If your hands are showing their age in ways that cannot be camouflaged by creams or paraffin treatments, you may want to know about an area of cosmetic dermatology called hand rejuvenation.
Nelson Lee Novick, MD, a cosmetic dermatologist and author of You Can Look Younger at Any Age, said that hand rejuvenation is based on the realization that loss of volume in subcutaneous fat (the layer of fat below the skin’s surface), rather than the effect of gravity, is what causes skin to sag and underlying structures to appear more prominent. This understanding led to the development of injectible fillers for the face—and now these fillers are being used on the backs of the hands, too. Restoring volume brings a more youthful appearance to hands by plumping up that saggy, wrinkled skin.
According to Dr. Novick, the best injectible fillers for hands are Restylane Lyft and Radiesse—sterile materials that contain a synthetic form of hyaluronic acid or calcium hydroxylapatite, substances that occur naturally in our bodies. “These materials impart a very smooth, pillowy texture and natural appearance,” he said. Permanent, nonnatural fillers such as silicone are not appropriate for use in hands, Dr. Novick cautioned.
The procedure: After injecting a local anesthetic, the doctor uses a very fine needle to inject the filling agent, which has a texture similar to Play-Doh or Silly Putty, into the troughs between the bones on the back of the hand. Then the doctor quickly manipulates the filler—literally moving the stuff around manually and molding it to achieve the desired effect—before it firms up and takes on the feel of normal tissue. The in-office procedure takes about 20 minutes. Effects are noticeable immediately and generally last about six months, after which the injections can be repeated if desired. Cost: About $1,000 to $2,000 for both hands, depending on the doctor, region of the country and number of injections given. Since this is a cosmetic procedure, insurance does not cover it.
Possible side effects: Some patients experience bruising, swelling or itching at the injection sites for a few days. As with any injection, there is a small risk for infection, allergic reaction and/or scarring. Rarely, patients may develop skin discoloration or unwanted lumps that can persist for several months (lumps resulting from hyaluronic acid fillers can be dissolved with hyaluronidase enzyme injections, Dr. Novick said).
If you are wondering whether the filler material could shift around or melt beneath the skin—for instance, if you squeezed your hands really hard or immersed them in very hot water—Dr. Novick said that these problems would not occur because, once the material is molded, it “sets” in place and does not migrate. He also said that there is no danger as the body gradually absorbs the fillers because these natural materials are subject to the same enzymatic processes that break down the body’s native hyaluronic acid or calcium hydroxylapatite.
If you are considering the procedure, you can find cosmetic dermatologists through the American Academy of Dermatology or American Academy of Cosmetic Surgery…then be sure to ask the practitioners about their level of experience with hand rejuvenation.
