The problem is probably not the camouflage. In studies, most patients required a full syringe or more of Radiesse to improve their hands. The studies done for the FDA trials used Radiesse mixed with just a small amount of liquid anesthetic. In 'real life', it is standard to use far more liquid anesthetic to mix the radiesse for hand injection. In softer form the radiesse is more easily molded so you are less likely to get lumps or bumps which could be visible in that thin skinned area. So the result you see when you leave the office will go down as the liquid is absorbed. Another real life consideration is trying to reduce the amount of swelling and discomfort after hand injection. The hands spend most of our day hanging at our sides or busy in action - neither is good for swelling. So for my patients and when I teach other physicians how to use Radiesse for the hands, I recommend using only half a syringe in each hand at a treatment session with the expectation that the patient will return in 2 - 4 weeks for another syringe split between the hands. If a patient has very thin hands, several sessions may be necessary to provide adequate filling. Radiesse has its effect first by directly filling the empty area then as it dissolves by stimulating new collagen. That secondary effect will be strongest in someone with healthier, less sun damaged skin so that is another variable to consider.You can use other fillers like Voluma or your own fat to fill the hands. The downside is that clear gel hyaluronic acid fillers like voluma - which I love using in the face - may give the skin a blue-ish hue when visible under very thin skin like that of the tops of the hands. Radiesse is opaque white so the blue tone is avoided and it acts to camouflage vessels. Fat is another good choice but requires a second procedure to harvest from elsewhere on your body.My recommendation is that you return to your physician and discuss your concerns. At that time you can also review your pre-treatment photos. I find that patients often forget how volume depleted (empty) the area looked before the first treatment. So it may not be that your treatment isn't lasting, just that you haven't yet had enough to reach optimal.I hope this answer was helpful. Best wishes.
