Hi and thank you for your question! Although it is quite tempting to get a "permanent" filler, I am not a big fan of that. Remember that our body is not always in the same state and shape either - there is nothing permanent in our body! So when you inject a permanent filler, it might look good today, but we can't tell how it will look 2, 5 or 10 years later. Unfortunately when it comes to anti-aging and rejuvenation treatments, there is no magic bullet or one-time treatment that fixes everything in one shot. Just as aging is an ongoing process, anti-aging treatments also require continuous commitment to be most effective. For hand rejuvenation, in case you are interested in a longer-lasting filler, I highly recommend Radiesse. It is not permanent, but it will last a good few years. I hope it helps and good luck!