For almost eight years I have been using Algeness as a volumizing and reshaping filler. Treatments ranged from single syringe injections, such as to increase chin projection, to extensive facial recontouring, with quantities running into tens of millilitres, administered in multiple, carefully planned sessions over the course of several years.

The advantages of Algeness are multiple.

Apart from initial irritation the first days after injection, I did not ever observe any clinical signs of water absorption by the filler or the surrounding tissues at mid or long term: no soft local swelling nor any loss of contour by local or general puffiness. What you see at injection is what you get as a resulting volume (WYSIWYG) for many months to come.

Increased projection of the cheekbones, the mandibular angles or the chin is maintained for a long time. It decreases as the product is being resorbed entirely in situ, but does not flatten out due to local spread or change of shape. As reported in peer-reviewed publications, the filler is surrounded histiocytes and macrophages without encapsulation or scar formation. Beside the high G’ of the product, the early deposition of histiocytes may well help to maintain the product in place and with it any improved projection. The effect of the higher concentrations, injected deep, lasts for well over a year, and the effect of lower concentrations lasts up to a year.

Subcutaneous injection of the lower concentration formulation with a cannula is very helpful for smoothing contours, such as hiding the temporal crest, filling excessive hollowing of the temples or the lateral or anterior cheek or smoothing out retro-jowl and pre-jowl concavity. Again, the absence of mid or long-term reactive oedema helps to prevent undesirable swelling of areas immediately adjacent to the treated area such as the jowls or the lateral forehead.

Because patients may experience mild stinging on injection and a mild to moderate burning sensation for up to several hours after injection of the higher concentrations, I recommend to compound a syringe of 1,4 ml with 0,2 ml of lidocaine 2% for patient comfort. Generally speaking, I prefer injection by cannula over injection by sharp needle for reasons of security. However, perforating muscle tissue with a cannula can be difficult and very painful. For deep intramuscular injections in the temples, on the mandibular angles or the chin, using a sharp needle causes less pain and making bone contact is unequivocal. Algeness, compounded as mentioned above, can be injected with a 30G needle, which is much less painful than higher calibres and helps to maintain a slow and therefore safer flow.

Some deep palpability is probably due to the cellular response and disappears over the course of a few weeks.   However, intradermal injection or subdermal injection under the delicate skin of the eyelids or the lips is to be strongly discouraged. The tissue response there is too intense, with the risk of hard and visible lumps developing. Subcutaneous injection in other areas with a low concentration requires advanced knowledge of the product and its clinical applications.

The various concentrations of Algeness allowed me to obtain excellent results, and the more experience I get with it, the more indications I see. However, the filler being held in place by the cellular response also means that there is a relatively small margin of error. Any remodelling by finger pressure has to be performed immediately after injection. Algeness is to be considered as a viscous, injectable implant and definitely not a wrinkle filler. I strongly recommend even the most experienced of colleagues who consider injecting Algeness agarose gel to carefully study the product properties and recommended injection techniques rather than performing a quick try-out based on previous experience with other fillers. To me, Algeness is an excellent filler for volumizing by deep injection in the temples, the midface, the mandibular contour and the chin. It is my first choice for any patients who already demonstrated signs of facial oedema (spontaneously or after hyaluronic acid gel injections) and for patients aged over 55, who have a higher propensity for reactive oedema. Other very fine indications require advanced knowledge and experience with this filler.

Paradoxically, using Algeness has also increased my clientele for other fillers, including hyaluronic acid gels, even the ones designed for volumizing injections. Differentiating the best indications for each medical device helps us to provide a better and more client-centred service to a continuously growing variety of patients.

Dr. Joan Vandeputte
Plastic Surgeon