Techniques for hand rejuvenation with fillers in aesthetic practice

The hands are an often-overlooked area of aesthetic medicine that can be improved upon to give a more complete anti-ageing improvement. The hand ages similarly to the face, with volume loss, wrinkling and pigmentation changes. The hands also have more tendons and veins, which become exposed with age. Fillers, such as hyaluronic acid and calcium hydroxyapatite, can be used to improve volume loss and camouflage the tendons and veins. To complete the rejuvenation, lasers/IPLs and peels can be used to improve the age spots to the back of the hands.

Fat Grafting for Hand Rejuvenation

The hands are one of the most visible parts of the body, and prominent dorsal veins and extensor tendons are the most readily recognized signs of the aging process. Fat grafting has been demonstrated to be a safe and effective method of hand rejuvenation by restoration of subcutaneous fat. Despite some variability in the technical approach, fat grafting techniques are consistent in their use of low-pressure injection with standard cannula sizes, small aliquots of graft, and a total volume of graft greater than or equal to 15 mL per hand. While distribution of the fat is an area of debate and a topic of active research, published studies have shown high patient satisfaction rates, suggesting that perhaps the restoration of volume alone is paramount. In this article, we will review the applications of fat grafting to the hand, focusing primarily on its role in hand rejuvenation.

Hand rejuvenation with CaHA guided by ultrasound

Volumizing the dorsal hand is one of the anatomical regions most frequently requested during the last decade. Calcium hydroxyapatite is the material used for this procedure since its beginning, due to its several benefits. However, despite the consensus among doctors of the dermal filler to be applied, the same does not happen to the chosen technique. This variation in methods is due to the divergence between anatomical studies in this region. Through this, we review the literature in order to establish the best method and confirming the correct plan through ultrasound to inject this material.