Aside from being asked to treat wrinkles on the face and neck, you may
also be asked to address aging issues that occur on the hands using dermal
fillers. Before this can happen you need to examine your patient’s hands for
signs of both intrinsic and extrinsic aging.
Intrinsic and Extrinsic
Aging
There are two types of aging that affects the hands of older
person.

By contrast, intrinsic aging comes from within the softer deeper tissue
planes creating a condition of decreased skin elasticity, soft and atrophied
tissue. This can manifest as translucent, waxy looking thinner skin and more
prominent veins joints and tendons.[1]
There are a number of methods for restoring the appearance of aging
hands using injections that are taught in the Pinewood Institute for the
Advancement of Natural Medicine Dermal Fillers course.
Hyaluronic Acid for Aging
Hands
All aging is due to the depletion of endogenous hyaluronic acid that
plays and important role in the hydration of tissues and joints, maintaining
the biomechanical integrity of the body and preventing it from oxidative
stress. Intradermal injections of HA increases the dermal thickness and
elasticity of the skin.
Hand fillers treated with hyaluronic acid may need further treatments as
it is a temporary solution.
Calcium Hydroxylyapatite
Calcium hydroxylyapatitie is an inert filler with a lot of applications
in dentistry and bone repair. It has been used as a filler for hands. It is
sold by the commercial name of Radiesse.
The color and viscosity of CaHa makes it a good option for concealing
unsightly veins.
Other Dermal Filler Options
for the Hands
Bovine Collagen has been used as a dermal filler in cosmetic surgery fro
years even though it is not currently on the market. The results are a bit iffy with this
treatment but there have been reports of more success using porcine bovine
fillers. In both the case of bovine and porcine collagen injections, the
results only last a year.
Poly-L-Lactic acid (PLLA) has
been used for over thirty years in surgical implants. However treatment with
this acid requires multiple injections and is expensive. Granuloma and visible
bumps under the skin could also develop with injected Poly-L_Lactic acid.
Injection Techniques for
the Hands
Injection technique is taught in full as part of the Pinewood
Institute’s Dermal Fillers course. You will learn techniques for volume restoration
including:
Tenting – injections through pinched skin
Serial punctures – injecting small amounts of filler along a line
Microdrooplets- injecting tiny amounts of filler across a large number
of points
Tunnelling- injecting the dermal filler while withdrawing a needle at
the same time
Fanning- injecting dermal filler radially without withdrawing the needle
There are many other techniques to learn as well that apply to
individual cases.
Learning how to inject dermal fillers without damage to the hands is
another important issue.
For more information
about The Pinewood Institute for the Advancement of Natural Medicine courses including
course outlines, detailed descriptions of courses and information about
upcoming training sessions, please go www.pinewoodinstitute.com. You can
also send us an email using our email form at http://pinewoodinstitute.com/contact.aspx
or call us at 416-656-8100. If you prefer to fax the number is 416-656-8107.
[1] Ulrich Kuhne and Matthias Imhof, Treatment of
the Aging Hands With Dermal Fillers, Journal of Cutanaeous and Aesthetic
Surgery, Medknow Pubulfication, 2012 5(3): 163-189.