cao nh\u1ea5t trong s\u1ed1 c\u00e1c s\u1ea3n ph\u1ea9m CPM. L\u00e0 1 filler m\u1ec1m, d\u1ec5 d\u00e0n tr\u1ea3i, Betolero Balance c\u00f3 kh\u1ea3 n\u0103ng t\u00edch h\u1ee3p lan t\u1ecfa v\u00e0 \u0111\u1ed3ng \u0111\u1ec1u v\u00e0o m\u00f4 gi\u00fap n\u00f3 th\u00edch h\u1ee3p \u0111\u1ec3 ti\u00eam v\u00e0o c\u00e1c m\u1eb7t ph\u1eb3ng n\u00f4ng c\u1ee7a h\u1ea1 b\u00ec. N\u00f3 th\u00edch h\u1ee3p kh\u00f4ng ch\u1ec9 \u0111\u1ec3 ch\u1ec9nh s\u1eeda c\u00e1c n\u1ebfp nh\u0103n v\u1eeba ph\u1ea3i m\u00e0 c\u00f2n \u0111\u1ec3 ti\u00eam hidro lifting v\u00e0o l\u1edbp h\u1ea1 b\u00ec \u0111\u1ec3 c\u1ea3i thi\u1ec7n \u0111\u1ed9 \u0111\u00e0n h\u1ed3i c\u1ee7a da v\u00e0 \u0111\u1ec3 l\u00e0m n\u1ed5i b\u1eadt \u0111\u01b0\u1eddng vi\u1ec1n m\u00f4i. Cu\u1ed1i c\u00f9ng, Betolero Soft c\u00f3 n\u1ed3ng \u0111\u1ed9 HA (20mg\/ml) v\u00e0 m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o th\u1ea5p nh\u1ea5t trong s\u1ed1 c\u00e1c s\u1ea3n ph\u1ea9m CPM v\u00e0 do \u0111\u00f3 c\u00f3 \u0111\u1ed9 nh\u1edbt th\u1ea5p nh\u1ea5t. Ng\u01b0\u1ee3c l\u1ea1i, ch\u00ednh nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m n\u00e0y \u0111\u00e3 t\u1ea1o n\u00ean 1 k\u1ebft c\u1ea5u m\u1ec1m m\u1ea1i, d\u1ec5 d\u00e0n tr\u1ea3i, khi\u1ebfn n\u00f3 tr\u1edf n\u00ean l\u00fd t\u01b0\u1edfng \u0111\u1ec3 s\u1eed d\u1ee5ng \u1edf b\u1ec1 m\u1eb7t l\u1edbp h\u1ea1 b\u00ec ho\u1eb7c \u1edf nh\u1eefng v\u00f9ng c\u00f3 m\u00f4 m\u1ecfng bao ph\u1ee7 nh\u01b0 v\u00f9ng quanh m\u1eaft v\u00e0 c\u1ed5.<\/p>\n

        B\u1ea3ng 2.7<\/strong>: C\u00e1c s\u1ea3n ph\u1ea9m Betolero (k\u00edch th\u01b0\u1edbc h\u1ea1t v\u00e0 MoD kh\u00f4ng \u0111\u01b0\u1ee3c ti\u1ebft l\u1ed9 b\u1edfi c\u00f4ng ty)<\/p>\n\n\n\n\n\n\n\n\n\n
        T\u00ean th\u01b0\u01a1ng m\u1ea1i<\/td>\nBetolero<\/p>\n

        Soft<\/td>\n

        		Betolero Balance<\/td>\nBetolero Intense<\/td>\nBetolero Volume<\/td>\n<\/tr>\n
        1 hay 2 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n1 pha<\/td>\n<\/tr>\n
        N\u1ed3ng \u0111\u1ed9 HA<\/td>\n20mg\/ml<\/td>\n22.5mg\/ml<\/td>\n25.5mg\/ml<\/td>\n26mg\/ml<\/td>\n<\/tr>\n
        Kh\u1ea3 n\u0103ng n\u00e2ng \u0111\u1ee1 m\u00f4<\/td>\n+<\/td>\n++<\/td>\n+++<\/td>\n++++<\/td>\n<\/tr>\n
        Kim<\/td>\n30G<\/td>\n30G , 27G<\/td>\n27G<\/td>\n27G , 30G<\/td>\n<\/tr>\n
        M\u1ee9c \u0111\u1ed9 ti\u00eam<\/td>\nB\u1ec1 m\u1eb7t \u0111\u1ebfn gi\u1eefa h\u1ea1 b\u00ec<\/td>\nGi\u1eefa \u0111\u1ebfn h\u1ea1 b\u00ec s\u00e2u<\/td>\nH\u1ea1 b\u00ec s\u00e2u \u0111\u1ebfn m\u00f4 d\u01b0\u1edbi da<\/td>\nH\u1ea1 b\u00ec s\u00e2u M\u00f4 d\u01b0\u1edbi da<\/td>\n<\/tr>\n
        <\/td>\n<\/td>\n<\/td>\n<\/td>\nTr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        YVOIRE: filler HA \u0111\u1ea7u ti\u00ean c\u1ee7a H\u00e0n Qu\u1ed1c (h\u00ecnh 2.32)<\/h3>\n

        YVOIRE l\u00e0 filler HA \u0111\u1ea7u ti\u00ean c\u1ee7a H\u00e0n Qu\u1ed1c \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n v\u00e0o n\u0103m 2011 v\u1edbi c\u00f4ng ngh\u1ec7 li\u00ean k\u1ebft ch\u00e9o HICE (High Concerntration Equalized) (b\u1ea3ng 2.8). C\u00e1c s\u1ea3n ph\u1ea9m YVOIRE c\u1ee7a LG Chem (H\u00e0n Qu\u1ed1c) l\u00e0 filler HA 2 pha, \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i d\u1ef1a theo k\u00edch th\u01b0\u1edbc h\u1ea1t HA \u0111\u1ec3 ph\u00f9 h\u1ee3p m\u1edbi m\u1ee5c \u0111\u00edch v\u00e0 c\u00e1ch s\u1eed d\u1ee5ng. C\u00f4ng ngh\u1ec7 li\u00ean k\u1ebft ch\u00e9o HICE l\u00e0 c\u00f4ng ngh\u1ec7 \u0111\u1ed9c quy\u1ec1n c\u1ee7a LG Chem, c\u00f3 th\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 li\u00ean k\u1ebft ch\u00e9o cao ngay c\u1ea3 khi th\u00eam 1 l\u01b0\u1ee3ng nh\u1ecf ch\u1ea5t x\u00fac t\u00e1c li\u00ean k\u1ebft ch\u00e9o v\u00e0o b\u1eb1ng c\u00e1ch ph\u00e2n t\u00e1n \u0111\u1ed3ng \u0111\u1ec1u c\u00e1c ch\u1ea5t x\u00fac t\u00e1c li\u00ean k\u1ebft ch\u00e9o v\u00e0 n\u1ed3ng \u0111\u1ed9 cao HA c\u00f3 kh\u1ed1i l\u01b0\u1ee3ng ph\u00e2n t\u1eed l\u1edbn. L\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a c\u00f4ng ngh\u1ec7 li\u00ean k\u1ebft ch\u00e9o, YVOIRE l\u00e0 s\u1ea3n ph\u1ea9m filler \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u1ed5n \u0111\u1ecbnh trong h\u01a1n 10 n\u0103m qua v\u00e0 \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn v\u1ec1 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u00e0 \u0111\u1ed9 an to\u00e0n cao nh\u1edd s\u1eed d\u1ee5ng \u00edt ch\u1ea5t x\u00fac t\u00e1c t\u1ea1o li\u00ean k\u1ebft ch\u00e9o. Nguy\u00ean li\u1ec7u HA th\u00f4 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong YVOIRE \u0111\u00e3 \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea trong Drug Master File (DMF) c\u1ee7a FDA Hoa K\u1ef3 v\u00e0 \u0111\u01b0\u1ee3c ch\u1ee9ng nh\u1eadn b\u1edfi EDQM ch\u00e2u \u00c2u (C\u1ee5c Qu\u1ea3n l\u00fd Ch\u1ea5t L\u01b0\u1ee3ng thu\u1ed1c v\u00e0 Ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe ch\u00e2u \u00c2u) \u0111\u1ea3m b\u1ea3o c\u00f4ng nh\u1eadn qu\u1ed1c t\u1ebf li\u00ean quan \u0111\u1ebfn an to\u00e0n v\u00e0 c\u00f4ng ngh\u1ec7 \u1edf n\u01b0\u1edbc ngo\u00e0i.<\/p>\n

        YVOIRE Classic\/ Classic Plus c\u00f3 k\u00edch th\u01b0\u1edbc h\u1ea1t gel nh\u1ecf nh\u1ea5t (350\u00ad400pm) v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i th\u1ea5p nh\u1ea5t th\u00edch h\u1ee3p \u0111\u1ec3 c\u1ea3i thi\u1ec7n n\u1ebfp nh\u0103n. YVOIRE Volume \/ Volume Plus c\u00f3 k\u00edch th\u01b0\u1edbc h\u1ea1t l\u1edbn h\u01a1n (800-900 pm) so v\u1edbi Classic th\u00ec c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao h\u01a1n, ph\u00f9 h\u1ee3p cho c\u00e1c nhu c\u1ea7u l\u00e0m \u0111\u1ea7y ph\u1ed5 bi\u1ebfn. Khi YVOIRE Classic ho\u1eb7c YVOIRE Volume \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho c\u00e1c nghi\u00ean c\u1ee9u m\u00f9 \u0111\u00f4i ng\u1eabu nhi\u00ean, ph\u00e2n chia khu\u00f4n m\u1eb7t, v\u1edbi 58 v\u00e0 57 \u0111\u1ed1i t\u01b0\u1ee3ng so s\u00e1nh m\u1ee9c \u0111\u1ed9 NLFs t\u1eeb trung b\u00ecnh \u0111\u1ebfn n\u1eb7ng so v\u1edbi Restylane Lift t\u01b0\u01a1ng \u1ee9ng, cho k\u1ebft qu\u1ea3 \u0111i\u1ec1u ch\u1ec9nh hi\u1ec7u qu\u1ea3 r\u00e3nh m\u0169i m\u00e1 v\u00e0 \u0111\u1ed9 an to\u00e0n t\u01b0\u01a1ng \u0111\u01b0\u01a1ng (p<0.052) [23]. YVOIRE Contour\/ Contour plus th\u00edch h\u1ee3p cho nh\u1eefng v\u00f9ng y\u00eau c\u1ea7u kh\u1ea3 n\u0103ng n\u00e2ng \u0111\u1ee1 m\u00f4 c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao nh\u1ea5t. V\u00ec YVOIRE Contour\/ Contour plus c\u00f3 th\u00e0nh ph\u1ea7n h\u1ea1t k\u00e9p cho kho\u1ea3ng tr\u1ed1ng gi\u1eefa c\u00e1c h\u1ea1t l\u1edbn (1400pm) \u0111\u01b0\u1ee3c l\u1ea5p \u0111\u1ea7y b\u1eb1ng c\u00e1c h\u1ea1t nh\u1edf h\u01a1n (350pm), n\u00f3 cho l\u1ef1c ti\u00eam li\u00ean t\u1ee5c, d\u1eabn \u0111\u1ebfn b\u1ec1 m\u1eb7t m\u1ecbn m\u00e0ng v\u00e0 t\u1ef1 nhi\u00ean tr\u00ean khu\u00f4n m\u1eb7t. Trong nghi\u00ean c\u1ee9u m\u00f9 \u0111\u00f4i ng\u1eabu nhi\u00ean v\u1edbi 83 \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb l\u00e0m \u0111\u1ea7y v\u00f9ng m\u00e1 tr\u01b0\u1edbc, kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t th\u1ed1ng k\u00ea (p<0.05) v\u1ec1 hi\u1ec7u qu\u1ea3 v\u00e0 \u0111\u1ed9 an to\u00e0n c\u1ee7a YVOIRE Contour khi so s\u00e1nh v\u1edbi Restylane SubQ \u1edf tu\u1ea7n th\u1ee9 26 v\u00e0 52 sau \u0111i\u1ec1u tr\u1ecb [23]. C\u00e1c s\u1ea3n ph\u1ea9m \u0111\u01b0\u1ee3c th\u00eam lidocain \u0111\u1ec3 gi\u1ea3m \u0111au sau ti\u00eam. N\u1ed3ng \u0111\u1ed9 HA c\u1ee7a s\u1ea3n ph\u1ea9m kh\u00f4ng c\u00f3 lidocain l\u00e0 22mg v\u00e0 n\u1ed3ng \u0111\u1ed9 HA c\u1ee7a s\u1ea3n ph\u1ea9m c\u00f3 lidocain l\u00e0 20mg. Ngay sau khi \u0111i\u1ec1u tr\u1ecbcos h\u01a1n 90% \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng YVOIRE Classic Plus ho\u1eb7c YVOIRE Volume Plus \u0111\u00e3 b\u00e1o c\u00e1o gi\u1ea3m \u0111au sau khi so s\u00e1nh v\u1edbi ng\u01b0\u1eddi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng YVOIRE Classic ho\u1eb7c YVOIRE Volume t\u01b0\u01a1ng \u1ee9ng \u1edf m\u1eb7t ph\u00e2n chia ng\u1eabu nhi\u00ean, \u1edf 1 nghi\u00ean c\u1ee9u m\u00f9 \u0111\u00f4i ng\u1eabu nhi\u00ean. \u0110i\u1ec1u \u0111\u00f3 n\u00f3i l\u00ean r\u1eb1ng hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng v\u00e0 h\u1ed3 s\u01a1 an to\u00e0n c\u1ee7a YVOIRE Classic Plus ho\u1eb7c YVOIRE Volume Plus t\u01b0\u01a1ng \u0111\u01b0\u0111\u01b0\u01a1nvoiws YVOIRE Classic ho\u1eb7c Volume t\u01b0\u01a1ng \u1ee9ng [27].<\/p>\n

        YVOIRE Y-Solution \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec3 t\u0103ng t\u00ednh li\u00ean k\u1ebft, th\u01b0\u1eddng th\u1ea5p h\u01a1n tron filler 2 pha. \u0110\u1ec3 \u0111\u00e1p \u1ee9ng c\u1ea3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i v\u00e0 \u0111\u1ed9 li\u00ean k\u1ebft cao, YVOIRE Y-solution l\u00e0 hi\u1ec7n thi\u1ec7n th\u00e2n c\u1ee7a c\u00f4ng ngh\u1ec7 li\u00ean k\u1ebft ch\u00e9o S-HICE (Superior, Stable High Concentration Equalized) ti\u00ean ti\u1ebfn h\u01a1n HICE \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111\u1ed9 li\u00ean k\u1ebft cao h\u01a1n. S-HICE l\u00e0 1 c\u00f4ng ngh\u1ec7 \u0111\u01b0\u1ee3c n\u00e2ng c\u1ea5p l\u00e0m t\u0103ng \u0111\u1ed9 b\u1ec1n v\u00e0 \u0111\u1ed9 li\u00ean k\u1ebft gi\u1eefa c\u00e1c h\u1ea1t nh\u1ecf th\u00f4ng qua qu\u00e1 tr\u00ecnh t\u1ea1o h\u1ea1t kh\u00e1c nhau. D\u1ef1a tr\u00ean c\u00f4ng ngh\u1ec7 li\u00ean k\u1ebft ch\u00e9o S-HICE, YVOIRE Y-solution l\u00e0 filler c\u00f3 kh\u1ea3 n\u0103ng n\u00e2ng \u0111\u1ee1 m\u00f4 cao, \u0111\u1ea1t \u0111\u01b0\u1ee3c b\u1eb1ng c\u00e1ch k\u1ebft h\u1ee3p \u01b0u \u0111i\u1ec3m c\u1ee7a filler 1 pha c\u00f3 \u0111\u1ed9 li\u00ean k\u1ebft cao v\u00e0 filler 2 pha c\u00f3 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i cao. YVOIRE Y-solution \u0111\u01b0\u1ee3c ra m\u1eaft l\u1ea7n \u0111\u1ea7u ti\u00ean t\u1ea1i H\u00e0n Qu\u1ed1c v\u00e0o n\u0103m 2018 v\u1edbi 3 s\u1ea3n ph\u1ea9m bao g\u1ed3m Y-solution 360, Y-solution 540 v\u00e0 Y-solution 720. T\u1ea5t c\u1ea3 c\u00e1c s\u1ea3n ph\u1ea9m YVOIRE Y-solution \u0111\u1ec1u ch\u01b0a lidocain, n\u1ed3ng \u0111\u1ed9 HA c\u1ee7a ch\u00fang l\u1ea7n l\u01b0\u1ee3t l\u00e0 12mg, 20mg v\u00e0 20mg v\u1edbi MoD l\u1ea7n l\u01b0\u1ee3t l\u00e0 2.4%, 3.5% v\u00e0 3.3%.<\/p>\n

