As a plastic surgeon, I'm often asked to guess someone's age.  My strategy is to look at the back of the hands.  While the face is generally well maintained, the back of the hands almost never is.  The wrinkled skin, prominent veins, and dark spots  invariably reveal a person's true age.

For hands, aging is evident in the following ways:

• Fat atrophies and collagen production slows
• The skin thins revealing underlying tendons and veins
• The thin skin wrinkles and dark age spots form

A Grading Scale (pictured above) categorizes hand aging as follows:

0. No loss of fatty tissue

1. Mild loss of fatty tissue; slight visibility of veins

2. Moderate loss of fatty tissue; mild visibility of veins

3. Severe loss of fatty tissue; moderate visibility of veins

4. Very severe loss of fatty tissue; marked visibility of veins bands

Replacing lost volume in the hands helps to replace loss of fatty tissue; rejuvenating the hand by pluming out the skin to hide unsightly veins and smooth wrinkles.

Restylane, a hyaluronic acid filler, just received FDA approval for use on hands.  Restylane is the first hyaluronic acid filler to receive FDA approval for use outside the face.

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Following a study of 89 patients, Restylane Lyft received FDA approval to treat age-related volume loss in the back of the hands.   Hyaluronic acid fillers are the mainstay of facial fillers due to their natural consistency.  Fillers are placed just below the skin and above underlying tendons using a microcannula technique to limit pain, bruising, and swelling.   

In the study for FDA approval, patients showed volume improvement in the hands for up to six months. Side effects (swelling, tenderness, itching) were predominantly mild and temporary.

*All patients are unique and results may vary

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