At A Glance; Hand Rejuvenation with fillers
- Best Results1-2 sessions
- Treatment RecoveryImmediate
- Procedure Time10 minutes
- Skin SpecialistDermatologist, Dr Davin Lim
- Duration of Results18 months +
- Back to WorkImmediately
- Cost$- $$
With age our hands will develop brown spots, wrinkles, prominent veins & volume loss. Dermal fillers & fat transfer can effectively turn back time, adding much needed volume to the hands. I use both hyaluronic acid & collagen stimulating dermal fillers in this area. Treatments are painless & take less than 5 minutes to perform. Best of all results are instant, with zero downtime.
FactsFacts on Hand Rejuvenation
- Volume loss & laxity increases with time. The hands are not exempted from this process
- Hands are often exposed to sun resulting in collagen loss
- Rejuvenation involves thickening the dermis with collagen stimulating fillers
- Age spots, pigmentation & laxity can be addressed with various lasers
- Fat transfer can be considered in cases of marked atrophy
- Most patients require only one filling session
Why the hands?
Hand rejuvenation combines treatments designed to turn back the clock on the backs of the hands. The thinner skin in this area can experience changes faster than other areas, resulting in protruding veins & tendons, brown spots, sunspots & wrinkles.
Sun exposure coupled with age degrades fat & collagen, resulting in volume depleted hands.
How are dermal fillers used for rejuvenating the hands?
As we age, we deplete dermal collagen & adipose tissue (fat). This decreases the support for the overlying skin. What this means is that skin becomes thin, easily bruised, with accentuation of veins & tendons. Volume loss coupled with ‘spots & dots’ from pigmentation results in the signs of accelerated ageing.
Dermal fillers replace loss collagen & fat. An increase in collagen results in a thicker dermal layer. This volume replacement masks the signs of ageing. I employ a range of dermal fillers ranging from hyaluronic acid fillers to longer lasting collagen stimulating fillers such as poly-L-lactic acid and calcium hydroxyl apatite. These filler lasts longer than the traditional hyaluronic acid fillers & provides more collagen over time.
How do I perform dermal fillers for hand rejuvenation?
I use a cannula to deliver fillers with one entry point. The filler solution is premixed with local numbing agents to ensure this procedure is painless. I prefer collagen stimulation for the hands over the traditional HA fillers because of the longevity & volume I can deliver with the former.
As a guide I use between 3 to 4.5 ml of filler per hand. In the context of volume, this is less than a teaspoon. Over the next 3 months, the actual volume increases as these fillers stimulate your own cells to produce collagen.
|Costs vs Volume
|Up to 1-5-2 years+
|Finesse & contours. Immediate one to one correction of volume.
Ca OH Apatite
Poly L Lactic acid
|Volume & bulk increase of collagen. Collagen maximal at 3-4 months after
How can fat transfer help rejuvenate hands?
For those who elect not to employ the use of dermal fillers, fat transfer is another option. This procedure involves taking fat from areas such as the flanks, abdomen or thigh area via a liposuction cannula. This fat is then processed through sedimentation & filtration, then re-injected in key areas such as the hands, cheeks, temples & tear troughs.
The advantage of fat transfer is that we are using a natural substance. Large volumes can be used, with a relative cost saving to the patient. Fat also contains millions of stem cells known as ASC or adipose stem cells. These cells can produce new skin, stimulate & produce collagen as well as new fat. Hence skin quality & volumes can be addressed with this procedure. In reality the actual epidermal remodelling from stem cells is marginal at best. Simple low downtime lasers will give a far superior & much more predictable result.
The disadvantage of fat transfer is that 50% or more of the volume injected will be resorbed within the first few months of injection. In some cases, the volume is more, in others it is less. Hence fat grafting is less predictable than dermal fillers. The pros & cons will be discussed during the time of consultation.
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How can lasers help with hand rejuvenation?
Lasers can help improve skin texture or skin quality, namely addressing pigmentation, spots, & sun damage. The aim of the laser is to blend, without the signs of sharp demarcation lines.
Lasers are best for flat brown spots. Raised spots may require surgical techniques including shaves & curettes. The laser device most often used is a fractional laser such as Fraxel. I also employ ablative erbium or CO2 fractional lasers in some cases. Most patients require 2-4 sessions for best results. Treatments are spaced 3-6 weeks apart.
Can IPL or BBL be used on the hands?
Yes. The biggest downside of IPL is that demarcation lines are universally seen after this treatment. This gridding is due to the rectangular shape of the IPL applicator. No big issue as subsequent treatments can blend this in.
A better treatment is to combine IPL-BBL with a fractional laser. This is termed Pulse-Fraxel or hybrid laser resurfacing. By combining two treatments we address both deep & superficial pigment as well as delivering a blend to the area. This reduces demarcation lines.
Can lasers and dermal filling be conducted in the same session?
Yes. As a guide I fill first, then laser. The filler takes approximately 5 minutes to complete, laser resurfacing takes an additional 10 to 15 minutes.
Downtime following filler is zero, however with laser resurfacing it often takes a week or longer to heal.
How much is the procedure?
Hand fillers start from $1290 (both hands). With severe volume loss, you may need more filler volume.
Lasers start from $790 for both hands. Discounts apply for combination treatments.
What is the best hand cream for ageing hands?
Protect– keep things simple, firstly prevent ageing with the regular use of sunscreen. Choose an SPF 50+ that you like to apply. My suggestion is the La Roche Posay line of sunscreens as they are cosmetically elegant. Other good sunscreens include Invisible Zinc or Cancer Council SPF.
Hydrate. Simple vitamin E creams can reduce wrinkles & add subtlety. For more hydration, a barrier repair cream such as Neutrogena Norwegian Formula can be used at night.
Repair– Discuss options with your treating dermatologists. Bespoke formulations containing Beta Hydroxy Acids, as well as Alpha Hydroxy Acids can repair & reverse early sun damage.
Most formulations contain 5-8 %salicylic acid or 5-12% lactic acid in a proprietary base, often with 5-8 %olive oil.
Davin’s Take on Hand Rejuvenation
Hands can tell a story of sun damage and age. Over time skin thins out, tendons & veins become more apparent in addition to easy bruising due to loss of collagen around the blood vessels & skin.
In most cases I combine lasers, IPL, photodynamic therapy as well as dermal fillers in the one session. Energy devices such as lasers treat skin texture & improves the quality of skin. Superficial pigmentation responds well to these modalities. Dermal fillers, as the name suggests, thickens the dermis, hiding veins & tendons. My go to filler is one called calcium hydroxyl apatite as this filler can be formulated according to the level of atrophy (loss of tissue). For severe cases of ageing a stronger formulation is required, whilst for mild to moderate cases I have the option of hyper dilution.
Another sensible option is fat transfer. This is especially so if larger volumes are used. Longevity of fat (once past the initial 3 to 6 months), is often longer than fillers.
Prevention is important post procedure. Sunscreens & repair formulations can prevent & treat future sun damage. People often overlook the importance of hand creams & skincare.
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