Since fillers have entered into the aesthetic market, it was a big success. The first collagen based filler was approved by the FDA in 1981, and in more than 30 years we assisted at growing popularity of this treatment and growing number of different fillers (collagen, hyaluronic acid, PLLA, caprolactone, etc.). Absorbable fillers have demonstrated during this long period to be efficient, relatively safe and discretely long lasting. Nevertheless the ideal filler is still at the step “work in progress”.

The Ideal Filler?

What are the characteristics of the ideal filler?
1. Totally biocompatible
2. Totally biodegradable
3. Pure, without dangerous chemicals inside
4. Without immunological interaction leading to tissue inflammation
5. Good tissue integration, no migration
6. Easy to inject
7. Efficient to correct volume loss and wrinkles
8. Stable result with no modifications in follow up
9. Long lasting result

A new, natural filler composed of purified agarose gel represents an interesting option for volume loss and wrinkle correction. Actually a similar product has already appeared in the market about 10 years ago, but it doesn’t have commercial success due to different problems, mostly due to the not correct protocol of using. We could remember the comparable destiny of injectable PLLA; since the right protocols have been created, this product became safe and efficient with really low rate of side effects. Personally I’ve been using injectable PLLA for about 15 year with only 1 case of nodules formation (palpable, not visible) absorbed without any treatment in about 10 months.

My choice: Agarose gel

The new agarose gel device is a fruit of 10 years of research and innovation, it’s distributed in Europe since 2014 and I’ve been using it in my practice for about 2 years with inspiring results.

Why I decided to try this new filler considering that today aesthetic practitioners have a large selection of fillers of very high quality?

The reason is that agarose gel has many characteristics that bring it over to the ideal filler. It’s totally biocompatible and biodegradable, and it’s been proved even by live human histology. The biodegradation occurs by means of macrophages. They move it to the RES where it’s degradated in pentose cycle. It’s 100% natural, made by sophisticated extraction process from red alga. There is no additional substance to create cross-linking or stabilize it. The stable structure of agarose gel is achieved by natural hydrocolloid three-dimensional matrix. The purity of this device is tested three times before commercializing, so no risk of bacterial proteins or other unwanted substances inside. Seeing that agarose has been used in different medical area as cell delivery system for cartilage repair or tissue engineering, it has been proved in manifold publications that it doesn’t create any immunological interaction leading to the tissue inflammation.

The integration with tissue is very good since the gel has a three-dimensional matrix. The risk of migration in this case is really minimal.

As for the practical use, it’s possible to extrude the agarose gel through a very thin needle without big effort. This characteristic depends on the fact that we deal with hydrocolloid which possesses the cohesive properties of a solid and the diffusion transport properties of a liquid. So it has sufficient low viscosity to be injected easily. The volume loss replacement and wrinkles correction thanks to above mentioned characteristics (good three-dimensional tissue support, low rate migration) are effective and long lasting (up to 1 year).

Last but not least is the unique property of agarose gel: it’s not hydrophilic! This means that we obtain instant result; no need to wait weeks for the final result. Moreover in particular anatomical areas (tear through) it seems particularly suitable since it doesn’t create the Tyndall effect or any unwanted swelling.

Clinical Cases

My personal experience confirms many advantages of agarose gel filler. The patient satisfaction is the driving factor for further using of it.

Below are some clinical cases of successful correction of volume loss and wrinkles.

In the modern era of growing patient attention to the composition of aesthetic and cosmetic products, it’s important to choose properly the devices for our practice selecting the new opportunities in accordance with modern requests of our patients.