        B\u1ea3ng 2.8: <\/strong>C\u00e1c s\u1ea3n ph\u1ea9m YVOIRE<\/p>\n\n\n\n\n\n\n\n\n\n\n
        T\u00ean th\u01b0\u01a1 ng m\u1ea1i<\/td>\nY – solutio n 360<\/td>\nY – solutio n 540<\/td>\nY – solutio n 720<\/td>\nYVOIRE Classic S<\/td>\nYVOIRE Classic Plus<\/td>\nYVOIRE Volum e S<\/td>\nYVOIRE Volum e Plus<\/td>\nYVOIRE Contou r<\/td>\nYVOIRE Contou r Plus<\/td>\n<\/tr>\n
        C\u00f4ng ngh\u1ec7<\/td>\nS-HICE<\/td>\nS-HICE<\/td>\nS-HICE<\/td>\nHICE<\/td>\nHICE<\/td>\nHICE<\/td>\nHICE<\/td>\nHICE<\/td>\nHICE<\/td>\n<\/tr>\n
        1\u00a0 hay<\/p>\n

        2\u00a0 pha<\/td>\n

        		Y- phasic<\/td>\nY- phasic<\/td>\nY- phasic<\/td>\n2 pha<\/td>\n2 pha<\/td>\n2 pha<\/td>\n2 pha<\/td>\n2 pha<\/td>\n2 pha<\/td>\n<\/tr>\n
        N\u1ed3ng \u0111\u1ed9 HA<\/td>\n12mg\/ ml<\/td>\n20mg\/ ml<\/td>\n20mg\/ ml<\/td>\n22mg\/ ml<\/td>\n20mg\/ ml<\/td>\n22mg\/ ml<\/td>\n20mg\/ ml<\/td>\n22mg\/ ml<\/td>\n20mg\/ ml<\/td>\n<\/tr>\n
        Kh\u1ea3 n\u0103ng n\u00e2ng \u0111\u1ee1 m\u00f4<\/td>\n+<\/td>\n+++<\/td>\n++++<\/td>\n++<\/td>\n++<\/td>\n+++<\/td>\n+++<\/td>\n++++<\/td>\n++++<\/td>\n<\/tr>\n
        Kim<\/td>\n29G<\/td>\n27G<\/td>\n27G<\/td>\n27G, 30G<\/td>\n27G, 30G<\/td>\n27G<\/td>\n27G<\/td>\n23G<\/td>\n23G<\/td>\n<\/tr>\n
        M\u1ee9c \u0111\u1ed9 ti\u00eam<\/td>\nTr\u00ean h\u1ea1 b\u00ec<\/td>\nH\u1ea1 b\u00ec s\u00e2u<\/td>\nM\u00f4 d\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\nH\u1ea1 b\u00ec s\u00e2u<\/td>\nH\u1ea1 b\u00ec s\u00e2u<\/td>\nH\u1ea1 b\u00ec s\u00e2u\/ m\u00f4 d\u01b0\u1edbi da<\/td>\nM\u00f4 d\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\nM\u00f4 d\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\nM\u00f4 d\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u1eddng<\/td>\n<\/tr>\n
        K\u00edch th\u01b0\u1edbc h\u1ea1t<\/td>\n230pm<\/td>\n360pm<\/td>\n360pm<\/td>\n400pm<\/td>\n400pm<\/td>\n900pm<\/td>\n900pm<\/td>\n1300p m 350pm<\/td>\n1300p m 350pm<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        Neuramis: \u0111\u1ea1i di\u1ec7n cho filler HA m\u1ec1n H\u00e0n Qu\u1ed1c (h\u00ecnh 2.33)<\/h3>\n

        Neuramis l\u00e0 1 d\u00f2ng filler HA 1 pha \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n b\u1edfi t\u1eadp \u0111o\u00e0n Medytox (H\u00e0n Qu\u1ed1c) (b\u1ea3ng 2.9). K\u1ec3 t\u1eeb khi s\u1ea3n ph\u1ea9m \u0111\u1ea7u ti\u00ean Neuramis Deep \u0111\u01b0\u1ee3c ch\u1ee9ng nh\u1eadn CE n\u0103m 2011, th\u00ec1 chu\u1ed7i \u0111\u1ea7y \u0111\u1ee7 c\u00e1c s\u1ea3n ph\u1ea9m ch\u1ee9a lidocain \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n, c\u00f3 t\u00ean l\u00e0 Neuramis Light lidocain, Neuramis Lidocain v\u00e0 Neuramis Volume Lidocain. Hi\u1ec7n t\u1ea1i Neuramis<\/p>\n

        Deep v\u00e0 Neuramis Deep Lidocain \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng nh\u1eadn CE. Qua qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t \u0111\u1ed9c quy\u1ec1n mang t\u00ean c\u00f4ng ngh\u1ec7 \u201cSHAPE\u201d (Stabilized Hyaluronic Acid and Purification Enhancement), li\u00ean k\u1ebft ch\u00e9o ho\u00e0n to\u00e0n ph\u00f9 h\u1ee3p c\u1ee7a HA \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh, d\u1eabn \u0111\u1ebfn 1 gel HA c\u00f3 \u0111\u1ed9 li\u00ean k\u1ebft cao. Kh\u00f4ng c\u00f3 HA kh\u00f4ng c\u00f3 li\u00ean k\u1ebft ch\u00e9o \u0111\u01b0\u1ee3c th\u00eam v\u00e0o s\u1ea3n ph\u1ea9m cu\u1ed1i c\u00f9ng ch\u1ee9a n\u1ed3ng \u0111\u1ed9 HA l\u00e0 20mg\/ml. \u0110\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng s\u1ea3n ph\u1ea9m, ch\u1ec9 s\u1eed d\u1ee5ng HA c\u00f3 ch\u1ea5t l\u01b0\u1ee3ng cao \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u0103ng k\u00fd trong DMF Hoa K\u1ef3 v\u00e0 trong EDQM ch\u00e2u \u00c2u. N\u1ed3ng \u0111\u1ed9 HA c\u1ee7a t\u1ea5t c\u1ea3 c\u00e1c s\u1ea3n ph\u1ea9m l\u00e0 20mg\/ml.<\/p>\n

        D\u00f2ng Neuramis Lidocain cung c\u1ea5p 4 s\u1ea3n ph\u1ea9m v\u1edbi c\u00e1c m\u1ee9c \u0111\u1ed9 li\u00ean k\u1ebft ch\u00e9o kh\u00e1c nhau \u0111\u1ec3 ph\u00f9 h\u1ee3p v\u1edbi c\u00e1c nhu c\u1ea7u kh\u00e1c nhau (b\u1ea3ng 2.9). Neuramis Light Lidocain l\u00e0 1 HA c\u00f3 \u00edt li\u00ean k\u1ebft ch\u00e9o \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 ti\u00eam v\u00e0o l\u1edbp h\u1ea1 b\u00ec \u0111\u1ec3 c\u1ea3i thi\u1ec7n c\u00e1c n\u1ebfp nh\u0103n nh\u1ecf. Neuramis Lidocain v\u00e0 Neuramis Deep Lidocain s\u1eed d\u1ee5ng nh\u1eb1m m\u1ee5c \u0111\u00edch ph\u1ee5c h\u1ed3i m\u00f4 \u1edf l\u1edbp gi\u1eefa trung b\u00ec \u0111\u1ebfn trung b\u00ec s\u00e2u. Trong 1 th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean n\u1eeda m\u1eb7t, Neuramis Deep Lidocain \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh c\u00f3 kh\u1ea3 n\u0103ng ch\u1ec9nh s\u1eeda r\u00e3nh c\u01b0\u1eddi t\u1ed1t h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi Restylane Lift t\u1ed1i \u0111a trong 24 tu\u1ea7n (p<0.05) [29]. Neuramis Volume Lidocain l\u00e0 s\u1ea3n ph\u1ea9m HA c\u00f3 li\u00ean k\u1ebft ch\u00e9o m\u1ea1nh nh\u1ea5t \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 ti\u00eam v\u00e0o l\u1edbp m\u00f4 d\u01b0\u1edbi da v\u00e0 \/ ho\u1eb7c l\u1edbp tr\u00ean m\u00e0ng x\u01b0\u01a1ng. Trong 1 nghi\u00ean c\u1ee9u ng\u1eabu nhi\u00ean m\u00f9 \u0111\u00f4m, so s\u00e1nh Neuramis Volume Lidocain co k\u1ebft qu\u1ea3 v\u1ec1 hi\u1ec7u qu\u1ea3 v\u00e0 \u0111\u1ed9 an to\u00e0n t\u01b0\u01a1ng t\u1ef1 Juvederm Voluma trong vi\u1ec7c ph\u1ee5c h\u1ed3i th\u1ec3 t\u00edch v\u00f9ng gi\u1eefa khu\u00f4n m\u1eb7t \u1edf 88 \u0111\u1ed1i t\u01b0\u1ee3ng [30].<\/p>\n

        B\u1ea3ng 2.9<\/strong>: \u0110\u1eb7c \u0111i\u1ec3m k\u1ef9 thu\u1eadt c\u1ee7a lo\u1ea1t s\u1ea3n ph\u1ea9m Neuramis Lidocain<\/p>\n\n\n\n\n\n\n\n\n\n
        T\u00ean th\u01b0\u01a1ng m\u1ea1i<\/td>\nNeuramis Light Lidocain<\/td>\nNeuramis Lidocain<\/td>\nNeuramis Deep Lidocain<\/td>\nNeuramis Volume Lidocain<\/td>\n<\/tr>\n
        C\u00f4ng ngh\u1ec7<\/td>\nSHAPE<\/td>\nSHAPE<\/td>\nSHAPE<\/td>\nSHAPE<\/td>\n<\/tr>\n
        1 hay 2 pha<\/td>\n1<\/td>\n1<\/td>\n1<\/td>\n1<\/td>\n<\/tr>\n
        N\u1ed3ng \u0111\u1ed9 HA<\/td>\n20<\/td>\n20<\/td>\n20<\/td>\n20<\/td>\n<\/tr>\n
        Kh\u1ea3 n\u0103ng n\u00e2ng \u0111\u1ee1 m\u00f4<\/td>\n+<\/td>\n++<\/td>\n+++<\/td>\n++++<\/td>\n<\/tr>\n
        Kim<\/td>\n30<\/td>\n30<\/td>\n27<\/td>\n27<\/td>\n<\/tr>\n
        M\u1ee9c \u0111\u1ed9 ti\u00eam<\/td>\nB\u1ec1 m\u1eb7t \u0111\u1ebfn gi\u1eefa h\u1ea1<\/td>\nGi\u1eefa \u0111\u1ebfn h\u1ea1 b\u00ec s\u00e2u<\/td>\nGi\u1eefa \u0111\u1ebfn h\u1ea1 b\u00ec s\u00e2u<\/td>\nM\u00f4 d\u01b0\u1edbi da\/ tr\u00ean m\u00e0ng x\u01b0\u01a1ng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        e.p.t.q: filler HA \u01b0u ti\u00ean h\u00e0ng \u0111\u1ea7u v\u1ec1 s\u1ef1 an to\u00e0n (h\u00ecnh 2.34)<\/h3>\n

        e.p.t.q (epitique) (JETEMA, H\u00e0n Qu\u1ed1c), l\u00e0 1 lo\u1ea1i filler HA 1 pha \u0111\u01b0\u1edbc ph\u00e1t tri\u1ec3n v\u00e0o n\u0103m 2017 b\u1edfi \u00e1p d\u1ee5ng c\u00f4ng ngh\u1ec7 2CM (2 Cross-linking Method) v\u00e0 \u0111\u1ea1t \u0111\u01b0\u1ee3c ch\u1ee9ng nh\u1eadn CE cho e.p.t.q Lidocain v\u00e0o n\u0103m 2020. C\u00f4ng ngh\u1ec7 2CM kh\u00f4ng ch\u1ec9 t\u1eadn d\u1ee5ng li\u00ean k\u1ebft ch\u00e9o h\u00f3a h\u1ecdc m\u00e0 c\u00f2n c\u1ea3 li\u00ean k\u1ebft ch\u00e9o v\u1eadt l\u00fd, \u0111\u1ec3 c\u00f3 th\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 li\u00ean k\u1ebft ch\u00e9o t\u1ed1i \u0111a v\u1edbi l\u01b0\u1ee3ng BDDE t\u1ed1i thi\u1ec3u \u0111\u1ec3 t\u1ea1o ra 1 c\u1ea5u tr\u00fac d\u1ea1ng t\u1ed5 ong c\u1ee9ng ch\u1eafc v\u00e0 \u1ed5n \u0111\u1ecbnh. e.p.t.q c\u00f3 m\u1ee9c s\u1eeda \u0111\u1ed5i MoD trong ph\u1ea1m vi 1% v\u1edbi \u0111\u1ea7u v\u00e0o t\u1ed1i thi\u1ec3u c\u1ee7a li\u00ean k\u1ebft ch\u00e9o cho t\u00ednh an to\u00e0n tuy\u1ec7t vv\u1edd, nh\u01b0ng v\u00e2n xgiuwx \u0111\u01b0\u1ee3c t\u00ednh li\u00ean k\u1ebft cao. S\u1eed d\u1ee5ng c\u00f4ng ngh\u1ec7 nghi\u1ec1n g\u1ecdi l\u00e0 quy tr\u00ecnh Downing, e.p.t.q c\u00f3 c\u00e1c h\u1ea1t m\u1ecbn v\u00e0 \u0111\u1ed3ng nh\u1ea5t. Nh\u1edd nh\u1eefng h\u1ea1t m\u1ecbn n\u00e0y, e.p.t.q c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ti\u00eam b\u1eb1ng kim nh\u1edf (30G). Th\u00f4ng th\u01b0\u1eddng, c\u00e1c s\u1ea3n ph\u1ea9m ch\u1ee9a h\u1ea1t gel k\u00edch th\u01b0\u1edbc l\u1edbn kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng v\u1edbi kim nh\u1ecf do c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u00edch th\u01b0\u1edbc h\u1ea1t v\u00e0 tr\u1ea1ng th\u00e1i c\u00e2n b\u1eb1ng l\u01b0u bi\u1ebfn [31].<\/p>\n

        e.p.t.q \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i theo \u0111\u1ed9 nh\u1edbt v\u00e0 \u0111\u1ed9 \u0111\u00e0n h\u1ed3i c\u1ee7a n\u00f3: S100, S300, S500 (b\u1ea3ng 2.10) [29]. C\u1ea3 3 \u0111\u1ec1u c\u00f3 n\u1ed3ng \u0111\u1ed9 HA l\u00e0 24mg\/ml v\u00e0 ch\u1ee9a lidocain gi\u1ea3m \u0111au. Trong khi e.p.t.q l\u00e0 filler 1 pha v\u1edbi c\u00f4ng th\u1ee9c gel m\u1ec1m, n\u00f3 c\u00f3 k\u00edch th\u01b0\u1edbc \u0111\u1ed3ng nh\u1ea5t v\u1edbi kh\u1ea3 n\u0103ng t\u1ea1o h\u00ecnh tuy\u1ec7t v\u1eddi. Ngo\u00e0i ra, do qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t c\u1ee7a con ng\u01b0\u1eddi t\u1eadp trung v\u00e0o v\u1ea5n \u0111\u1ec1 an to\u00e0n nh\u01b0 h\u00e0m l\u01b0\u1ee3ng tr\u00ecnh li\u00ean k\u1ebft t\u1ed1i thi\u1ec3u (MoD kho\u1ea3ng 1%), t\u1ef7 l\u1ec7 ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn ch\u1eadm d\u01b0\u1eddng nh\u01b0 th\u1ea5p h\u01a1n 0.1% d\u01b0\u1ea1 tr\u00ean kinh nghi\u1ec7m c\u1ee7a t\u00f4i khi s\u1eed d\u1ee5ng 2.000 \u1ed1ng ti\u00eam trong 2 n\u0103m qua.<\/p>\n

