Melbourne Hand Surgery

Dermal Fillers in Hand Rejuvenation

moisturising cream hands

Dermal fillers can provide a significant improvement to the appearance of the ageing hand,obscuring or softening the appearance of veins and tendons, creating an appearance of plump skin with a youthful fullness.

What does the procedure involve?

Hyaluronic acid, poly-L-lactic acid or calcium hyroxylapatite fillers can be used. The office-based procedure does not require sedation or an anaesthetic. There is no downtime.

Can other therapies be used to improve the hand appearance?

forearms and hands together

Yes. Chemical peels and laser and light therapies (Q-switched lasers, CO2 lasers, erbium lasers, intense pulsed light and photodynamic therapy) can improve the skin appearance by exfoliating, improving skin elasticity and removing sun spots and freckles. These treatments do not restore a youthful fullness to the hand but the aesthetic benefit that can be obtained by a combination of treatments is greater than that which can be achieved with a single treatment method.

If, like many older Australians, you have sun damage with roughened areas of skin on your hands and forearms you may gain significant benefit from topical prescription creams containing powerful medications proven to treat actinic keratoses, solar keratoses and Bowen's disease.

Would a surgical hand lift help me?

Excision of skin can be of benefit in hand rejuvenation in certain patients, but is generally not recommended as an isolated treatment. In most patients simply tightening the skin will accentuate the veins and tendons, making the hand look older despite having fewer wrinkles.

What does a youthful hand look like?

hands on towel for manicureThe healthy, youthful hand has a subcutaneous fullness with soft skin and no wrinkles except for flexion creases over the finger joints. Veins may be visible, especially in slender and athletic individuals, but their blue colour is subtle. Tendons are often visible, particularly when the fingers are extended, but subtly so. Fullness of the skin and tissues prevents the hand from appearing bony.

What does an ageing hand look like?

We can all recognise an aged hand when we see it, but an understanding of the ageing process is important in determining what treatments can optimally transform your hands, leaving them looking younger.

elderly handsThe hand is constantly exposed to environmental factors which can accelerate the ageing process. Hand ageing is a three-dimensional process involving bone and subcutaneous tissues as well as the skin. The dermis in the skin becomes thinner. Loss of dermal thickness and atrophy of the subcutaneous tissues makes the veins more prominent, tortuous and blue in colour. Age spots become more common, as do pigmentation irregularities. The tendons become more obvious, even at rest. The fibres of the tendons may become visible. The skin becomes thin and wrinkled with reduced elasticity. The muscles become more wasted, leading to hollowing of the hand and a more prominent appearance of the joints. Arthritic nodules can further emphasise the prominence of the joints.

Can all these changes be addressed with dermal fillers?

two hands with red nailsIncreasing the volume of the subcutaneous tissues of the hand will address the majority of changes of the ageing hand. The veins and tendons will become less prominent. Muscle wasting is disguised. Skin texture and appearance is improved. Dermal fillers will not address arthritic nodules on the fingers or the skin pigment and quality changes that occur with age. The skin pigment and quality changes are best targeted with combination skin therapies.

What are the possible complications?

The most common issue is that of mild swelling and occasionally bruising, which resolves over 1-2 weeks. Some patients may notice small lumps or irregularitites as the swelling resolves, perhaps caused by uneven filler distribution or migration. Other possible complications include infection, cyst formation and temporary alteration in sensation (numbness, burning or tingling).

Hand Rejuvenation Filler Transfer Video from The Doctors

The video below (from "The Doctors") demonstrates how the filler injection is performed:

 References

Jakubietz RG, Kloss DF, Gruenert JG, Jakubietz MG. The ageing hand. A study to evaluate the chronological ageing process of the hand. J Plast Reconstr Aesthet. (2008) 61, 681-686.
Bidic M, Hatef DA, Rohrich RJ. Dorsal Hand Anatomy Relevant to Volumetric Rejuvenation. Plast Reconstr Surg. 126: 163-168, 2010.

FRACS

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