Agarose Gel: An Overview of the Dermal Filler and a Clinical Experience With 700 Patients.

Background: Dermal fillers currently in the market have several advantages and disadvantages over each other. Agarose gel (AG) is a unique material due to its special rheological characteristics and gel-forming capability. Objectives: The authors aimed to share their clinical experience on AG for a variety of facial augmentation procedures and its long-term results. Methods: The study population consisted of 700 patients (532 females; 168 males) aged 18 to 52 years. Follow-up visits were at 1, 3, 6, 12, and 24 months after the injections. Patient satisfaction was evaluated on a scale from 0 to 10 using a survey and clinical improvement was evaluated using the Global Aesthetic Improvement Scale (GAIS) by 2 independent plastic surgeons before the injection and at 1-year follow-up. Results: Eighty-two percent of the patients scored 1 or 2 (exceptional or great improvement) on GAIS. Eighty-five percent of the patients scored 8 or above (very satisfied). Most patients experienced at least 80% persistence of effect at 1-year follow-up. Conclusions: AG appears to be suitable for a variety of facial augmentation and contouring applications, as it is safe and has long-lasting favorable cosmetic efficacy.

Evaluation of Post-Operative Patient Satisfaction and Rhinoplasty Decision Based on Pre-and PostOperative Images on Social Media.

Objective: The novel objective of this research was to evaluate post-operative patient satisfaction among Turkish patients who decided to have rhinoplasty by seeing their pre-operative and post-operative images on social media. Method: This research compared and evaluated the collected data from three patient groups, namely Group 1, Group 2, and Group 3 to investigate the satisfaction level of the patients after the first year of the surgery. Result: The study found that the number of patients who decided to get rhinoplasty done after looking at images from social media were similar to other groups according to surgeon's scores. However, it was determined that the patient satisfaction of those who came after looking at images from social media was lower by a large margin and their expectations were not met by rhinoplasty. Conclusion: This research presented a novel theoretical implication that was not determined and evaluated by other studies in prior studies. The contribution of this research has reliable justification to improve patient satisfaction based on their health behavior to improve their level of satisfaction with rhinoplasty.

Hybrid Nasal Filler: Combining Agarose Gel and Hyaluronic Acid for Nonsurgical Rhinoplasty.

Given its structural properties, it would be a mistake to assume that a single type of filler fits perfectly to each anatomical region of the nose in nonsurgical rhinoplasty procedures. Therefore, we aimed to develop a hybrid treatment model by applying two different structural types of fillers. Hyaluronic acid (HA), a hydrophilic material, and agarose gel (AG), a nonhydrophilic and high G-prime material, were used in the study according to their advantages and disadvantages. Methods: Patients who presented to the office desiring filler treatment for nonsurgical correction of the nose in a 2-year period were enrolled in the study. HA was used intradermally 0.1 ml per each point in the tip defining points and supratip. Injections of 0.4-0.7 and 0.4-0.6 ml AG were used supraperiosteally in the radix and nasal spine, respectively. Clinical improvement was evaluated two weeks later using the Global Aesthetic Improvement Scale from 1 to 5 (1: exceptional improvement; 5: worsened patient). Patient satisfaction was evaluated on a scale from 0 to 10 (0: not satisfied; 10: very satisfied). Results: A total of 32 patients (mean age: 27 years) were enrolled in the study. Mean score of patient satisfaction was 9.09 of 10 after injection and 9 of 10 after 2 weeks. Clinical evaluation scores after injection were 1.72 of 5 and 1.69 of 5 on the Global Aesthetic Improvement Scale. No major complication was observed. Conclusion: The HA and AG filler hybrid concept applied in different anatomical locations represents a safe and convenient option for nonsurgical rhinoplasty procedures.

Increasing topical anesthetic efficacy with microneedle application.

INTRODUCTION: Since topical anesthetics alone seldom provide adequate analgesia for laser resurfacing procedures, injectable forms of anesthesia are often required. However, their application is uncomfortable for the patient. In this study, it is investigated whether microneedle application would enhance the efficacy of topical anesthetics. METHODS: Forty-seven patients participated in the study. Topical anesthetic agent EMLA was applied to the whole face of the patients. Microneedle treatment was applied to one side of the face with a roller-type device. Whole-face carbon dioxide laser resurfacing therapy was carried out then. The pain that patients experienced was assessed by using visual analog scale (VAS) method. VAS scores of two sides of the face were compared by using Wilcoxon signed-rank test. RESULTS: The mean of VAS score of the microneedle treated side was 2.1 ± 1.1 while that of the untreated side was 5.9 ± 0.9 and this difference was statistically significant (Wilcoxon signed-rank test, the Z-value is - 5.9683 and the p-value is < 0.001). SUMMARY: This study revealed that microneedle application, with a roller-type device, is a safe and easy procedure in providing sufficient anesthesia for facial laser resurfacing without the need for supplementary nerve blocks or injections.