A Prospective, Multicenter, Randomized, Evaluator-Blinded, Split-Hand Study to Evaluate the Effectiveness and Safety of Large-Gel-Particle Hyaluronic Acid with Lidocaine for the Correction of Volume Deficits in the Dorsal Hand

Abstract

Background:Hand rejuvenation has become increasingly popular, but there are few reports published on the use of hyaluronic acid gels for correction of volume deficits in the dorsal hand.Methods:This study evaluated the efficacy and safety of large-gel-particle hyaluronic acid with lidocaine, a 20-mg/ml hyaluronic acid gel with 0.3% lidocaine, compared to no treatment for the correction of volume deficits in the dorsal hand. This was a prospective, multicenter, split-hand study in 90 subjects who received treatment with product in one hand. The primary efficacy endpoint was based on a 1 point of improvement with treatment versus no treatment according to the Merz Hand Grading Scale at week 12. Other assessments included Central Independent Photographic Reviewers evaluations of hand photographs, Global Aesthetic Improvement Scale, subject satisfaction, and safety.Results:The mean injection volume was 2.1 ml at the first treatment. Subjects demonstrated significantly higher response rates with treatment compared to no treatment at week 12 (85.9 percent versus 21.2 percent) and at weeks 16, 20, and 24 (p < 0.0001). Photographic Reviewers assessments showed consistently greater improvements in the treated hands compared with the untreated hands from week 12 to week 24. Most subjects and investigators (≥92.8 percent) reported improvements in Global Aesthetic Improvement Scale score across all time points with treatment. Treatment-related adverse events were reported in seven subjects (7.9 percent). Most of these were mild, and none were serious.Conclusion:Hyaluronic acid with lidocaine is safe, effective, and well tolerated for the correction of volume deficits in the dorsal hand.CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, II.

Autologous fat transfer for hand rejuvenation: A systematic review on technique and outcome

“…Effects are temporary; thus, frequent touch ups are not unusual. Lastly, in these articles, satisfaction rates are high, and only mild complications are seen, which is similar to AFT 35 , 36 , 37 , 38 . Nevertheless, foreign-body granulomas is a known and severe complication of dermal fillers and is also described after hand rejuvenation.…”

“…Another option to treat age-related volume loss to the dorsal aspect of the hand is the use of dermal fillers. Although high-quality clinical studies on AFT and hand rejuvenation are rare, several randomized clinical trials assessing the effectiveness of calcium hydroxylapatite (CaHA) and hyaluronic acid (HA) in hand rejuvenation have been published 35 , 36 , 37 , 38 . Several major differences are noted compared with AFT.…”

Long-term Outcomes of Temporal Hollowing Augmentation by Targeted Volume Restoration of Fat Compartments in Chinese Adults

“…15 However, as a subunit of the total face, there is no consensus on fat-grafting techniques for the temple area, including the entry site for the cannula and the plane for fat placement. The literature on temporal hollowing augmentation using fat grafting or other fillers, such as hyaluronic acid, suggests placing the filler into the subcutaneous space, 18 deep to the superficial temporal fascia, 17 or even within the temporalis 19 through multiple entry sites, such as the lateral orbital rim or the tail of the brow. 17,20 These suggested techniques are based on personal experiences and a lack of solid anatomical and clinical data support.…”

“…The literature on temporal hollowing augmentation using fat grafting or other fillers, such as hyaluronic acid, suggests placing the filler into the subcutaneous space, 18 deep to the superficial temporal fascia, 17 or even within the temporalis 19 through multiple entry sites, such as the lateral orbital rim or the tail of the brow. 17,20 These suggested techniques are based on personal experiences and a lack of solid anatomical and clinical data support. In the present study, we focused on how to restore the physiologic volume in the temporal region with a high survival rate of the fat grafts, minimal tissue injury, and a low complication hollowing rate.…”

“…The survival rate of the fat tissue was defined as Augmentation Volume/(Grafted Fat Volume ×100), and the augmentation rate was defined as Augmentation Volume/ (Required Fat Volume ×100). The subjective assessments included the Hollowness Severity Rating Scale (HSRS) 17 assessment and the patient satisfaction rate. Three independent observers reviewed the preoperative and postoperative images.…”