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Collagen synthesis in adult skin is slow, elastin almost does not regenerate at all, and as the underlying volume drops, the dermis loses its scaffold and laxity becomes obvious at the jawline, temples, and under-eye region

Any such combination is off-label and should be guided by clinical history, vitals, sleep quality, and GI tolerance

To address these challenges and promote appropriate medication use, many insurers implement utilization management tools like prior authorization and step therapy

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doi:10.1016/j.ejps.2017.03.020 73

This creates a genuine paradox