        B\u1ea3ng 2.10<\/strong>: C\u00e1c s\u1ea3n ph\u1ea9m e.p.t.q<\/p>\n\n\n\n\n\n\n\n\n\n\n\n
        T\u00ean th\u01b0\u01a1ng m\u1ea1i<\/td>\ne.p.t.q Lidocain s1qq<\/td>\ne.p.t.q Lidocain<\/p>\n

        S300<\/td>\n

        		e.p.t.q Lidocain<\/p>\n

        S500<\/td>\n<\/tr>\n

        C\u00f4ng ngh\u1ec7<\/td>\n2CM<\/td>\n2CM<\/td>\n2CM<\/td>\n<\/tr>\n
        Pha<\/td>\n1<\/td>\n1<\/td>\n1<\/td>\n<\/tr>\n
        N\u1ed3ng \u0111\u1ed9 HA<\/td>\n24<\/td>\n24<\/td>\n24<\/td>\n<\/tr>\n
        Kh\u1ea3 n\u0103ng n\u00e2ng \u0111\u1ee1 m\u00f4<\/td>\n+<\/td>\n+++<\/td>\n++++<\/td>\n<\/tr>\n
        Kim<\/td>\n27<\/td>\n27<\/td>\n27<\/td>\n<\/tr>\n
        M\u1ee9c \u0111\u1ed9 ti\u00eam<\/td>\nH\u1ea1 b\u00ec<\/td>\nH\u1ea1 b\u00ec s\u00e2u<\/td>\nM\u00f4 d\u01b0\u1edbi da<\/td>\n<\/tr>\n
        K\u00edch th\u01b0\u1edbc h\u1ea1t<\/td>\n310<\/td>\n310<\/td>\n310<\/td>\n<\/tr>\n
        MoD (%)<\/td>\n1.18<\/td>\n1.53<\/td>\n1.89<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        C\u00e1c lo\u1ea1i ch\u1ea5t l\u00e0m \u0111\u1ea7y ti\u00eam kh\u00e1c<\/h2>\n

        Collagen Fillers<\/h3>\n

        L\u00e0 1 th\u00e0nh ph\u1ea7n quan tr\u1ecdng c\u1ee7a da c\u00f3 kh\u1ea3 n\u0103ng t\u1ea1o ra s\u1ee9c m\u1ea1nh v\u00e0 kh\u1ea3 n\u0103ng ph\u1ee5c h\u1ed3i c\u1ee7a da, collagen l\u00e0 v\u1eadt li\u1ec7u \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 l\u00e0m \u0111\u1ea7y trong m\u00f4 m\u1ec1m. Filler d\u1ef1a tr\u00ean collagen \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c USFDA ch\u1ea5p thu\u1eadn s\u1eed d\u1ee5ng v\u00e0o \u0111\u1ea7u nh\u1eefng n\u0103m 1980 d\u1ef1a tr\u00ean collagen b\u00f2 l\u00e0 ZYDERM 1 (collagen b\u00f2 35mg\/ml) v\u00e0 ZYDERM 2 (collagen b\u00f2 65mg\/ml) v\u00e0 ZYPLAST (collagen b\u00f2 35mg\/ml, li\u00ean k\u1ebft ch\u00e9o v\u1edbi glutaraldehyde) (Allergan, CA, US) [3]. Phi\u00ean b\u1ea3n c\u1ee7a Nh\u1eadt B\u1ea3n l\u00e0 Koken Atelocollagen ( c\u00f4ng ty Koken Nh\u1eadt B\u1ea3n), c\u0169ng c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb b\u00f2. Tuy nhi\u00ean, do c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb \u0111\u1ed9ng v\u1eadt, nh\u1eefng filler collagen b\u00f2 n\u00e0y \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u l\u00e0m x\u00e9t nghi\u1ec7m d\u1ecb \u1ee9ng tr\u01b0\u1edbc 4 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb, m\u1eb7c d\u00f9 x\u00e9t nghi\u1ec7m \u00e2m t\u00ednh nh\u01b0ng v\u1eabn kh\u00f4ng lo\u1ea1i tr\u1eeb nguy c\u01a1 x\u1ea3y ra ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng. Tuy nhi\u00ean, v\u1edbi s\u1ef1 ra \u0111\u1eddi v\u00e0 th\u1ed1ng tr\u1ecb c\u1ee7a ch\u1ea5t l\u00e0m \u0111\u1ea7y HA, filler collagen b\u00f2 nhanh ch\u00f3ng kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng tr\u00ean to\u00e0n c\u1ea7u, \u0111i\u1ec1u n\u00e0y khi\u1ebfn cho Allergan cu\u1ed1i c\u00f9ng ph\u1ea3i ch\u1ea5m d\u1ee9t vi\u1ec7c cung c\u1ea5p ZYDERM v\u00e0 ZYPLAST v\u00e0o n\u0103m 2010. Trong khi \u0111\u00f3, EVOLENCE (Jonhson & Jonhson, New Jersey, US) l\u00e0 ch\u1ea5t l\u00e0m \u0111\u1ea7y collagen c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb l\u1ee3n (collagen l\u1ee3n 30mg\/ml), \u0111\u00e3 \u0111\u01b0\u1ee3c USFDA ph\u00ea duy\u1ec7t v\u00e0o n\u0103m 2008 [3]. L\u1ee3i \u00edch c\u1ee7a EVOLENCE l\u00e0 ch\u00fang c\u00f3 li\u00ean k\u1ebft ch\u00e9o, do \u0111\u00f3 cho k\u1ebft qu\u1ea3 l\u00e2u d\u00e0i h\u01a1n so v\u1edbi c\u00e1c ch\u1ea5t l\u00e0m \u0111\u1ea7y collagen tr\u01b0\u1edbc \u0111\u00f3 v\u00e0 kh\u00f4ng y\u00eau c\u1ea7u x\u00e9t nghi\u1ec7m d\u1ecb \u1ee9ng. Tuy nhi\u00ean, m\u1eb7c d\u00f9 c\u00f3 nh\u1eefng \u01b0u \u0111i\u1ec3m n\u00e0y, nh\u1ee9ng J&J v\u1eabn bu\u1ed9c ph\u1ea3i ng\u1eebng cung c\u1ea5p EVOLENCE v\u00e0o n\u0103m 2009 do th\u1ecb tr\u01b0\u1eddng ng\u00e0y c\u00e0ng \u00edt quan t\u00e2m \u0111\u1ebfn ch\u1ea5t l\u00e0m \u0111\u1ea7y collagen. Trong khi \u0111\u00f3, COSMODERM v\u00e0 COSMOPLAST (Allergan, CA) l\u00e0 ch\u1ea5t l\u00e0m \u0111\u1ea7y collagen c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb m\u00f4 ng\u01b0\u1eddi v\u00e0 \u0111\u01b0\u1ee3c USFDA ph\u00ea duy\u1ec7t v\u00e0o n\u0103m 2003 nh\u01b0ng sau \u0111\u00f3 c\u0169ng \u0111\u00e3 ng\u1eebng s\u1ea3n xu\u1ea5t v\u00e0o n\u0103m 2010.<\/p>\n

        B\u00e0n lu\u1eadn: <\/strong>ch\u1ea5t l\u00e0m \u0111\u1ea7y collagen m\u1eb7c d\u00f9 t\u1ea1o ra b\u01b0\u1edbc \u0111\u1ed9t ph\u00e1 m\u1edbi b\u1eb1ng c\u00e1ch \u0111i ti\u00ean phong trong th\u1ecb tr\u01b0\u1eddng ch\u1ea5t l\u00e0m \u0111\u1ea7y d\u1ea1ng ti\u00eam, nh\u01b0ng gi\u00e1 tr\u1ecb c\u1ee7a ch\u00fang ng\u00e0y nay ch\u1ee7 y\u1ebfu l\u00e0 l\u1ecbch s\u1eed, v\u00ec ch\u00fang \u0111\u00e3 tr\u1edf th\u00e0nh l\u1ed7i th\u1eddi b\u1edfi nguy c\u01a1 x\u1ea3y ra ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng v\u00e0 t\u00e1c d\u1ee5ng ng\u1eafn t\u1eeb 3-6 th\u00e1ng. \u0110i\u1ec1u \u0111\u00f3 n\u00f3i l\u00ean r\u1eb1ng, c\u1ea7n ph\u1ea3i ch\u1ea5p nh\u1eadn ch\u1ea5t l\u00e0m \u0111\u1ea7y collagen cung c\u1ea5p kh\u1ea3 n\u0103ng t\u1ea1o h\u00ecnh t\u1ed1t v\u00e0 d\u1ec5 d\u00e0ng d\u00e0n tr\u1ea3i v\u00e0o c\u00e1c m\u00f4 trong khi kh\u00f4ng x\u1ea3y ra hi\u1ec7u \u1ee9ng Tyndall, \u0111i\u1ec1u n\u00e0y l\u00e0m ch\u00fang tr\u1edf n\u00ean l\u00fd t\u01b0\u1edfng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c n\u1ebfp nh\u0103n nh\u1ecf \u1edf v\u00f9ng da m\u1ecfng nh\u01b0 quanh m\u1eaft.<\/p>\n

        Ch\u1ea5t l\u00e0m \u0111\u1ea7y v\u0129nh vi\u1ec5n<\/h3>\n

        PMMA ( Polymethyl Methacrylate)<\/h4>\n

        PMMA ( Polymethyl Methacrylate) l\u00e0 1 ch\u1ea5t th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh l\u00e0m cement x\u01b0\u01a1ng trong c\u01a1 th\u1ec3 con ng\u01b0\u1eddi (h\u00ecnh 2.35). BellaFill ( t\u1eadp \u0111o\u00e0n Suneva Medical, M\u1ef9) l\u00e0 1 ch\u1ea5t l\u00e0m \u0111\u1ea7y v\u0129nh vi\u1ec5n d\u1ef1a tr\u00ean PMMA ch\u1ee9a c\u00e1c vi c\u1ea7u PMMA c\u00f3 b\u1ec1 m\u1eb7t m\u1ecbn, k\u00edch th\u01b0\u1edbc 30-50pm \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 tr\u00e1nh \u0111\u1ea1i th\u1ef1c b\u00e0o [31] (h\u00ecnh 2.36). N\u0103m 2006, PMMA d\u1ea1ng ti\u00eam \u0111\u00e3 \u0111\u01b0\u1ee3c USFDA ph\u00ea duy\u1ec7t d\u01b0\u1edbi t\u00ean th\u01b0\u01a1ng m\u1ea1i ArteFill (Artes Medical, US), theo \u0111\u00f3, ArteFill tr\u1edf th\u00e0nh ch\u1ea5t l\u00e0m \u0111\u1ea7y m\u00f4 m\u1ec1m v\u0129nh vi\u1ec5n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c USFDA ch\u1ea5p thu\u1eadn. ArteFill \u0111\u01b0\u1ee3c \u0111\u1ed5i t\u00ean th\u00e0nh BellaFill v\u00e0o n\u0103m 2014. BellaFill bao g\u1ed3m c\u00e1c vi c\u1ea7u PMMA l\u01a1 l\u1eedng trong 3.5% collagen b\u00f2 v\u1edbi t\u1ef7 l\u1ec7 1:4 [30]. Theo th\u1eddi gian, collagen \u0111\u01b0\u1ee3c h\u1ea5p thu v\u00e0 c\u00e1c h\u1ea1t vi c\u1ea7u PMMA ho\u1ea1t \u0111\u1ed9ng nh\u01b0 1 gi\u00e0n gi\u00e1o \u0111\u1ec3 k\u00edch th\u00edch sinh t\u1ed5ng h\u1ee3p collagen. Trong ph\u1ea1m vi s\u1ea3n ph\u1ea9m ch\u1ee9a collagen b\u00f2 l\u00e0m ch\u1ea5t v\u1eadn chuy\u1ec3n, c\u1ea7n ph\u1ea3i th\u1ef1c hi\u1ec7n ki\u1ec3m tra d\u1ecb \u1ee9ng tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng BellaFill. M\u1eb7c d\u00f9 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 hi\u1ebfm g\u1eb7p, bao g\u1ed3m ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng, u h\u1ea1t, bi\u1ebfn d\u1ea1ng v\u00e0 vi\u00eam [30]. C\u1ea7n th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng v\u00ec PMMA l\u00e0 1 h\u1ee3p ch\u1ea5t t\u1ed5ng h\u1ee3p v\u00e0 kh\u00f4ng th\u1ec3 ph\u00e2n gi\u1ea3i v\u1edbi c\u00e1c t\u00e1c nh\u00e2n ph\u00e2n gi\u1ea3i n\u1ebfu c\u00f3 v\u1ea5n \u0111\u1ec1 x\u1ea3y ra.<\/p>\n

        B\u00e0n lu\u1eadn: <\/strong>T\u00ednh l\u00e2u d\u00e0i c\u1ee7a ch\u1ea5t l\u00e0m \u0111\u1ea7y ng\u1ee5 \u00fd r\u1eb1ng b\u1ea5t k\u1ef3 bi\u1ebfn ch\u1ee9ng ti\u1ec1m \u1ea9n n\u00e0o ph\u00e1t sinh t\u1eeb ch\u1ea5t l\u00e0m \u0111\u1ea7y \u0111\u1ec1u t\u1ed3n t\u1ea1i v\u0129nh vi\u1ec5n. \u0110\u1ec3 tr\u00e1nh kh\u00f3 ch\u1ecbu b\u1ea5t ng\u1edd trong cu\u1ed9c s\u1ed1ng, c\u00e1c h\u1ecdc vi\u00ean, tr\u1eeb nh\u1eefng ng\u01b0\u1eddi t\u00e1o b\u1ea1o nh\u1ea5t, \u0111\u01b0\u1ee3c khuy\u00ean n\u00ean tr\u00e1nh xa c\u00e1c ph\u01b0\u01a1ng ph\u00e1p l\u00e2u d\u00e0i n\u00e0y.<\/p>\n

