While we spend significant time and energy on facial rejuvenation — improving and preventing the sagging skin, fine lines, wrinkles, and folds that appear around our eyes, brows, nose, and mouth — we may be revealing our true age with every handshake. The backs of our hands receive more sun exposure than other parts of our body, which causes the skin to age more rapidly; this results in volume loss, reduced elasticity, thinning skin, increased exposure of our veins and tendons, and a thin, emaciated, or malnourished appearance. Hand rejuvenation with injectable fillers offers quick, minimally invasive, no-downtime improvement in volume loss, wrinkles, and the appearance of unsightly veins and tendons.

One of the most popular recent trends in aesthetic medicine is treating the signs of aging on all parts of the body (aside from the face), from the wrinkles on our chest to the crepey skin or lost volume on our hands to the sagging skin on our knees and thighs. Board-certified  dermatologist and skin care specialist Dr. Jason Emer achieves visible improvement in a single treatment by injecting dermal fillers into the dorsum (backside) of the hands, resulting in a plumper, smoother, and dramatically more youthful look. Once injected, the fillers occupy the space that is lost with aging, so there is an instant volumization, rejuvenation, and lifting in the area while maintaining a natural-looking appearance.

How does it work?

Using a blunt-tipped cannula to reduce pain and limit bruising, Dr. Emer injects dermal fillers like Radiesse and Restylane Lyft into the hollows around the tendons and larger veins to camouflage the area and soften crepey skin and wrinkles. The cannula glides easily beneath the skin and under the blood vessels as Dr. Emer strategically injects tiny aliquots (or “small matzo balls”) of filler in the area between the knuckles and the wrist. He then lightly massages the filler across the skin, ensuring an even distribution throughout the area. Using a “tenting” technique, in which he pinches the skin upwards, Dr. Emer can target specific low-volume areas safely and effectively. Warming up the hands immediately after treatment can also assist with distribution of the product.

Due to the large number of veins and tendons running through the hands, it is essential that hand rejuvenation procedures are performed by an experienced, skilled professional like Dr. Emer who understands the importance of placing the fillers superficially and steering clear of the veins, nerves, and tendon sheaths (the layers of connective tissue that protect the tendons) deep beneath the skin. Dr. Emer also avoids placing fillers in the fingers, where the skin is too thin for injection.

Injecting fillers with a needle is more commonplace than using a cannula, although needles can often cause more swelling and bruising post-treatment.

Radiesse for Hand Rejuvenation

Radiesse is a calcium-based filler that is FDA-approved to smooth facial wrinkles and folds and correct volume loss in the backs of the hands. Radiesse is comprised of calcium microspheres that minimize the visibility of tendons and veins and give an immediate lift and plumping effect. In addition to improving volume, Radiesse also stimulates long-term collagen production to aid in tissue tightening and the reduction of fine lines and wrinkles. Radiesse results last for approximately 12 to 15 months, so hand rejuvenation with a calcium-based filler is typically a once-yearly treatment.

Restylane Lyft for Hand Rejuvenation

The first and only hyaluronic acid (HA) filler FDA-approved to rejuvenate the backs of the hands, Restylane Lyft uses HA (a naturally occurring substance in your skin) to revolumize and add fullness to the treatment area. With a larger median particle size than other Restylane products, Lyft is specially engineered for lifting and contouring treatments. Restylane Lyft results typically last for up to 6 months, so hand rejuvenation with HA fillers is typically a twice-yearly treatment.

Alternative Methods for Hand Rejuvenation

While Radiesse and Restylane Lyft are the only FDA-approved fillers for hand rejuvenation in the United States, cosmetic dermatologists like Dr. Emer have long been using other HA fillers and fat injections to obtain improvement in this area.

How long do hand rejuvenation improvements last?

On average, hand rejuvenation with fillers lasts up to 6 to 12 months, depending on the filler used. Patients who diet and exercise regularly may experience greater volume loss and more rapid aging in the hands and therefore may require more frequent touch-ups and maintenance treatments.

