Do Juvederm and Radiesse Have Good Results in the Hands?

No matter how nice the face and neck may look after nonsurgical rejuvenation techniques, untreated hands can be the biggest betrayor of a person's true age. Bulging veins and tendons on the backs of the hands scream aging as loudly as bags and tear troughs under the eyes or sagging marionette line angles at the sides of the mouth. 

Radiesse, composed of calcium hydroxyl apatite, is my first choice for treating this area. It is a natural material, which has been found to be very successful in giving long-lasting (between one to two years) results for treating the backs of aging, thinning hands. In general, when premixed with local anesthesia, the treatment is quick and simple. A bolus (a glob) of the material is injected into the back of each hand and then massaged forward into place until the tendons and blood vessels are sufficiently masked. One syringe is usually required for each hand. The results are immediate and typically quite gratifying. 

While Juvederm Ultra XC (composed of hyaluronic acid premixed with local anesthetic) may also be used for this purpose, the results typically do not last as long (eight to twelve months) as with Radiesse. In general this material may be reserved for "first-timers" (i.e. those that have never experienced hand rejuvenation) who might want a material that provides the safety of knowing that hyaluronidase (an enzyme that can quickly dissolve away hyaluronic acid) may be used if for some reason they wish tor reverse the effects. When injected for this purpose, Juvederm is typically layered between the tendons and then massaged in place, rather than injected as a glob. The esthetic results are also quite satisfying. 

To restore volume to "old-looking" hands, I prefer Radiesse or autologous fat (fat taken from one part of your body and injected into the backs of your hands). Both give excellent results. You have less down time with Radiesse than you would with autologous fat, but, even with the fat transfer procedure, post-operative pain/swelling/bruising is really minimal. I never use a hyaluronic acid filler (like Juvederm or Restylane) to restore volume to the hands. Using it in combination with Radiesse (in the backs of the hands) does not prolong the effects of the Radiesse. There is nothing harmful about using Juvederm to restore volume to the backs of the hands, it's just that you'd need quite a few syringes of the product (Juvederm or Restylane) to achieve comparable results as you'd get with one to one-and-a-half syringes of Radiesse (1.5cc in each syringe), and the effects would not last as long as they would with the Radiesse.

To treat aging hands, I like to use a combination of volume restoration with IPL (intense pulsed light) or the Q-switched alexandrite/ruby/nd:yag laser to remove the sun spots. In addition, another laser, the fractionated carbon dioxide laser (Fraxel Re:pair or Lumenis Active/Deep FX) can be used on the backs of the hands to promote skin thickening (collagen regeneration and remodeling) and even out pigment irregularities. Finally, if the veins on the backs of your hands appear prominent and still bother you despite the restoration of volume to the area, they can be treated with sclerotherapy (injections into the veins which cause your body to ultimately break them down and subsequently resorb them).

For each of these procedures, I'd recommend that you see a physician who has experience specifically in treating the hands (ie. cosmetic dermatologists/plastic surgeons), and with whom you feel comfortable. Asking your doctor for examples of "before" and "after" pictures from patients that she/he has treated is always a good idea.