        PAAG (Polyacrylamide Gel)<\/h4>\n

        PAAG (Polyacrylamide Gel) l\u00e0 1 lo\u1ea1i polyme cao ph\u00e2n t\u1eed \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0m th\u00e0nh ph\u1ea7n trong s\u1ea3n xu\u1ea5t k\u00ednh \u00e1p tr\u00f2ng m\u1ec1m (h\u00ecnh 2.37). Ch\u1ea5t l\u00e0m \u0111\u1ea7y m\u00f4 m\u1ec1m v\u0129nh vi\u1ec5n ch\u1ee9a PAAG \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n l\u1ea7n \u0111\u1ea7u ti\u00ean v\u00e0o n\u0103m 1980 t\u1ea1i Ukraine v\u1edbi t\u00ean th\u01b0\u01a1ng m\u1ea1i l\u00e0 Interfall v\u00e0 \u0111\u01b0\u1ee3c c\u1ea5p ch\u1ee9ng nh\u1eadn CE v\u00e0o n\u0103m 2001 t\u1ea1i \u0110an M\u1ea1ch v\u1edbi t\u00ean th\u01b0\u01a1ng m\u1ea1i l\u00e0 Aquamid (Contura International A\/S, Demark). Aquamid l\u00e0 1 s\u1ea3n ph\u1ea9m hydrogel k\u1ebft h\u1ee3p 2.5% polyacrylamide li\u00ean k\u1ebft ch\u00e9o v\u00e0 97.5% n\u01b0\u1edbc, \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 k\u1ebft c\u1ea5u t\u1ef1 nhi\u00ean v\u00e0 kh\u1ea3 n\u0103ng t\u01b0\u01a1ng th\u00edch sinh h\u1ecdc thu\u1eadn l\u1ee3i [31]. Tuy nhi\u00ean, u h\u1ea1t, bi\u1ebfn d\u1ea1ng v\u00e0 s\u1ef1 di chuy\u1ec3n c\u1ee7a s\u1ea3n ph\u1ea9m th\u01b0\u1eddng \u0111\u01b0\u1ee3c quan s\u00e1t sau khi s\u1eed d\u1ee5ng n\u00f3 [33]. Th\u1eadt may m\u1eafn, s\u1ea3n ph\u1ea9m c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf th\u1eadm ch\u00ed v\u00e0i n\u0103m sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng dung d\u1ecbch mu\u1ed1i g\u1ea5p 2-3 l\u1ea7n th\u1ec3 t\u00edch PAAG \u0111\u00e3 ti\u00eam, sau \u0111\u00f3 xoa b\u00f3p m\u1ea1nh 3-5m v\u00e0 ch\u1ecdc th\u1ee7ng b\u1eb1ng kim 18G ho\u1eb7c v\u1ebft r\u1ea1ch, sau \u0111\u00f3 v\u1ec1 c\u01a1 b\u1ea3n s\u1ea3n ph\u1ea9m c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c v\u1eaft ki\u1ec7t (h\u00ecnh 2.38) [32,33]. Tr\u01b0\u1edbc nh\u1eefng d\u01b0 lu\u1eadn ti\u00eau c\u1ef1c xung quanh c\u00e1c bi\u1ebfn ch\u1ee9ng t\u1eeb Amazing gel (c\u00f4ng ty Fuhua High Molecular, Trung Qu\u1ed1c), ti\u00eam \u0111\u1ec3 n\u00e2ng ng\u1ef1c, PAAG ph\u1ea7n l\u1edbn \u0111\u00e3 kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng v\u00e0 th\u1ef1c t\u1ebf \u0111\u00e3 kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng n\u1eefa. Trong khi Aquafilling (S\u00e9c), bao g\u1ed3m PAAG (2%) v\u00e0 n\u01b0\u1edbc 98 % \u0111\u00e3 \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u ra th\u1ecb tr\u01b0\u1eddng 1 v\u00e0i n\u0103m tr\u01b0\u1edbc tuy\u00ean b\u1ed1 l\u00e0 c\u00f3 th\u1ec3 ph\u00e2n gi\u1ea3i v\u1edbi n\u01b0\u1edbc mu\u1ed1i th\u00f4ng th\u01b0\u1eddng, Aquafilling ti\u00eam, nh\u01b0 v\u1edbi Aquamid kh\u00f4ng th\u1ec3 b\u1ecb h\u00f2a tan ch\u1ec9 \u0111\u01a1n gi\u1ea3n b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng t\u00e1c nh\u00e2n ph\u00e2n gi\u1ea3i (h\u00ecnh 2.39).<\/p>\n

        Ch\u1ea5t l\u00e0m \u0111\u1ea7y k\u00edch th\u00edch collagen<\/h3>\n

        Tr\u01b0\u1edbc n\u0103m 2000, ch\u1ea5t l\u00e0m \u0111\u1ea7y m\u00f4 m\u1ec1m \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n ch\u1ee7 y\u1ebfu \u0111\u1ec3 s\u1eed d\u1ee5ng nh\u01b0 ch\u1ea5t l\u00e0m t\u0103ng th\u1ec3 t\u00edch ho\u1eb7c l\u00e0m \u0111\u1ea7y, ch\u1ea5t l\u00e0m \u0111\u1ea7y collagen ho\u1eb7c HA \u0111\u01b0\u1ee3c ti\u00eam \u0111\u1ec3 t\u0103ng th\u1ec3 t\u00edch cho v\u00f9ng m\u1eb7t b\u1ecb thi\u1ebfu h\u1ee5t th\u1ec3 t\u00edch. T\u1eeb n\u0103m 2000 tr\u1edf \u0111i, xu h\u01b0\u1edbng ph\u1ed5 bi\u1ebfn trong ph\u00e1t tri\u1ec3n ch\u1ea5t l\u00e0m \u0111\u1ea7y m\u00f4 m\u1ec1m chuy\u1ec3n t\u1eeb ch\u1ea5t l\u00e0m \u0111\u1ea7y thay th\u1ebf sang ch\u1ea5t l\u00e0m \u0111\u1ea7y ph\u00e2n h\u1ee7y sinh h\u1ecdc polyme cao ph\u00e2n t\u1eed c\u00f3 kh\u1ea3 n\u0103ng k\u00edch th\u00edch sinh h\u1ecdc collagen trong v\u00f9ng \u0111\u01b0\u1ee3c ti\u00eam trong khi ch\u00fang b\u1ecb ph\u00e2n h\u1ee7y t\u1eeb t\u1eeb trong c\u01a1 th\u1ec3. Nh\u1eefng ch\u1ea5t l\u00e0m \u0111\u1ea7y k\u00edch th\u00edch collagen n\u00e0y c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ch\u1ea5t l\u00e0m \u0111\u1ea7y k\u00edch th\u00edch sinh h\u1ecdc, \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 mang l\u1ea1i tu\u1ed5i th\u1ecd t\u1ed1t h\u01a1n so v\u1edbi ch\u1ea5t l\u00e0m \u0111\u1ea7y HA. V\u00ed d\u1ee5 ch\u00ednh bao g\u1ed3m, ch\u1ea5t l\u00e0m \u0111\u1ea7y d\u1ef1a tr\u00ean canxi hydroxylapatite (CaHA), PLLA, PDLLA, PCA v\u00e0 PDO. Tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng ch\u1ea5t l\u00e0m \u0111\u1ea7y k\u00edch th\u00edch sinh h\u1ecdc mang l\u1ea1i nh\u1eefng r\u1ee7i ro v\u00e0 th\u00e1ch th\u1ee9c li\u00ean quan, bao g\u1ed3m s\u1ef1 bi\u1ebfn \u0111\u1ed5i c\u1ee7a t\u1eebng c\u00e1 nh\u00e2n trong qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p collagen, s\u1ef1 h\u00ecnh th\u00e0nh n\u1ed1t s\u1ea7n do s\u1ea3n xu\u1ea5t qu\u00e1 m\u1ee9c collagen v\u00e0 s\u1ef1 g\u1ed3 gh\u1ec1 tr\u00ean b\u1ec1 m\u1eb7t do c\u00e1c n\u1ed1t s\u1ea7n cao l\u00ean. Quan tr\u1ecdng nh\u1ea5t, k\u1ebft qu\u1ea3 c\u1ee7a ch\u1ea5t l\u00e0m \u0111\u1ea7y k\u00edch th\u00edch sinh h\u1ecdc v\u1eabn kh\u00f4ng th\u1ec3 thay \u0111\u1ed5i trong tr\u01b0\u1eddng h\u1ee3p l\u1ea1c ch\u1ed7 ho\u1eb7c bi\u1ebfn ch\u1ee9ng. Do \u0111\u00f3, n\u00ean tr\u00e1nh s\u1eed d\u1ee5ng ch\u00fang \u1edf nh\u1eefng v\u00f9ng da m\u1eb7t kh\u00f4ng l\u00e0nh l\u1eb7n v\u1edbi l\u1edbp da m\u1ecfng, v\u00ed d\u1ee5 quanh m\u1eaft ho\u1eb7c ni\u00eam m\u1ea1c m\u00f4i.<\/p>\n

        Ch\u1ea5t l\u00e0m \u0111\u1ea7y Calcium Hydroxylapatite (CaHA)<\/h4>\n

        Calcium Hydroxylapatite (Ca10(PO4)6(OH)2) hay CaHA l\u00e0 ch\u1ea5t kho\u00e1ng ch\u00ednh c\u1ea5u t\u1ea1o n\u00ean r\u0103ng v\u00e0 x\u01b0\u01a1ng. Th\u00e0nh ph\u1ea7n t\u01b0\u01a1ng t\u1ef1 s\u1ecfi m\u1eadt ho\u1eb7c s\u1ecfi ti\u1ebft ni\u1ec7u, ch\u00fang \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e2u trong ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh ho\u1eb7c \u1ee9ng d\u1ee5ng trong nha khoa l\u00e0m v\u1eadt li\u1ec7u tr\u00e1m r\u0103ng ho\u1eb7c v\u1eadt li\u1ec7u t\u00e1i t\u1ea1o nha khoa. Ch\u1ea5t l\u00e0m \u0111\u1ea7y Canxi hydroxylapatite bao g\u1ed3m 30% CaHA v\u00e0 70% natri carboxymethylcellulose (CMC), glycerine v\u00e0 n\u01b0\u1edbc v\u00f4 tr\u00f9ng. C\u00e1c CaHA l\u00e0 c\u00e1c vi c\u1ea7u m\u1ecbn c\u00f3 \u0111\u01b0\u1eddng k\u00ednh t\u1eeb 25-45pm \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 kh\u00f4ng b\u1ecb th\u1ef1c b\u00e0o b\u1edfi \u0111\u1ea1i th\u1ef1c b\u00e0o (h\u00ecnh 2.40). Sau khi \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o m\u00f4 m\u1ec1m, c\u00e1c vi c\u1ea7u CaHA t\u1ea1o ra s\u1ef1 t\u00e2n t\u1ea1o t\u1ea1i v\u1ecb tr\u00ed ti\u00eam trong khi b\u1ea3n th\u00e2n ch\u00fang t\u1eeb t\u1eeb b\u1ecb ph\u00e2n h\u1ee7y th\u00e0nh c\u00e1c ion canxi v\u00e0 photphat, v\u00e0 b\u1ecb lo\u1ea1i b\u1ecf ho\u00e0n to\u00e0n kh\u1ecfi c\u01a1 th\u1ec3 [34] (h\u00ecnh 2.41). Trong khi \u0111\u00f3, ch\u1ea5t mang gel, CMC cung c\u1ea5p th\u1ec3 t\u00edch ban \u0111\u1ea7u trong v\u00e0i tu\u1ea7n \u0111\u1ebfn v\u00e0i th\u00e1ng sau ti\u00eam, sau \u0111\u00f3 d\u1ea7n b\u1ecb ti\u00eau bi\u1ebfn, \u0111\u1ec3 l\u1ea1i v\u1ecb tr\u00ed \u0111\u1ec3 collagen l\u1ea5p \u0111\u1ea7y kho\u1ea3ng tr\u1ed1ng [35].<\/p>\n

        Radiesse (Merz, \u0110\u1ee9c) l\u00e0 ch\u1ea5t l\u00e0m \u0111\u1ea7y CaHA \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c FDA Hoa K\u1ef3 ph\u00ea duy\u1ec7t v\u00e0o n\u0103m 2001 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng d\u00e2y thanh \u00e2m v\u00e0 l\u1ea5p \u0111\u1ea7y kho\u1ea3ng tr\u1ed1ng c\u1ee7a x\u01b0\u01a1ng (h\u00ecnh 2.42). V\u00e0o n\u0103m 2006, n\u00f3 \u0111\u00e3 \u0111\u01b0\u1ee3c FDA Hoa K\u1ef3 ch\u1ea5p thu\u1eadn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c n\u1ebfp nh\u0103n nghi\u00eam tr\u1ecdng tr\u00ean khu\u00f4n m\u1eb7t v\u00e0 \/ ho\u1eb7c ch\u1ee9ng teo m\u1ee1 tr\u00ean khu\u00f4n m\u1eb7t \u1edf nh\u1eefng ng\u01b0\u1eddi b\u1ecb HIV. M\u1eb7c d\u00f9 \u0111\u01b0\u1ee3c c\u1ea5u t\u1ea1o ch\u1ee7 y\u1ebfu t\u1eeb canxi, nh\u01b0ng Radiesse kh\u00f4ng h\u00f3a l\u1ecfng ho\u1eb7c canxi h\u00f3a trong m\u00f4 m\u1ec1m ho\u1eb7c m\u00e0ng x\u01b0\u01a1ng – n\u01a1i m\u00e0 ch\u00fang \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o [36]. Kh\u00f4ng c\u00f3 tr\u01b0\u1eddng h\u1ee3p n\u00e0o \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 c\u00f3 s\u1ef1 t\u1ea1o x\u01b0\u01a1ng x\u1ea3y ra do ti\u00eam Radiesse v\u00e0o m\u00f4 m\u1ec1m [34]. V\u1ec1 l\u00fd thuy\u1ebft \u0111i\u1ec1u n\u00e0y do s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ebf b\u00e0o m\u1edbi \u1edf n\u01a1i CaHA \u0111\u01b0\u1ee3c c\u1ea5y v\u00e0o l\u00e0 ph\u00f9 h\u1ee3p v\u1edbi m\u00f4 xung quanh, v\u00e0 c\u00e1c t\u1ebf b\u00e0o m\u1edbi th\u00ec kh\u00f4ng bi\u1ec7t h\u00f3a th\u00e0nh c\u00e1c lo\u1ea1i t\u1ebf b\u00e0o kh\u00e1c [34].<\/p>\n