How does Dr. Emer do it differently?

Similar to facial rejuvenation procedures, hand rejuvenation cannot be achieved through a single filler, device or treatment. Significant anti-aging improvement involves a customized combination approach that blends multiple methodologies and innovative techniques. A pioneer of patient-tailored combination procedures, Dr. Emer pairs hand rejuvenation with dermal fillers with:

• microdroplet injections of Belotero Balance, a soft tissue filler that integrates completely into the tissue to improve crepey skin and fine wrinkles that occur most often around the eyes and mouth as well as on the hands, neck, and chest.
• non-ablative (Fraxel or Halo) or ablative (Erbium or CO2) laser resurfacing to promote skin tightening, visibly improve wrinkles and mild skin laxity, and enhance skin texture and tone.
• powerful skin resurfacing treatments that help to remove deeper layers of sun damage, sun spots, and scars, shrink pores, and stimulate long-term collagen production.

• microneedling radiofrequency (RF) devices like InMode Fractora, Morpheus8, or EndyMed Intensif, which deliver RF energy subdermally to tighten and rejuvenate the skin, improve surface texture, and enhance collagen production.
• fractional or nanofractional RF devices like Venus Viva and Skinfinity for textural improvements and skin tightening.
• autologous fat transfer or Renuva Adipose Matrix synthetic fat grafting to create small-volume improvements and correct any irregularities, indentations, or scars in the skin.

• chemical peels such as RevePeel, Cosmelan, or Enlighten to maintain the tightening and brightening achieved through laser skin resurfacing, improve hyperpigmentation, and accelerate cellular turnover to remove dead and precancerous skin cells, soften texture, smooth the skin, and reduce pores and fine lines. The ReveSkin Enlighten Peel can be purchased for at-home use following an in-person or virtual consultation with Dr. Jason Emer or a member of his staff.
• mesotherapy, which delivers hydrating nutrients and serums through superficial micro-injections, plumping the skin and giving an overall more youthful appearance.
• platelet-rich plasma (PRP), which works in conjunction with lasers, RF devices, and microneedling to improve wrinkles and sun damage.
• Venus Versa IPL to address brow discoloration and sun damage.
• post-procedure healing treatments such as LightStim LED Light Therapy, which can increase blood circulation, accelerate healing, and help improve overall skin quality.
• a patient-tailored daily skin care protocol and sun protection to keep the treated skin exfoliated, hydrated, and bright.

Are there any risks involved with hand fillers?

As with any dermal filler treatment, there is a potential for pain, swelling, bruising, headaches, lumps or bumps, and/or impaired hand function. Meticulous technique by an experienced and skilled injector is the best means of reducing risks and complications. Additionally, hand rejuvenation treatments are not advised for patients with certain conditions that affect the hands, such as arthritis or Reynaud’s disease. For these reasons, it is important to schedule a formal evaluation with a board-certified dermatologist like Dr. Jason Emer to determine the best and safest method of treatment for you.

Is hand rejuvenation painful?

Most patients experience a pinching sensation or mild discomfort during the procedure; for others, the treatment can be moderately painful. To help alleviate pain, Dr. Emer combines the filler with lidocaine, an anesthetic that numbs the area once injected and has a temporary whitening effect on the skin. Adding lidocaine to the filler also gives the solution a thinner, more viscous consistency, allowing Dr. Emer to massage the product more easily across the back of the hands and ensuring proper distribution of the filler.

What is the downtime for hand rejuvenation?

There is minimal downtime with a hand rejuvenation procedure. Although you may experience redness, swelling, and/or tenderness in the area for up to 2 weeks, patients can return to their everyday activities immediately after treatment.

How do I schedule a consultation with Dr. Emer?

To schedule a consultation with Dr. Emer in Beverly Hills / Los Angeles / West Hollywood, California, please reach out to our concierge to schedule an appointment. Call 424-800-4140 or email us at appointments@jasonemermd.com.

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