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Introduction
CHAPTER 80 Approaches to Hand
Rejuvenation
Isabela T. Jones Ross C. Radusky Sabrina G. Fabi
SUMMARY
As many patients seek facial cosmetic procedures, a discrepancy forms between
the rejuvenated look of their face and the aged appearance of their hands.
Hand rejuvenation addresses both surface changes and volume loss, and
combination multimodality approaches may be best.
Beginner Tips
A thorough understanding of hand anatomy is a prerequisite for procedural
intervention.
IPL and lasers are highly effective at improving surface changes on the hands.
When using CaHA fillers, the scrape skin threading technique may help to avoid overly
deep product placement.
Expert Tips
If nodule formation occurs after filler injections: antibiotics -> hyaluronidase/ILK ->
excision.
Overcorrect when performing autologous fat transfer.
Consider sclerotherapy if volumization does not solve vein prominence.
Donโt Forget!
Sclerotherapy and autologous fat transfer should be performed separately.
Vein treatments should be performed at least 1 month prior to other procedures.
Pitfalls and Cautions
When performing chemical peels on the hand, it is important to remember that
treatments should be limited to superficial and medium depth peels because of the risk of impaired wound healing.
Since the dorsal hand skin is thinner, has decreased vascularity, and fewer
pilosebaceous units than the face, the fluence, density, and number of passes should generally be reduced to minimize recovery time.
Patient Education Points
Patients should understand that they will likely require multiple treatments.
Remember the 5โ5โ5 rule after filler injection: massage for 5 minutes at a time, 5
times per day, for a total of 5 days.
As always, appropriate patient selection and assuring adequate motivation are of vital
importance.
CHAPTER 80 Approaches to Hand