        M\u1eb7c d\u00f9 Radiesse \u0111\u01b0\u1ee3c bi\u1ebft c\u00f3 tu\u1ed5i th\u1ecdp k\u00e9o d\u00e0i v\u00e0i n\u0103m, nh\u01b0ng ban \u0111\u1ea7u b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea3m nh\u1eadn \u0111\u01b0\u1ee3c t\u00e1c d\u1ee5ng ch\u1ec9 l\u00e0 t\u1ea1m th\u1eddi v\u00e0 t\u1ed3n t\u1ea1i trong th\u1eddi gian ng\u1eafn khi ch\u1ea5t mang gel b\u1ecb x\u1eb9p xu\u1ed1ng sau v\u00e0i tu\u1ea7n \u0111\u1ebfn v\u00e0i th\u00e1ng sau ti\u00eam. Trong tr\u01b0\u1eddng h\u1ee3p nh\u01b0 v\u1eady, s\u1ebd h\u1eefu \u00edch n\u1ebfu ti\u00eam th\u00eam 1 m\u0169i sau \u0111i\u1ec1u tr\u1ecb 1-2 th\u00e1ng [36]. C\u0169ng c\u1ea7n l\u01b0u \u00fd r\u1eb1ng vi\u1ec7c ti\u00eam Radiesse c\u00f3 th\u1ec3 g\u00e2y \u0111au do pH c\u1ee7a s\u1ea3n ph\u1ea9m (6.8-8.0) n\u1eb1m ngo\u00e0i ph\u1ea1m vi pH b\u00ecnh t\u01b0\u1eddng c\u1ee7a c\u01a1 th\u1ec3 ng\u01b0\u1eddi. Pha 1.3ml Radiesse v\u1edbi 0.2ml lidocain tr\u01b0\u1edbc khi ti\u00eam c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m \u0111au \u0111\u00e1ng k\u1ec3 [36]. Radiesse c\u0169ng c\u00f3 xu h\u01b0\u1edbng g\u00e2y s\u01b0ng ban \u0111\u1ea7u l\u1edbn h\u01a1n ch\u1ea5t l\u00e0m \u0111\u1ea7y HA do ch\u1ea5t mang gel c\u1ee7a n\u00f3. Do \u0111\u00f3 t\u1ed1t nh\u1ea5t l\u00e0 tr\u00e1nh ti\u00eam l\u01b0\u1ee3ng l\u1edbn Radiesse v\u00e0o c\u00f9ng 1 v\u1ecb tr\u00ed, trong 1 l\u1ea7n ti\u00eam duy nh\u1ea5t. Thay v\u00e0o \u0111\u00f3, t\u1ed1t h\u01a1n l\u00e0 s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p ti\u1ebfp c\u1eadn t\u1eebng b\u01b0\u1edbc v\u1edbi c\u00e1c l\u1ea7n \u0111i\u1ec1u tr\u1ecb c\u00e1ch nhau t\u1eeb 2-4 tu\u1ea7n cho \u0111\u1ebfn khi \u0111\u1ea1t k\u1ebft qu\u1ea3 mong mu\u1ed1n. M\u1ed9t bi\u1ebfn ch\u1ee9ng \u0111\u00e1ng l\u01b0u \u00fd c\u1ee7a Radiesse l\u00e0 h\u00ecnh th\u00e0nh c\u00e1c n\u1ed1t s\u1ea7n c\u1ee9ng sau khi ti\u00eam bolus \u1edf nh\u1eefng v\u00f9ng c\u00f3 da m\u1ecfng nh\u01b0 quanh m\u1eaft ho\u1eb7c ni\u00eam m\u1ea1c m\u00f4i. C\u1ea7n ph\u1ea3i ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf ho\u1eb7c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1ch ti\u00eam triamcinolone trong tr\u01b0\u1eddng h\u1ee3p h\u00ecnh th\u00e0nh n\u1ed1t s\u1ea7n [37]. Ng\u01b0\u1ee3c l\u1ea1i, s\u1ef1 h\u00ecnh th\u00e0nh u h\u1ea1t do ph\u1ea3n \u1ee9ng c\u1ee7a c\u01a1 th\u1ec3 v\u1edbi ch\u1ea5t l\u1ea1 kh\u00f4ng th\u01b0\u1eddng xuy\u00ean x\u1ea3y ra do Radiesse so v\u1edbi c\u00e1c ch\u1ea5t l\u00e0m \u0111\u1ea7y v\u0129nh vi\u1ec5n kh\u00e1c, PLLA ho\u1eb7c th\u1eadm ch\u00ed c\u1ea3 ch\u1ea5t l\u00e0m \u0111\u1ea7y HA [37-39]. C\u00f3 th\u1ec3 gi\u1ea3i quy\u1ebft c\u00e1c ph\u00e0n n\u00e0n v\u1ec1 \u0111\u01b0\u1eddng vi\u1ec1n kh\u00f4ng \u0111\u1ec1u ho\u1eb7c ch\u1ec9nh s\u1eeda qu\u00e1 m\u1ee9c trong v\u00f2ng 2 tu\u1ea7n \u0111\u1ea7u ti\u00ean b\u1eb1ng c\u00e1ch d\u00f9ng kim 18G ch\u00edch r\u1ea1ch v\u1ebft ti\u00eam v\u00e0 l\u1ea5y s\u1ea3n ph\u1ea9m ra theo c\u00e1ch th\u1ee7 c\u00f4ng qua v\u1ebft ch\u00edch. Tuy nhi\u00ean, trong tr\u01b0\u1eddng h\u1ee3p th\u1eddi gian \u0111\u00e1ng k\u1ec3 \u0111\u00e3 qua k\u1ec3 t\u1eeb l\u1ea7n \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u th\u00ec ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf ho\u1eb7c ti\u00ean triamcinolone tr\u1edf th\u00e0nh l\u1ef1a ch\u1ecdn duy nh\u1ea5t.<\/p>\n

        B\u00e0n lu\u1eadn: <\/strong>Radiesse \u0111\u00e3 tr\u1edf th\u00e0nh 1 c\u1ed9t m\u1ed1c m\u1edbi trong quy tr\u00ecnh l\u00e0m \u0111\u1ea7y g\u01b0\u01a1ng m\u1eb7t k\u1ec3 t\u1eeb khi n\u00f3 \u0111\u01b0\u1ee3c tung ra th\u1ecb tr\u01b0\u1eddng. Tuy nhi\u00ean, s\u1ef1 ph\u1ed5 bi\u1ebfn v\u00e0 t\u00ednh linh ho\u1ea1t ban \u0111\u1ea7u c\u1ee7a n\u00f3 \u0111\u00e3 s\u1edbm b\u1ecb h\u1ea1n ch\u1ebf b\u1edfi nh\u1eefng nh\u01b0\u1ee3c \u0111i\u1ec3m nh\u01b0 s\u01b0ng t\u1ea5y ban \u0111\u1ea7u \u0111\u00e1ng k\u1ec3, h\u00ecnh th\u00e0nh n\u1ed1t s\u1ea7n khi ti\u00eam bolus v\u00e0 nguy c\u01a1 ph\u00e1t tri\u1ec3n qu\u00e1 m\u1ee9c c\u1ee7a c\u00e1c s\u1ee3i collagen c\u00f3 th\u1ec3 ng\u0103n c\u1ea3n \u0111\u01b0\u1eddng \u0111i c\u1ee7a cannula trong l\u1ea7n \u0111i\u1ec1u tr\u1ecb th\u1ee9 2 ho\u1eb7c th\u1ee9 3. H\u01a1n n\u1eefa, do s\u1ea3n ph\u1ea9m kh\u00f4ng th\u1ec3 b\u1ecb h\u00f2a tan trong c\u00e1c t\u00e1c nh\u00e2n \u0111\u1ea3o ng\u01b0\u1ee3c n\u00ean l\u00e0m \u0111\u1ea7y khu\u00f4n m\u1eb7t kh\u00f4ng th\u1ec3 \u0111\u1ec3 x\u1ea3y ra sai s\u00f3t. Nh\u1eefng y\u1ebfu t\u1ed1 n\u00e0y k\u1ebft h\u1ee3p v\u1edbi nhau h\u1ea1n ch\u1ebf vi\u1ec7c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i Radiesse trong \u1ee9ng d\u1ee5ng l\u00e0m \u0111\u1eb9p v\u00f9ng m\u1eb7t. Tuy nhi\u00ean, t\u00e1c d\u1ee5ng k\u00edch th\u00edch sinh h\u1ecdc s\u1ea3n sinh collagen c\u1ee7a Radiesse \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn cho m\u1ee5c \u0111\u00edch l\u00e0m s\u0103n ch\u1eafc da b\u1eb1ng c\u00e1ch pha lo\u00e3ng s\u1ea3n ph\u1ea9m 2-3 l\u1ea7n v\u1edbi n\u01b0\u1edbc mu\u1ed1i sinh l\u00fd v\u00e0 lidocain \u0111\u1ec3 ti\u00eam v\u00e0o b\u1ec1 m\u1eb7t l\u1edbp d\u01b0\u1edbi da [40]. V\u00ed d\u1ee5 nh\u01b0 tr\u1ebb h\u00f3a n\u1ebfp nh\u0103n \u1edf c\u1ed5 v\u00e0 mu b\u00e0n tay.<\/p>\n

        Ch\u1ea5t l\u00e0m \u0111\u1ea7y PCL (h\u00ecnh 2.43)<\/h4>\n

        Polycaprolactone (PCL) l\u00e0 1 lo\u1ea1i polyme c\u00f3 kh\u1ea3 n\u0103ng ph\u00e2n h\u1ee7y sinh h\u1ecdc t\u1eeb l\u00e2u \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0m ch\u1ec9 kh\u00e2u ph\u1eabu thu\u1eadt trong y t\u1ebf (h\u00ecnh 2.24). Ch\u1ea5t l\u00e0m \u0111\u1ea7y m\u00f4 m\u1ec1m d\u1ef1a tr\u00ean PCL \u0111\u01b0\u1ee3c b\u00e1n tr\u00ean th\u1ecb tr\u01b0\u1eddng v\u1edbi t\u00ean Ellans\u00e9 (AQTIS Medical, H\u00e0 Lan). Ellans\u00e9 \u0111\u1ea1i di\u1ec7n cho ch\u1ea5t l\u00e0m \u0111\u1ea7y polyme cao ph\u00e2n t\u1eed c\u00f3 th\u1ec3 ph\u00e2n h\u1ee7y sinh h\u1ecdc bao g\u1ed3m 30% PCL l\u01a1 l\u1eedng trong 70% CMC. T\u01b0\u01a1ng t\u1ef1 Radiesse, Ellans\u00e9 d\u1ef1a tr\u00ean PCL bao g\u1ed3m c\u00e1c vi c\u1ea7u m\u1ecbn k\u00edch th\u01b0\u1edbc 25-50pm \u0111\u1ec3 tr\u00e1nh \u0111\u1ea1i th\u1ef1c b\u00e0o. Sau khi \u0111\u01b0\u1ee3c ti\u00eam, c\u00e1c vi c\u1ea7u PCL s\u1ebd th\u00fac \u0111\u1ea9y h\u00ecnh th\u00e0nh collagen m\u1edbi trong c\u00e1c m\u00f4 xung quanh v\u00e0 d\u1ea7n ph\u00e2n h\u1ee7y th\u00e0nh n\u01b0\u1edbc v\u00e0 CO2<\/sub>, sau \u0111\u00f3 ch\u00fang \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf kh\u1ecfi c\u01a1 th\u1ec3c\u01a1chaats mang gel CMC cung c\u1ea5p kh\u1ea3 n\u0103ng \u0111i\u1ec1u ch\u1ec9nh th\u1ec3 t\u00edch ngay l\u1eadp t\u1ee9c trong nh\u1eefng tu\u1ea7n ho\u1eb7c th\u00e1ng \u0111\u1ea7u ti\u00ean v\u00e0 ti\u00eau bi\u1ebfn trong 3 th\u00e1ng \u0111\u1ec3 \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng collagen m\u1edbi. T\u00f3m l\u1ea1i, ngo\u00e0i s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 th\u00e0nh ph\u1ea7n ho\u1ea1t ch\u1ea5t, Ellanse c\u00f3 nhi\u1ec1u \u0111i\u1ec3m t\u01b0\u01a1ng \u0111\u1ed3ng v\u1edbi Radiesse v\u1ec1 th\u00e0nh ph\u1ea7n, c\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng, ch\u1ec9 \u0111\u1ecbnh v\u00e0 bi\u1ebfn ch\u1ee9ng.<\/p>\n

        PLLA (Poly-L-Lactic Acid) (h\u00ecnh 2.45)<\/h4>\n

        PLLA (Poly-L-Lactic Acid) l\u00e0 1 polyme t\u01b0\u01a1ng h\u1ee3p sinh h\u1ecdc c\u00f3 kh\u1ea3 n\u0103ng ph\u00e2n h\u1ee7y sinh h\u1ecdc \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong th\u1ef1c h\u00e0nh y t\u1ebf t\u1eeb nh\u1eefng n\u0103m 1970 nh\u01b0 ch\u1ec9 kh\u00e2u ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 h\u1ea5p th\u1ee5 ho\u1eb7c l\u00e0m v\u1eadt li\u1ec7u c\u1ea5y gh\u00e9p, \u0111inh ghim v\u00e0 l\u1ee3i gi\u1ea3 trong x\u01b0\u01a1ng trong ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh ho\u1eb7c th\u1ee7 thu\u1eadt nha khoa (h\u00ecnh 2.46). Sculptra (Galderma, Th\u1ee5y S\u0129) l\u00e0 1 c\u00f4ng th\u1ee9c bao g\u1ed3m b\u1ed9t \u0111\u00f4ng kh\u00f4 PLLA \u0111\u00e3 nh\u1eadn \u0111\u01b0\u1ee3c ch\u1ee9ng nh\u1eadn CE v\u00e0o n\u0103m 1999 v\u00e0 \u0111\u01b0\u1ee3c FDA Hoa K\u1ef3 ch\u1ea5p thu\u1eadn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng teo m\u1ee1 v\u00f9ng m\u1eb7t \u1edf b\u1ec7nh nh\u00e2n HIV v\u00e0o n\u0103m 2003 [41]. Sau \u0111\u00f3 v\u00e0o n\u0103m 2009, n\u00f3 \u0111\u00e3 \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn cho vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh c\u00e1c n\u1ebfp nh\u0103n v\u00e0 c\u00e1c r\u00e3nh tr\u00ean khu\u00f4n m\u1eb7t t\u1ea1i th\u1ecb tr\u01b0\u1eddng Hoa K\u1ef3. Sau khi \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o m\u00f4, PLLA \u0111\u00e0n b\u1ecb ph\u00e1 v\u1ee1 th\u00e0nh c\u00e1c mono acid lactic trong v\u00f2ng 24 th\u00e1ng th\u00f4ng qua qu\u00e1 tr\u00ecnh th\u1ee7y ph\u00e2n kh\u00f4ng c\u00f3 enzyme [42]. Trong qu\u00e1 tr\u00ecnh n\u00e0y, n\u00f3 t\u1ea1o ra t\u00ecnh tr\u1ea1ng vi\u00eam c\u00f3 ki\u1ec3m so\u00e1t t\u1ea1i khu v\u1ef1c \u0111\u01b0\u1ee3c ti\u00eam \u0111\u1ec3 k\u00edch th\u00edch s\u1ea3n xu\u1ea5t collagen [43]. Sau \u0111\u00f3, acid lactic \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a th\u00e0nh CO2 v\u00e0 n\u01b0\u1edbc v\u00e0 \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft ra kh\u1ecfi c\u01a1 th\u1ec3 1 c\u00e1ch t\u1ef1 nhi\u00ean [44]. C\u00e1c vi h\u1ea1t PLLA c\u00f3 trong s\u1ea3n ph\u1ea9m \u1edf d\u1ea1ng tinh th\u1ec3 kh\u00f4ng \u0111\u1ec1u thay v\u00ec vi c\u1ea7u m\u1ecbn. Scultra ch\u1ec9 ch\u1ee9a h\u1ea1t PLLA c\u00f3 \u0111\u01b0\u1eddng k\u00ednh 40-60pm \u0111\u1ec3 tr\u00e1nh \u0111\u1ea1i th\u1ef1c b\u00e0o [44]. C\u00e1c th\u00e0nh ph\u1ea7n kh\u00e1c c\u00f3 trong b\u1ed9t ngo\u00e0i PLLA bao g\u1ed3m Mannitol v\u00e0 natri. Sculptra c\u00f3 d\u1ea1ng l\u1ecd c\u00f3 kh\u1ed1i l\u01b0\u1ee3ng 367.55m, v\u1edbi m\u1ed7i l\u1ecd ch\u1ee9a PLLA 150mg, CMC 90mg v\u00e0 Mannitol 127.5mg. CMC \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o s\u1ef1 ph\u00e2n b\u1ed1 \u0111\u1ed3ng \u0111\u1ec1u c\u1ee7a c\u00e1c h\u1ea1t PLLA [45] trong khi mannitol c\u00f3 t\u00e1c d\u1ee5ng \u0111\u00f3ng b\u00e1nh \u0111\u1ed3ng nh\u1ea5t, ch\u1eafc ch\u1eafn trong qu\u00e1 tr\u00ecnh \u0111\u00f4ng kh\u00f4 cu\u1ed1i c\u00f9ng [46].<\/p>\n

