Can I have fillers in my hands after fat transfer 18 months ago?

We are starting to add the first batch of patients on our surgery schedule for revisions from hand injections from Radiesse. Their complaints are of lumpiness that does not go away.
Microdroplet fat injection is an option, with the usual pluses and minus of fat injection.
IPL treatments of the brown spots and PhotoFacials of the hands, along with microdermabrasion and light TCA peels are all options as well.

Thank you for your question. Radiesse and Restylane Lyfe are FDA-approved injectable fillers for hands. They help improve contour and replace volume loss in the hands. I had the pleasure of being among a group of select physicians to take part in the Radiesse clinical drug trial that eventually led to it’s FDA-approval and have seen incredible results when using the product for hand rejuvenation. The procedure takes about 10 minutes and lasts for about 1 year.

Thank you for your question.  We are often asked this question.  In Las Vegas, we get many card dealers who take pride in the appearance of their hands, as that is what the public sees.  Often the aging had will have more visible vessels and tendons.  The hands may also have solar damage, or just aging changes to the skin.  We often will inject patients with Radiesse to add volume to the hands and decrease the harsh appearance of the vessels and tendons.  Radiesse is FDA approved for this.  We often will follow this up with appropriate peels to help smooth the coloration and give the skin a more vibrant look.  Best to see a Board Certified Plastic Surgeon.  They have had multiple years of hand surgery training, and know the hand anatomy and function well.   Some, (like our office), have had additional hand fellowship training.   They are also well versed in how to best treat the skin, as they diagnose and operate on it.               

I've had great results using Radiesse to fill the hands.  I find warming the product prior to injections helps in avoiding lumpiness.  Results can last between 6-14 months.  Caution is needed in clients who have jobs involving fine motor skills (seamstress, tattoo artists, surgeon's, etc).  It's fine for them to be treated, they just need to know that swelling following treatment can effect them.

I think Radiesse is one option to consider. It is readily available, can be performed in the office, and unlike fat, does not need to be overcorrected in order to see a durable result. It usually lasts at least a year, and in many cases longer.
It's important to find someone in your area that is comfortable performing this procedure, as it is relatively new. In addition, it can also be combined with a chemical peel to really rejuvenate the appearance of the hands quite nicely.
Best of luck!
Dr. Salemy

Hands can be treated with a dermal filler and we recommend Ellanse
which stimulates the body to create collagen after the initial gel has been
absorbed by the body.  In this way the
effects of the treatment are both extremely natural looking but can last up to
2 years.  At River Aesthetics we have
treated many hands in this way – including those of TV celebrity Anthea Turner.

If you wish to avoid a more invasive procedure, Radiesse can be a great product for hand rejuvenation.  The procedure is quick and painless using a cannula.  Given reports of prolonged swelling, I recommend being conservative and splitting one syringe with the caveat that you can always add more.  If overlying skin texture and pigment is a problem, simultaneous IPL can be done to improve skin quality.

Not all fat grafting is created equal. Structural fat grafting involves small amounts (less than 0.1 cc at a time) of fat being carefully microinjected in a series of discrete layers to gradually 'build' new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist. If this process of blood vessel ingrowth (neovascularization) does not occur, then the injected tissue cannot truly be considered a 'graft' and is instead just another 'soft tissue filler' of limited duration.
Fat Grafting requires specialized training and specialized surgical instruments, as well as patience and attention to detail on the part of the surgeon. When performed properly, permanent improvements. Fat grafting, in my opinion and experience is the only filler ideal for hands. Fat grafting in the hands can provide beautiful, long lasting natural looking results.

Some surgeons are using fat injections to augment the dorsum of the hand to improve the aged appearance. Some doctors use radiesse and juvederm, but lumpiness can happen.

Radiesse can be injected  and gives a good result and will last more than a year. Fat grafting is a better option but it is very surgeon and technique dependent.