A Double-Blind, Comparative Study of Nonanimal-Stabilized Hyaluronic Acid versus Human Collagen for Tissue Augmentation of the Dorsal Hands

Man, Jeremy; Rao, Jaggi; Goldman, Mitchel P.

doi:10.1111/j.1524-4725.2008.34201.x

Cited by 31 publications

(26 citation statements)

References 15 publications

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“…Because the hand lacks efficient deep venous drainage, the remaining veins will likely engorge over time. Fat injections to augment low-volume areas and soften the outline of deeper structures seem to be very promising [6,9,10,16,17]; however, since this is invasive therapy, it has led to some teams testing other fillers such as collagen or hyaluronic acid [15]. Hyaluronic acid is a glycosaminoglycan found in epithelial and connective tissue.…”

Section: Discussionmentioning

confidence: 99%

“…In this context it is important to emphasize that the results at 6 months are not as good as those at 2 weeks after the procedure, and a longer follow-up is needed to determine if this procedure provides long-lasting benefit. Moreover, this study focused on the restoration of volume and largely omits the changes in skin physiology [15]. We preferred to focus our efforts on the subjective evaluation of the injection that has been largely neglected in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Its typical effects can last up to 9 months depending on the treated area. Despite the numerous studies evaluating this therapy on the face [1][2][3][4][5], there is still a paucity of studies [14,15] describing its potential on hand rejuvenation. This prospective study was initiated to evaluate the effect of subcutaneous HA injections in aging hands, with special attention paid to complications, patient satisfaction, and outcomes, i.e., clearance of rhytids, veins, bony prominences, and dermal and subcutaneous atrophy.…”

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confidence: 99%

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Nonanimal Stabilized Hyaluronic Acid for Tissue Augmentation of the Dorsal Hands: A Prospective Study on 38 Patients

et al. 2012

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Background Often ignored, hands are one of the most telltale signs of aging. This prospective study was initiated to evaluate the effect of subcutaneous hyaluronic acid (HA) injections in aging hands, with special attention to complications and long-term outcomes. Methods Between January 2010 and December 2010, a total of 38 patients with skin phototypes II-IV and between 58 and 76 years old were treated with HA injection for aging hands. The quantity of injection never exceeded 1.0-1.5 ml HA per hand. A clinical follow-up was performed at 2 weeks, 4 weeks, 3 months, and 6 months after injection. Complications were reviewed for the whole series. At the first follow-up, 2 weeks after the procedure, ultrasound was carried out to determine if additional filling material was required. At each follow-up, patients were asked to fill out a satisfaction questionnaire. Results Nine patients developed slight ecchymosis that disappeared after 1 week. No other complications were seen in the series. Pain during the injection and discomfort after the procedure were minimal. At the 2-week follow-up, after ultrasound control, nine patients received a complementary injection. At each follow-up, overall patient satisfaction was high and was validated by clearance of rhytids, veins, bony prominences, and dermal and subcutaneous atrophy. Conclusion Skin revitalization with injectable HA can improve the clinical appearance of the back of the hands. However, this therapy requires knowledge of the possible complications and their remediation as well as knowledge and respect of injected doses. Moreover, despite excellent results at each follow-up, the results of our series are not as good after 6 months, and a longer follow-up would be needed to determine if this procedure provides long-lasting benefit.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Nonanimal Stabilized Hyaluronic Acid for Tissue Augmentation of the Dorsal Hands: A Prospective Study on 38 Patients

et al. 2012

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“…Patient tolerance for scars and complications is extremely poor in those who seek hand rejuvenation as a purely-aesthetic treatment; function must also be strictly maintained. [15][16][17] These concerns explain practitioners' persistent resistance to surgical approaches for treating the hand and patients' and surgeons' preference for minimally-invasive techniques, [3][4][5][6][7][8][9][10][11][12][13][14] even if these nonsurgical approaches fail to address skin excess. However, as mentioned in several studies, 3,15,16 overall patient satisfaction cannot be sufficiently achieved by treating only extrinsic or intrinsic aging changes.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 For this reason, minimally-invasive techniques addressing skin texture, age marks, prominent veins, and tissue loss dominate the current cosmetic market. [3][4][5][6][7][8][9][10][11][12][13][14] However, none of these techniques offer fully-satisfying results, since they do not treat excess skin on the aged hand.…”

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confidence: 99%

Minimal-Scar Handlift: A New Surgical Approach

Handle

Bonfatti-Ribeiro

Barcaro-Machado

et al. 2011

Aesthetic Surgery Journal

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Background: Removal of excess skin from the aging hand can cause scarring in one of the body's most visible areas, which is highly undesirable for patients. A minimal-scar approach to tightening this skin, in conjunction with the rejuvenating effects of minimally-invasive procedures, is therefore needed. Objectives: The authors describe a new technique for limiting scar size and visibility by locating the incision in a unique position on the ulnar side of the dorsum of the hand. Methods: Eleven patients were treated with the authors' method between March and September 2009. Both hands were treated for each patient, but these procedures occurred separately, at an interval of two to four months. The surgical approach included skin flap advancement and rotation, and the procedure took place under local anesthesia and sedation. The resultant scar was S-shaped. Changes in postoperative stress ratio were visualized. Results: Patients reported being highly satisfied with this procedure with regard to scar size, quality, and location. No major complications were observed, such as infection, flap necrosis, and nerve damage. All minor complications were treated conservatively. Patients with Fitzpatrick skin types I-III profited from less scar visibility in their outcomes. All patients experienced quick recovery with minimal downtime, independent of skin type. Conclusions: The minimal-scar handlift technique is an effective surgical approach to rejuvenating the hand and can be implemented concurrently with minimally-invasive techniques for volume restoration. The complication rate is low, and patient/surgeon satisfaction with outcomes is high.

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Temporary Fillers

Narins¹,

Med²,

França³

et al. 2012

Dermatologic Surgery

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A Double-Blind, Comparative Study of Nonanimal-Stabilized Hyaluronic Acid versus Human Collagen for Tissue Augmentation of the Dorsal Hands

Abstract: Aging of the hands is a common problem that is often overlooked. The use of soft tissue fillers is a viable tool in hand rejuvenation. In this study hyaluronic acid proved to be superior in efficacy to collagen.

Cited by 31 publications

References 15 publications

Nonanimal Stabilized Hyaluronic Acid for Tissue Augmentation of the Dorsal Hands: A Prospective Study on 38 Patients

Nonanimal Stabilized Hyaluronic Acid for Tissue Augmentation of the Dorsal Hands: A Prospective Study on 38 Patients

Minimal-Scar Handlift: A New Surgical Approach

Temporary Fillers

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