        Kh\u00f4ng gi\u1ed1ng Radiesse v\u00e0 Ellanse k\u1ebft h\u1ee3p ch\u1ea5t mang gel, Sculptra \u1edf d\u1ea1ng b\u1ed9t \u0111\u00f4ng kh\u00f4 v\u00e0 do \u0111\u00f3 y\u00eau c\u1ea7u kh\u00f4i ph\u1ee5c b\u1eb1ng n\u01b0\u1edbc c\u1ea5t v\u00f4 tr\u00f9ng (sau \u0111\u00e2y g\u1ecdi l\u00e0 \u2018’n\u01b0\u1edbc c\u1ea5t\u201d) 2-72 gi\u1edd tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng [47,48]. V\u1edbi s\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a mannitol trong b\u1ed9t, n\u00ean s\u1eed d\u1ee5ng n\u01b0\u1edbc c\u1ea5t thay v\u00ec n\u01b0\u1edbc mu\u1ed1i \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o kh\u1ea3 n\u0103ng th\u1ea9m th\u1ea5u th\u00edch h\u1ee3p. M\u1eb7c d\u00f9 th\u1ec3 t\u00edch kh\u00f4i ph\u1ee5c \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb l\u00e0 5ml m\u1ed7i l\u1ecd [48,49], nh\u01b0ng xu h\u01b0\u1edbng ph\u1ed5 bi\u1ebfn trong qu\u00e1 tr\u00ecnh ti\u00eam l\u00e0 s\u1eed d\u1ee5ng th\u1ec3 t\u00edch kh\u00f4i ph\u1ee5c cao h\u01a1n l\u00e0 10ml \u0111\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 h\u00ecnh th\u00e0nh n\u1ed1t s\u1ea7n [50]. Thay v\u00ec kh\u00f4i ph\u1ee5c v\u1edbi ch\u1ec9 nguy\u00ean n\u01b0\u1edbc c\u1ea5t, t\u1ed1t h\u01a1n n\u00ean th\u00eam 1-2ml lidocain 1% v\u00e0o 8-9ml n\u01b0\u1edbc c\u1ea5t \u0111\u1ec3 pha s\u1ea3n ph\u1ea9m nh\u1eb1m gi\u1ea3m thi\u1ec3u c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu khi ti\u00eam [50]. V\u1ec1 th\u1eddi gian, n\u00ean pha s\u1ea3n ph\u1ea9m tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng \u00edt nh\u1ea5t 1 ng\u00e0y. S\u1ef1 kh\u00f4n ngoan c\u1ee7a vi\u1ec7c kh\u00f4i ph\u1ee5c s\u1ea3n ph\u1ea9m tr\u01b0\u1edbc v\u1edbi n\u01b0\u1edbc c\u1ea5t v\u00e0 \u0111\u1ec3 s\u1ea3n ph\u1ea9m \u1edf tr\u1ea1ng th\u00e1i \u0111\u1ee7 hydrat h\u00f3a l\u00e0 \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o s\u1ef1 ph\u00e2n t\u00e1n \u0111\u1ed3ng \u0111\u1ec1u c\u1ee7a c\u00e1c vi h\u1ea1t PLLA trong h\u1ed7n h\u1ee3p v\u00e0 ng\u0103n ch\u1eb7n s\u1ea3n ph\u1ea9m v\u00f3n c\u1ee5c g\u00e2y ra c\u00e1c n\u1ed1t s\u1ea7n. Trong khi b\u1ea3o qu\u1ea3n l\u00ean \u0111\u1ebfn 3 ng\u00e0y sau khi \u0111\u01b0\u1ee3c hidrat h\u00f3a \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 trong d\u01b0\u1ee3c l\u00fd, Sculptra \u0111\u00e3 kh\u00f4i ph\u1ee5c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c b\u1ea3o qu\u1ea3n \u0111\u01b0\u1ee3c 3-4 tu\u1ea7n trong t\u1ee7 l\u1ea1nh, mi\u1ec5n l\u00e0 c\u00f3 c\u00e1c bi\u1ec7n ph\u00e1p c\u1ea7n thi\u1ebft \u0111\u1ec3 ng\u0103n ng\u1eeba \u00f4 nhi\u1ec5m [50]. B\u1ea3n th\u00e2n PLLA kh\u00f4ng h\u00f2a tan trong n\u01b0\u1edbc m\u00e0 tr\u1edf n\u00ean l\u01a1 l\u1eedng khi \u0111\u01b0\u1ee3c kh\u00f4i ph\u1ee5c b\u1eb1ng n\u01b0\u1edbc c\u1ea5t. M\u1eb7t kh\u00e1c, CMC v\u00e0 mannitol c\u00f3 th\u1ec3 h\u00f2a tan sau khi \u0111\u01b0\u1ee3c kh\u00f4i ph\u1ee5c b\u1eb1ng n\u01b0\u1edbc c\u1ea5t s\u1ebd \u0111\u01b0\u1ee3c hidrat h\u00f3a. Do \u0111\u00f3, ch\u00fang t\u00f4i khuy\u1ebfn c\u00e1o r\u1eb1ng l\u1ecd Sculptra 1 khi \u0111\u00e3 \u0111\u01b0\u1ee3c ng\u1eadm n\u01b0\u1edbc b\u1eb1ng n\u01b0\u1edbc c\u1ea5t n\u00ean \u0111\u01b0\u1ee3c khu\u1ea5y nh\u1eb9 tr\u01b0\u1edbc khi ti\u00eam \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o ph\u00e2n t\u00e1n \u0111\u1ed3ng \u0111\u1ec1u v\u00e0 \u0111\u1ed3ng nh\u1ea5t c\u1ee7a PLLA. Sau \u0111\u00f3 dung d\u1ecbch huy\u1ec1n ph\u00f9 \u0111\u01b0\u1ee3c chuy\u1ec3n t\u1eeb l\u1ecd v\u00e0o \u1ed1ng ti\u00eam 1ml. \u0110\u1ec3 tr\u00e1nh v\u00f4 t\u00ecnh g\u00e2y b\u1ea7m t\u00edm v\u00e0 ti\u00eam Sculptra v\u00e0o n\u1ed9i m\u1ea1ch n\u00ean s\u1eed d\u1ee5ng cannula 23G \u0111\u1ec3 \u0111\u01b0a s\u1ea3n ph\u1ea9m \u0111\u1ed3ng \u0111\u1ec1u v\u00e0o m\u1eb7t ph\u1eb3ng s\u00e2u d\u01b0\u1edbi da ho\u1eb7c tr\u00ean m\u00e0ng x\u01b0\u01a1ng. Khu v\u1ef1c duy nh\u1ea5t s\u1eed d\u1ee5ng kim 21G l\u00e0 v\u00f9ng th\u00e1i d\u01b0\u01a1ng \u0111\u01b0\u1ee3c bao ph\u1ee7 b\u1eb1ng m\u00e0ng c\u00e2n d\u00e0y kh\u00f4ng d\u1ec5 b\u1ecb xuy\u00ean th\u1ee7ng b\u1edfi cannuca.<\/p>\n

        Th\u1ec3 t\u00edch ti\u00eam c\u1ea7n thi\u1ebft cho to\u00e0n b\u1ed9 g\u01b0\u01a1ng m\u1eb7t bao g\u1ed3m c\u1ea3 r\u00e3nh tr\u01b0\u1edbc m\u00e1, m\u00e1 gi\u1eefa, th\u00e1i d\u01b0\u01a1ng dao \u0111\u1ed9ng t\u1eeb 1 \u0111\u1ebfn 2 l\u1ecd t\u00f9y thu\u1ed9c v\u00e0o th\u1ec3 t\u00edch v\u00f9ng m\u1eb7t b\u1ecb thi\u1ebfu h\u1ee5t [48]. Theo c\u00e1c v\u00f9ng tr\u00ean khu\u00f4n m\u1eb7t, th\u1ec3 t\u00edch s\u1ea3n ph\u1ea9m \u0111\u01b0\u1ee3c ti\u00eam l\u00e0 1-2ml \u0111\u1ed1\u00ec v\u1edbi v\u00f9ng m\u00e1 tr\u01b0\u1edbc, 2-4ml cho v\u00f9ng m\u00e1 gi\u1eefa v\u00e0 1-3ml cho th\u00e1i d\u01b0\u01a1ng m\u1ed7i b\u00ean. Theo nguy\u00ean t\u1eafc chung 1 l\u1ecd \u0111\u1ee7 d\u00f9ng cho 1 l\u1ea7n \u0111i\u1ec1u tr\u1ecb trong tr\u01b0\u1eddng h\u1ee3p v\u00f9ng th\u00e1i d\u01b0\u01a1ng kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb. N\u1ebfu c\u1ea7n \u0111i\u1ec1u tr\u1ecb cho v\u00f9ng th\u00e1i d\u01b0\u01a1ng ho\u1eb7c c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng thi\u1ebfu h\u1ee5t th\u1ec3 t\u00edch v\u00f9ng m\u1eb7t nghi\u00eam tr\u1ecdng th\u00ec c\u00f3 th\u1ec3 c\u1ea7n 2 l\u1ecd trong 1 l\u1ea7n \u0111i\u1ec1u tr\u1ecb. \u0110\u1ec3 tr\u00e1nh xu\u1ea5t hi\u1ec7n n\u1ed1t s\u1ea7n, \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 h\u1ea1n ch\u1ebf ti\u00eam n\u00f4ng ho\u1eb7c ti\u00eam \u1edf nh\u1eefng v\u00f9ng da m\u1ecfng nh\u01b0 quanh m\u1eaft. Do \u0111\u00f3 v\u00f9ng tr\u00e1n, m\u0169i c\u00f3 l\u1edbp da m\u1ecfng kh\u00f4ng ph\u00f9 h\u1ee3p \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Sculptra. PLLA c\u0169ng n\u00ean tr\u00e1nh \u0111i\u1ec1u tr\u1ecb \u1edf nh\u1eefng v\u00f9ng di \u0111\u1ed9ng nhi\u1ec1u nh\u01b0 quanh mi\u1ec7ng, m\u00f4i (h\u00ecnh 2.47). Ngay sau khi ti\u00eam, b\u1ea1n n\u00ean b\u00f3p nh\u1eb9 nh\u00e0ng c\u00e1c v\u00f9ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 ph\u00e2n ph\u1ed1i PLLA \u0111\u1ed3ng \u0111\u1ec1u kh\u1eafp m\u00f4 v\u00e0 tr\u00e1nh h\u00ecnh th\u00e0nh n\u1ed1t s\u1ea7n. Ngo\u00e0i ra, b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn xoa b\u00f3p c\u00e1c khu v\u1ef1c \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb trong 5 ph\u00fat x 5 l\u1ea7n\/ ng\u00e0y trong 5 ng\u00e0y sau khi \u0111i\u1ec1u tr\u1ecb (ph\u00e1c \u0111\u1ed3 5-5-5) [51].<\/p>\n

        Hi\u1ec7u \u1ee9ng l\u00e0m \u0111\u1ea7y xu\u1ea5t hi\u1ec7n ngay sau khi ti\u00eam Sculptra l\u00e0 do s\u1ef1 thay th\u1ebf th\u1ec3 t\u00edch tr\u1ef1c ti\u1ebfp \u0111\u01b0\u1ee3c cung c\u1ea5p b\u1edfi v\u1eadt li\u1ec7u ho\u00e0n nguy\u00ean bao g\u1ed3m n\u01b0\u1edbc c\u1ea5t, s\u1ebd bi\u1ebfn m\u1ea5t trong v\u00f2ng 2-3 ng\u00e0y sau \u0111i\u1ec1u tr\u1ecb k\u1ec3 t\u1eeb ng\u00e0y h\u00f4m sau. S\u1ea3n xu\u1ea5t collagen m\u1edbi t\u1eeb ti\u00eam PLLA b\u1eaft \u0111\u1ea7u trong 4 tu\u1ea7n k\u1ec3 t\u1eeb khi \u0111i\u1ec1u tr\u1ecb v\u00e0 \u0111\u1ea1t \u0111\u1ec9nh sau th\u00e1ng th\u1ee9 3, v\u1edbi qu\u00e1 tr\u00ecnh k\u00edch th\u00edch sinh h\u1ecdc collagen k\u00e9o d\u00e0i h\u01a1n 25 th\u00e1ng. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng Sculptra th\u01b0\u1eddng c\u1ea7n kho\u1ea3ng 3 l\u1ea7n ti\u00eam c\u00e1ch nhau 3-4 tu\u1ea7n \u0111\u1ec3 cho hi\u1ec7u qu\u1ea3 t\u1ed1t nh\u1ea5t [51].<\/p>\n

