Cosmetic Question:
The backs of my hands look old with bulging veins. Can fillers be used to make my hands look younger? What is the best filler to use? What is the best way to have it done and does it work?
Cosmetic Answer:
Yes, fillers can be used to hide the visible veins and tendons that appear in time on the backs of our hands. These veins and tendons and sometimes even bone becomes visible as fat is absorbed from the hands. Hand fillers are injected in the office. The filler, Radiesse is usually used. Radiesse is calcium hydroxylapatite and is FDA approved for use in the hand. It cannot be dissolved like the fillers made from hyaluronic acid.
Hyaluronic acid fillers (Juvederm, Restylane) can be used but light reflects differently from these fillers. This means they may be visible under the skin. So, Radiesse is preferable.
How is the injection done?
The Radiesse is pre-mixed with local anesthetic. Under sterile conditions, an injection numbs the skin and then a long cannula (blunt needle) is placed just under the skin between two knuckles. The skin is tented up and tiny amounts of Radiesse are placed directly under the skin along the edges of veins and tendons. The Radiesse is massaged into position with each droplet placed. Some doctors use sharp needles and go deeper, but recent anatomical studies show that directly under the skin is probably the ideal place.
How much is needed?
Between 2 – 4 syringes of 1.5 cc of Radiesse or between $1250 – $2500 worth of filler. How much you need depends on how visible your veins and tendons are and the more they stand out, the more filler is needed. Many people like to start with 2 syringes, one for each hand and if you like the result, you can always have more.
How long does Radiesse last?
It’s visible effects last about 9 months but there is almost always some remaining Radiesse which is usually made of filler and collagen. As time goes by and you have your hands re-done each year, you may find that you need Radiesse less often to maintain your result.
What are the risks of Radiesse hand injections?
These injections will often cause swelling, redness, tenderness and bruising of the back of the hand. This is usually gone in 3 weeks or sometimes less. In contrast, fat injections to the back of the hands can cause swelling that lasts for many months.
What are the post injection instructions?
You will want to avoid exercise that uses your hands such as horseback riding, hand ball or tennis for 7 to 14 days. The bruising can lead to comments so plan to have Radiesse at least 3 weeks before extremely important social occasions, such as a wedding or a Gala Charity ball unless you are planning to wear gloves.
Radiesse vs. Fat
Although fat can be used instead of Radiesse, it costs more, it causes much more swelling that lasts much longer, it tends to look lumpy and the result depends on whether your tissues can keep the fat alive. It does not make fat a bad choice but Radiesse is a better one.