        Tuy nhi\u00ean kh\u00f4ng gi\u1ed1ng nh\u01b0 c\u00e1c ch\u1ea5t l\u00e0m \u0111\u1ea7y<\/strong> kh\u00e1c nh\u01b0 HA, cho ph\u00e9p b\u00e1c s\u0129 ho\u1eb7c b\u1ec7nh nh\u00e2n t\u00f9y ch\u1ec9nh th\u1ec3 t\u00edch theo mong mu\u1ed1n, k\u1ebft qu\u1ea3 c\u1ee7a Sculptra t\u00f9y thu\u1ed9c v\u00e0o s\u1ef1 thay \u0111\u1ed5i c\u1ee7a t\u1eebng c\u00e1 nh\u00e2n trong qu\u00e1 tr\u00ecnh h\u00ecnh th\u00e0nh collagen m\u1edbi \u1edf v\u00f9ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb. Do \u0111\u00f3, t\u1ed3n t\u1ea1i nguy c\u01a1 kh\u00f4ng th\u1ea5y \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 ngay c\u1ea3 sau khi ho\u00e0n th\u00e0nh c\u1ea3 3 v\u00f2ng \u0111i\u1ec1u tr\u1ecb. Do \u0111\u00f3, \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Sculptra \u0111\u00f2i h\u1ecfi n\u1ed7 l\u1ef1c t\u01b0\u01a1ng \u1ee9ng c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u1ec3 t\u1ed1i \u0111a h\u00f3a kh\u1ea3 n\u0103ng h\u00ecnh th\u00e0nh collagen, v\u00ed d\u1ee5, b\u1eb1ng c\u00e1ch tr\u00e1nh gi\u1ea3m c\u00e2n, \u0103n u\u1ed1ng l\u00e0nh m\u1ea1nh gi\u00e0u protein v\u00e0 duy tr\u00ec gi\u1ea5c ng\u1ee7 \u0111\u1ec1u \u0111\u1eb7n, ch\u1ea5t l\u01b0\u1ee3ng. Li\u00ean quan \u0111\u1ebfn t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n, 1 bi\u1ebfn ch\u1ee9ng cua Sculptra l\u00e0 h\u00ecnh th\u00e0nh n\u1ed1t s\u1ea7n do s\u1ef1u ph\u00e2n b\u1ed1 kh\u00f4ng \u0111\u1ed3ng \u0111\u1ec1u c\u1ee7a s\u1ea3n ph\u1ea9m trong m\u00f4 v\u00e0 s\u1ef1 k\u1ebft t\u1ee5 c\u1ee7a PLLA trong s\u1ea3n ph\u1ea9m \u0111\u01b0\u1ee3c ti\u00eam. C\u00e1ch ph\u00f2ng tr\u00e1nh t\u1ed1t nh\u1ea5t l\u00e0 s\u1eed d\u1ee5ng h\u1ed7n d\u1ecbch pha lo\u00e3ng th\u00e0nh 10ml v\u00e0 \u0111\u1ed3ng nh\u1ea5t \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o n\u00f3 \u0111\u01b0\u1ee3c ti\u00eam \u0111\u1ec1u trong m\u00f4. C\u0169ng h\u1eefu \u00edch khi b\u1ec7nh nh\u00e2n massage \u0111\u1ecbnh k\u1ef3 c\u00e1c khu v\u1ef1c \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb trong tu\u1ea7n \u0111\u1ea7u ti\u00ean. C\u1ea7n l\u01b0u \u00fd r\u1eb1ng c\u00e1c n\u1ed1t s\u1ea7n d\u1ec5 xu\u1ea5t hi\u1ec7n h\u01a1n \u1edf nh\u1eefng v\u00f9ng da m\u1ecfng bao g\u1ed3m quanh m\u1eaft v\u00e0 tr\u00e1n. Ch\u00fang th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n v\u1edbi k\u00edch th\u01b0\u1edbc b\u1eb1ng h\u1ea1t \u0111\u1eadu l\u0103ng ho\u1eb7c \u0111\u1eadu H\u00e0 Lan \u1edf 1-2 th\u00e1ng sau khi ti\u00eam v\u00e0 bi\u1ebfn m\u1ea5t trong v\u00f2ng g\u1ea7n 1 n\u0103m. Trong khi \u0111\u00f3, c\u00f3 th\u1ec3 c\u1ed1 g\u1eafng massage m\u1ea1nh \u0111\u1ec3 l\u00e0m v\u1ee1 c\u00e1c n\u1ed1t s\u1ea7n 1 c\u00e1ch c\u01a1 h\u1ecdc [52,53]. N\u1ebfu kh\u00f4ng c\u1ea3i thi\u1ec7n, c\u00f3 th\u1ec3 s\u1ebd c\u1ea7n xem x\u00e9t l\u00e0m nh\u1edf c\u00e1c h\u1ea1t PLLA \u0111\u00e3 k\u1ebft t\u1ee5 b\u1eb1ng c\u00e1ch ti\u00eam n\u01b0\u1edbc mu\u1ed1i v\u00e0o v\u00f9ng \u0111i\u1ec1u tr\u1ecb. Trong khi \u0111\u00f3 u h\u1ea1t l\u00e0 \u0111\u1ea1i di\u1ec7n cho 1 bi\u1ebfn ch\u1ee9ng kh\u00e1c c\u1ee7a Sculptra, c\u1ea7n \u0111\u01b0\u1ee3c ph\u00e2n bi\u1ec7t v\u1edbi n\u1ed1t s\u1ea7n (h\u00ecnh 2.48). U h\u1ea1t th\u01b0\u1eddng x\u1ea3y ra sau 3-6 th\u00e1ng sau ti\u00eam do ph\u1ea3n \u1ee9ng qu\u00e1 m\u1ee9c c\u1ee7a c\u01a1 th\u1ec3 [51,53]. M\u1eb7c d\u00f9 ch\u00fang xu\u1ea5t hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng n\u1ed1t ho\u1eb7c s\u1ea9n nh\u01b0ng v\u1ec1 m\u1eb7t m\u00f4 h\u1ecdc, ch\u00fang \u0111\u1ea1i di\u1ec7n cho u h\u1ea1t do v\u1eadt th\u1ec3 l\u1ea1 t\u1eeb b\u00ean ngo\u00e0i. U h\u1ea1t c\u00f3 th\u1ec3 k\u00e8m theo \u0111\u1ed5i m\u00e0u da, ph\u00f9 n\u1ec1, ban \u0111\u1ecf. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 c\u00f3 v\u1edbi u h\u1ea1t bao g\u1ed3m ti\u00eam trong da triamcinolone ho\u1eb7c 5-FU [54]. N\u1ebfu u h\u1ea1t kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi ti\u00eam trong da, n\u00ean ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf. C\u1ea7n c\u1ea3nh gi\u00e1c v\u00ec u h\u1ea1t kh\u00f4ng \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i h\u01a1n 10 n\u0103m.<\/p>\n

        B\u00e0n lu\u1eadn: <\/strong>L\u00e0 1 ch\u1ea5t k\u00edch th\u00edch sinh h\u1ecdc \u0111\u01b0\u1ee3c cung c\u1ea5p \u0111\u1ec3 k\u00edch th\u00edch ch\u00ednh c\u01a1 th\u1ec3 s\u1ea3n sinh collagen, Sculptra c\u00f3 th\u1ec3 l\u00e0 1 s\u1ef1 thay th\u1ebf h\u1ea5p d\u1eabn cho nh\u1eefng b\u1ec7nh nh\u00e2n mu\u1ed1n tr\u1ebb h\u00f3a nh\u01b0ng kh\u00f4ng mu\u1ed1n s\u1eed d\u1ee5ng ch\u1ea5t l\u00e0m \u0111\u1ea7y d\u1ea1ng ti\u00eam do kh\u00f4ng th\u00edch c\u1ea5y ch\u1ea5t l\u1ea1 v\u00e0o m\u1eb7t. Tuy nhi\u00ean h\u1ea1n ch\u1ebf c\u1ee7a Sculptra l\u00e0 k\u1ebft qu\u1ea3 ph\u1ee5 thu\u1ed9c nhi\u1ec1u v\u00e0o ph\u1ea3n \u1ee9ng c\u1ee7a c\u01a1 th\u1ec3 \u0111\u1ec3 x\u00e2y d\u1ee5ng collagen t\u1ef1 nhi\u00ean, c\u00f3 th\u1ec3 kh\u00e1c nhau \u0111\u00e1ng k\u1ec3 gi\u1eefa c\u00e1c c\u00e1 th\u1ec3, do \u0111\u00f3, k\u1ebft qu\u1ea3 c\u00f3 th\u1ec3 b\u1ecb h\u1ea1n ch\u1ebf n\u1ebfu nh\u01b0 kh\u00f4ng mu\u1ed1n n\u00f3i l\u00e0 kh\u00f4ng \u0111\u00e1ng k\u1ec3 \u1edf 1 s\u1ed1 b\u1ec7nh nh\u00e2n. \u0110i\u1ec3m y\u1ebfu n\u00e0y c\u00f3 v\u1ebb nh\u01b0 \u0111\u01b0\u1ee3c coi l\u00e0 l\u1ee3i th\u1ebf c\u1ee7a Scultra trong vi\u1ec7c x\u00e2y d\u1ef1ng kh\u1ed1i l\u01b0\u1ee3ng nh\u1ecf nh\u01b0ng t\u1ef1 nhi\u00ean theo th\u1eddi gian. G\u1ea7n \u0111\u1ea7y PLLA c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 1 ch\u1ea5t k\u00edch th\u00edch sinh h\u1ecdc, kh\u00f4ng ch\u1ec9 \u1edf t\u0103ng c\u01b0\u1eddng \u0111\u1ed9 \u0111\u00e0n h\u1ed3i c\u1ee7a da, m\u00e0 c\u00f2n \u1edf c\u1ea3i thi\u1ec7n l\u1ed7 ch\u00e2n l\u00f4ng, v\u1ebft s\u1eb9o, \u0111\u1ed9 s\u00e1ng v\u00e0 \u0111\u1ec1u m\u00e0u da qua vi\u1ec7c ti\u00eam n\u00f4ng v\u00e0o l\u1edbp d\u01b0\u1edbi da [42].<\/p>\n

        PDLLA (Poly-D,L-Lactic Acid)<\/h4>\n

        PDLLA (Poly-D,L-Lactic Acid) l\u00e0 1 \u0111\u1ed3ng ph\u00e2n l\u1eadp th\u1ec3 c\u1ee7a acid polylactic bao g\u1ed3m c\u00e1c acid D v\u00e0 L – Lactic \u0111\u01b0\u1ee3c s\u1eafp x\u1ebfp theo th\u1ee9 t\u1ef1 xen k\u1ebd t\u1ea1o th\u00e0nh 1 c\u1ea5u tr\u00fac chu\u1ed7i kh\u00f4ng \u0111\u1ec1u. Kh\u00f4ng gi\u1ed1ng PLLA ch\u1ec9 bao g\u1ed3m c\u00e1c acid-L-lactic \u0111\u01b0\u1ee3c \u0111\u00f3ng g\u00f3i ch\u1eb7t ch\u1ebd, c\u00e1c \u0111\u1ed3ng ph\u00e2n D v\u00e0 L trong PDLLA \u0111\u01b0\u1ee3c \u0111\u1eb7t c\u00e1ch xa nhau h\u01a1n. \u0110i\u1ec1u n\u00e0y l\u00e0m cho PDLLA c\u00f3 \u0111\u1eb7c t\u00ednh m\u1ec1m, b\u1edf v\u1edbi \u0111\u1ed9 c\u1ee9ng gi\u1ea3m v\u00e0 h\u00ecnh d\u1ea1ng v\u00f4 \u0111\u1ecbnh h\u00ecnh, kh\u00f4ng gi\u1ed1ng PLLA c\u00f3 \u1edf d\u1ea1ng h\u1ea1t tinh th\u1ec3 [55].<\/p>\n

        Lenisna (VAIM, H\u00e0n Qu\u1ed1c) v\u00e0 Juvelook (VAIM, H\u00e0n Qu\u1ed1c) l\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m ch\u1ee9a c\u00e1c vi c\u1ea7u t\u1ea1o b\u1ecdt d\u1ea1ng l\u01b0\u1edbi c\u1ee7a PDLLA v\u00f4 \u0111\u1ecbnh h\u00ecnh trong h\u1ed7n h\u1ee3p c\u1ee7a DMSO (dimethylsulfoxide) v\u00e0 EC (ethylene cacbonate) (h\u00ecnh 2.49). Lenisa v\u00e0 Juvelook \u0111\u01b0\u1ee3c ch\u1ee9ng nh\u1eadn CE v\u00e0o n\u0103m 2020 v\u00e0 \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn s\u1eed d\u1ee5ng \u1edf ch\u00e2u \u00c2u. 1 \u01b0u \u0111i\u1ec3m \u0111\u00e1ng ch\u00fa \u00fd c\u1ee7a Lenisa v\u00e0 Juvelook l\u00e0 ch\u00fang ch\u1ee9a HA thay v\u00ec CMC, m\u1eb7c d\u00f9 \u1edf d\u1ea1ng kh\u00f4ng li\u00ean k\u1ebft ch\u00e9o, cho ph\u00e9p c\u00e1c s\u1ea3n ph\u1ea9m n\u00e0y \u0111i\u1ec1u ch\u1ec9nh th\u1ec3 t\u00edch ngay l\u1eadp t\u1ee9c trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb.<\/p>\n

        1 l\u1ecd Lenisa ch\u1ee9a 200mg PDLLA \u0111\u00f4ng kh\u00f4 (PDLLA 170mg, HA 30mg), trong khi Juvelook c\u00f3 trong l\u1ecd v\u1edbi li\u1ec1u 50mg (PDLLA 42.5mg, HA 7.5mg). \u0111i\u1ec1u \u0111\u00f3 n\u00f3i l\u00ean r\u1eb1ng, Juvelook kh\u00f4ng ch\u1ec9 \u0111\u01a1n gi\u1ea3n l\u00e0 c\u00f3 \u0111\u00f3ng g\u00f3i nh\u1ecf h\u01a1n Lenisa, m\u00e0 n\u00f3 \u0111\u1eb7c bi\u1ec7t v\u00ec n\u00f3 \u0111\u01b0\u1ee3c pha ch\u1ebf ch\u1ec9 ch\u1ee9a vi c\u1ea7u PDLLA c\u00f3 k\u00edch th\u01b0\u1edbc 50pm ho\u1eb7c nh\u1ecf h\u01a1n. K\u00edch th\u01b0\u1edbc h\u1ea1t trung b\u00ecnh c\u1ee7a Juvelook c\u00f3 \u0111\u01b0\u1eddng k\u00ednh 24pm (20-50 pm) so v\u1edbi 51 pm (50-80 pm) c\u1ee7a Lenisa. \u0110i\u1ec1u n\u00e0y cho ph\u00e9p Juvelook \u0111\u01b0\u1ee3c \u0111\u01b0a tr\u1ef1c ti\u1ebfp v\u00e0o l\u1edbp h\u1ea1 b\u00ec \u0111\u1ec3 t\u00e1i t\u1ea1o da m\u00e0 kh\u00f4ng lo h\u00ecnh th\u00e0nh n\u1ed1t s\u1ea7n, \u0111i\u1ec1u n\u00e0y gi\u00fap ph\u00e2n bi\u1ec7t n\u00f3 v\u1edbi Sculptra m\u1eb7c d\u00f9 \u0111i\u1ec1u n\u00e0y l\u00e0m gi\u1ea3m tu\u1ed5i th\u1ecd v\u00e0 th\u1ec3 t\u00edch so v\u1edbi Lenisa [55].<\/p>\n

        C\u00e1c vi c\u1ea7u c\u00f3 trong Lenisa v\u00e0 Juvelook bao g\u1ed3m c\u1ea5u tr\u00fac x\u1ed1p \u0111a l\u1ed7, khi\u1ebfn ch\u00fang d\u1ec5 b\u1ecb th\u1ee7y ph\u00e2n nhanh h\u01a1n t\u1eeb b\u00ean trong (h\u00ecnh 2.50). k\u1ebft qu\u1ea3 l\u00e0 khi b\u1ecb th\u1ee7y ph\u00e2n s\u1ea3n ph\u1ea9m d\u1ea7n b\u1ecb ph\u00e1 v\u1ee1 th\u00e0nh c\u00e1c mono acid lactic trong kho\u1ea3ng t\u1eeb 1-1.5 n\u0103m. Nh\u01b0 v\u1edbi PLLA, PDLLA c\u0169ng g\u00e2y ra t\u00ecnh tr\u1ea1ng vi\u00eam \u1edf v\u00f9ng \u0111\u01b0\u1ee3c ti\u00eam trong qu\u00e1 tr\u00ecnh tho\u00e1i h\u00f3a, k\u00edch th\u00edch s\u1ea3n sinh collagen m\u1eb7c d\u00f9 th\u1eddi gian v\u00e0 s\u1ed1 l\u01b0\u1ee3ng gi\u1ea3m so v\u1edbi PLLA. Tuy nhi\u00ean, \u0111i\u1ec3m n\u00e0y \u0111\u1ed3ng th\u1eddi c\u0169ng c\u00f3 th\u1ec3 l\u00e0 \u0111i\u1ec3m m\u1ea1nh, v\u00ec n\u00f3 ng\u1ee5 \u00fd r\u1eb1ng gi\u1ea3m nguy c\u01a1 h\u00ecnh th\u00e0nh n\u1ed1t s\u1ea7n v\u00e0 u h\u1ea1t. Lenisa th\u00edch h\u1ee3p \u0111\u1ec3 b\u1ed5 sung th\u1ec3 t\u00edch, t\u01b0\u01a1ng t\u1ef1 Sculptra th\u00f4ng qua ti\u00eam v\u00e0o m\u1eb7t ph\u1eb3ng s\u00e2u d\u01b0\u1edbi da, so s\u00e1nh v\u1edbi Juvelook bao g\u1ed3m c\u00e1c h\u1ea1t m\u1ecbn h\u01a1n, \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf ch\u1ee7 y\u1ebfu \u0111\u1ec3 t\u00e1i t\u1ea1o th\u00f4ng qua ti\u00eam v\u00e0o da.<\/p>\n

        C\u0169ng gi\u1ed1ng nh\u01b0 Sculptra, Lenisa v\u00e0 Juvelook \u1edf d\u1ea1ng b\u1ed9t \u0111\u00f4ng kh\u00f4 v\u00e0 kh\u00f4ng b\u1ecb l\u01a1 l\u1eedng trong ch\u1ea5t gel mang m\u00e0 thay v\u00e0o \u0111\u00f3, c\u1ea7n ph\u1ea3i kh\u00f4i ph\u1ee5c b\u1eb1ng n\u01b0\u1edbc c\u1ea5t v\u00f4 tr\u00f9ng tr\u01b0\u1edbc khi ti\u00eam. Xem x\u00e9t r\u1eb1ng b\u1ed9t ch\u1ee9a mannitol, n\u00ean s\u1eed d\u1ee5ng n\u01b0\u1edbc c\u1ea5t thay v\u00ec n\u01b0\u1edbc mu\u1ed1i \u0111\u1ec3 ho\u00e0n nguy\u00ean gi\u00fap \u0111\u1ea3m b\u1ea3o n\u1ed3ng \u0111\u1ed9 th\u1ea9m th\u1ea5u ph\u00f9 h\u1ee3p c\u1ee7a s\u1ea3n ph\u1ea9m. V\u1ec1 th\u1ec3 t\u00edch pha lo\u00e3ng, Lenisa \u0111\u01b0\u1ee3c pha v\u1edbi 6ml n\u01b0\u1edbc c\u1ea5t v\u00e0 1ml lidocain \u0111\u01b0\u1ee3c th\u00eam v\u00e0o, trong khi Juvelook \u0111\u01b0\u1ee3c pha v\u1edbi 4ml n\u01b0\u1edbc c\u1ea5t v\u00e0 1ml lidocain \u0111\u01b0\u1ee3c th\u00eam v\u00e0o [56]. V\u1edbi Lenisa v\u00e0 juvelook bao g\u1ed3m nhi\u1ec1u vi c\u1ea7u v\u00e0 b\u00e3o h\u00f2a d\u1ec5 d\u00e0ng h\u01a1n so v\u1edbi Sculptra, ch\u00fang c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ngay l\u1eadp t\u1ee9c sau 30-60phuts hydrat h\u00f3a. Tuy nhi\u00ean, c\u00f3 th\u1ec3 h\u1eefu \u00edch n\u1ebfu s\u1eed d\u1ee5ng m\u00e1y quay t\u1ea1o xo\u00e1y \u0111\u1ec3 khu\u1ea5y l\u1ecd trong kho\u1ea3ng 20p tr\u01b0\u1edbc khi ti\u00eam ho\u1eb7c \u0111\u1ec3 s\u1ea3n ph\u1ea9m \u0111\u00e3 pha 1 ng\u00e0y ho\u1eb7c t\u1ed1t nh\u1ea5t 1 tu\u1ea7n tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng. C\u00e1c s\u1ea3n ph\u1ea9m \u0111\u00e3 pha c\u00f3 th\u1ec3 b\u1ea3o qu\u1ea3n trong t\u1ee7 l\u1ea1nh 3-4 tu\u1ea7n v\u1edbi \u0111i\u1ec1u ki\u1ec7n tr\u00e1nh b\u1ecb nhi\u1ec5m khu\u1ea9n.<\/p>\n

        Ngay tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng, n\u00ean l\u1eafc nh\u1eb9 l\u1ecd \u0111\u00e3 hidrat h\u00f3a c\u1ee7a Lenisa ho\u1eb7c Juvelook \u0111\u1ec3 c\u00f3 \u0111\u01b0\u1ee3c h\u1ed7n d\u1ecbch \u0111\u1ed3ng \u0111\u1ec1u. Sau \u0111\u00f3 dung d\u1ecbch huy\u1ec1n ph\u00f9 \u0111\u01b0\u1ee3c chuy\u1ec3n t\u1eeb l\u1ecd v\u00e0o \u1ed1ng ti\u00eam 1ml \u0111\u1ec3 ti\u00eam v\u00e0o m\u00f4. \u0110\u1ec3 tr\u00e1nh b\u1ea7m t\u00edm v\u00e0 v\u00f4 t\u00ecnh v\u00e0o m\u1ea1ch m\u00e1u n\u00ean s\u1eed d\u1ee5ng cannula 23G \u0111\u1ec3 \u0111\u01b0a s\u1ea3n ph\u1ea9m \u0111\u1ed3ng \u0111\u1ec1u v\u00e0o m\u1eb7t ph\u1eb3ng s\u00e2u d\u01b0\u1edbi da ho\u1eb7c tr\u00ean m\u00e0ng x\u01b0\u01a1ng. Khu v\u1ef1c th\u00e1i d\u01b0\u01a1ng \u0111\u01b0\u1ee3c bao ph\u1ee7 b\u1edfi l\u1edbp c\u00e2n d\u00e0y cannula kh\u00f3 \u0111i qua, n\u00ean s\u1eed d\u1ee5ng kim 21G. Khi s\u1eed d\u1ee5ng s\u1ea3n ph\u1ea9m \u0111\u1ec3 thay th\u1ebf th\u1ec3 t\u00edch b\u1ecb thi\u1ebfu h\u1ee5t, n\u00ean s\u1eed dung 0.7ml Lenisa ho\u00e0n nguy\u00ean \u0111\u00e3 \u0111\u01b0\u1ee3c pha lo\u00e3ng th\u00eam 0.3ml n\u01b0\u1edbc mu\u1ed1i [56]. \u0110i\u1ec1u n\u00e0y t\u1ea1o ra hi\u1ec7u qu\u1ea3 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng Sculptra \u0111\u01b0\u1ee3c pha th\u00e0nh 10ml. Th\u1ec3 t\u00edch s\u1ea3n ph\u1ea9m \u0111\u01b0\u1ee3c ti\u00eam tr\u00ean m\u1ed7i v\u00f9ng \u0111i\u1ec1u tr\u1ecb (m\u1ed7i b\u00ean) l\u00e0 1-2ml \u0111\u1ed1i v\u1edbi v\u00f9ng m\u00e1 tr\u01b0\u1edbc, 2-4ml v\u1edbi m\u00e1 gi\u1eefa v\u00e0 1-3ml \u0111\u1ed1i v\u1edbi th\u00e1i d\u01b0\u01a1ng. M\u1ed7i l\u1ea7n \u0111i\u1ec1u tr\u1ecb c\u1ea7n 01 l\u1ecd n\u1ebfu v\u00f9ng th\u00e1i d\u01b0\u01a1ng kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb. Tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec1u tr\u1ecb cho c\u1ea3 v\u00f9ng th\u00e1i d\u01b0\u01a1ng v\u00e0 thi\u1ebfu h\u1ee5t th\u1ec3 t\u00edch n\u1eb7ng tr\u00ean khu\u00f4n m\u1eb7t th\u00ec c\u00f3 th\u1ec3 c\u1ea7n \u0111\u1ebfn 2 l\u1ecd cho m\u1ed7i l\u1ea7n \u0111i\u1ec1u tr\u1ecb. C\u00f3 th\u1ec3 c\u00e2n nh\u1eafc k\u1ebft h\u1ee3p v\u1edbi HA li\u00ean k\u1ebft ch\u00e9o \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n mu\u1ed1n b\u1ed5 sung th\u1ec3 t\u00edch ngay l\u1eadp t\u1ee9c ho\u1eb7c kh\u00f4ng mu\u1ed1n \u0111i\u1ec1u tr\u1ecb l\u1eb7p l\u1ea1i. Trong tr\u01b0\u1eddng h\u1ee3p \u0111\u00f3, khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng 0.7ml Lenisa ho\u00e0n nguy\u00ean \u0111\u00e3 pha lo\u00e3ng th\u00eam v\u1edbi 0.3ml HA li\u00ean k\u1ebft ch\u00e9o[56].<\/p>\n

        Th\u1ec3 t\u00edch ti\u00eam li\u00eann quan ph\u1ea3i t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi 1.5-2 l\u1ea7n l\u01b0\u1ee3ng \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u00eam n\u1ebfu ch\u1ec9 s\u1eed d\u1ee5ng HA li\u00ean k\u1ebft ch\u00e9o. M\u1eb7c d\u00f9 k\u1ebft qu\u1ea3 ban \u0111\u1ea7u c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u1ee7, nh\u01b0ng th\u1ec3 t\u00edch d\u1ea7n tr\u1edf n\u00ean r\u00f5 r\u00e0ng sau tu\u1ea7n th\u1ee9 4, khi s\u1ea3n xu\u1ea5t collagen t\u1eeb vi\u1ec7c ti\u00eam PDLLA b\u1eaft \u0111\u1ea7u. M\u1ed9t \u01b0u \u0111i\u1ec3m c\u1ee7a Lenisa l\u00e0 gi\u1ea3m thi\u1ec3u nguy c\u01a1 h\u00ecnh th\u00e0nh n\u1ed1t s\u1ea7n ngay c\u1ea3 khi \u0111\u01b0a s\u1ea3n ph\u1ea9m v\u00e0o l\u1edbp n\u00f4ng c\u1ee7a da. \u0110i\u1ec1u n\u00e0y mang l\u1ea1i cho s\u1ea3n ph\u1ea9m t\u00ednh linh ho\u1ea1t, kh\u00f4ng ch\u1ec9 \u0111\u1ec3 b\u1ed5 sung th\u1ec3 t\u00edch cho khu\u00f4n m\u1eb7t m\u00e0 c\u00f2n gi\u00fap s\u0103n ch\u1eafc da. Khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 tr\u1ebb h\u00f3a da, n\u00ean th\u00eam 0.5ml n\u01b0\u1edbc mu\u1ed1i v\u00e0o 0.5ml Lenisa \u0111\u00e3 ho\u00e0n nguy\u00ean \u0111\u1ec3 \u0111\u01b0a v\u00e0o l\u1edbp d\u01b0\u1edbi da. Ngay sau khi ti\u00eam, s\u1ebd r\u1ea5t t\u1ed1t n\u1ebfu nh\u01b0 massage c\u00e1c khu v\u1ef1c \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 ph\u00e2n ph\u1ed1i PDLLA \u0111\u1ec1u kh\u1eafp m\u00f4, m\u1eb7c d\u00f9 xoa b\u00f3p nh\u1eb9 nh\u00e0ng h\u01a1n so v\u1edbi khi s\u1eed d\u1ee5ng Sculptra. B\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn \u0111\u1ec3 xoa c\u00e1c khu v\u1ef1c \u0111i\u1ec1u tr\u1ecb trong 3 ph\u00fat x 3 l\u1ea7n\/ng\u00e0y x 3 ng\u00e0y sau khi \u0111i\u1ec1u tr\u1ecb (ph\u00e1c \u0111\u1ed3 3-3-3) [56].<\/p>\n

        \u01afu \u0111i\u1ec3m l\u1edbn nh\u1ea5t c\u1ee7a Juvelook l\u00e0 kh\u1ea3 n\u0103ng \u0111\u01b0\u1ee3c \u0111\u01b0a tr\u1ef1c ti\u1ebfp v\u00e0o l\u1edbp h\u1ea1 b\u00ec \u0111\u1ec3 l\u00e0m s\u0103n ch\u1eafc da, v\u00ec n\u00f3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 h\u00ecnh th\u00e0nh n\u1ed1t s\u1ea9n ngay c\u1ea3 khi \u0111\u01b0\u1ee3c \u0111\u01b0a r\u1ea5t n\u00f4ng v\u00e0o da. PDLLA \u0111\u01b0\u1ee3c ti\u00eam v\u00e0o l\u1edbp h\u1ea1 b\u00ec c\u00f3 th\u1ec3 ho\u1ea1t \u0111\u1ed9ng nh\u01b0 1 ch\u1ea5t k\u00edch th\u00edch sinh h\u1ecdc, kh\u00f4ng ch\u1ec9 t\u0103ng \u0111\u1ed9 \u0111\u00e0n h\u1ed3i c\u1ee7a da m\u00e0 c\u00f2n c\u1ea3i thi\u1ec7n l\u1ed7 ch\u00e2n l\u00f4ng, v\u1ebft s\u1eb9o, \u0111\u1ed9 s\u00e1ng v\u00e0 \u0111\u1ed9 \u0111\u1ec1u m\u00e0u c\u1ee7a da gi\u1ed1ng nh\u01b0 PLLA [57]. Juvelook c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u0111\u01a1n l\u1ebb ho\u1eb7c k\u1ebft h\u1ee3p v\u1edbi HA li\u00ean k\u1ebft ch\u00e9o ho\u1eb7c c\u00e1c th\u00e0nh ph\u1ea7n skin-boosting kh\u00e1c nh\u01b0 PDRN, chi\u1ebft xu\u1ea5t nhau thai v\u00e0 exosome, c\u1ea7n th\u1eadn tr\u1ecdng \u1edf nh\u1eefng v\u00f9ng da m\u1ecfng, v\u00ed d\u1ee5 nh\u01b0 quanh m\u1eaft. C\u00e1c n\u1ed1t s\u1ea7n do Juvelook \u0111\u01b0\u1ee3c bi\u1ebft s\u1ebd bi\u1ebfn m\u1ea5t trong v\u00f2ng 1 th\u00e1ng sau khi massage l\u1eb7p \u0111i l\u1eb7p l\u1ea1i b\u1eb1ng thi\u1ebft b\u1ecb t\u1ea7n s\u1ed1 radio, v\u00ec vi\u1ec7c \u00e1p d\u1ee5ng nhi\u1ec7t k\u1ebft h\u1ee3p \u00e1p l\u1ef1c m\u1ea1nh c\u00f3 th\u1ec3 c\u00f3 hi\u1ec7u qu\u1ea3 trong vi\u1ec7c lo\u1ea1i b\u1ecf c\u00e1c vi c\u1ea7u PDLLA c\u00f3 c\u1ea5u tr\u00fac x\u1ed1p v\u00e0 c\u00f3 \u0111i\u1ec3m n\u00f3ng ch\u1ea3y l\u00e0 55-60 \u0111\u1ed9 C, th\u1ea5p h\u01a1n 10 \u0111\u1ed9 C so v\u1edbi PLLA.<\/p>\n

        T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
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          Ch\u01b0\u01a1ng 2: Ch\u1ea5t l\u00e0m \u0111\u1ea7y – t\u00e1c gi\u1ea3 Kyle K.Seo D\u1ecbch: Bs Nguy\u1ec5n Th\u1ecb Thu Huy\u1ec1n – BV\u0110K Sa Pa \u0110\u1ec3 t\u1ea3i file PDF v\u1ec1 c\u00e1c lo\u1ea1i ch\u1ea5t l\u00e0m \u0111\u1ea7y, click t\u1ea1i \u0111\u00e2y. C\u00e1c lo\u1ea1i ch\u1ea5t l\u00e0m \u0111\u1ea7y V\u1ec1 \u0111\u1ecbnh ngh\u0129a, c\u00e1c lo\u1ea1i filler li\u00ean quan \u0111\u1ebfn t\u1ea5t c\u1ea3 c\u00e1c th\u00e0nh ph\u1ea7n \u0111\u01b0\u1ee3c th\u00eam v\u00e0o […]\n","protected":false},"author":1,"featured_media":34003,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-33998","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/33998","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=33998"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/33998\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/34003"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=33998"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=33998"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=33998"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}