In my patients, I have seen dramatic results that truly take years off of

Expert Opinions
“In my patients, I have seen
dramatic results that truly take
years off of the hand.
”
Kimberly Butterwick, M.D.
Dermal fillers are known for their use
in erasing facial lines and creases.
However, recent consumer demand for
hand rejuvenation treatments has physicians introducing fillers as an easy, noninvasive way to reverse the signs of
aging seen in hands.
Radiesse from BioForm (San Mateo,
Calif.) provides “an immediate effect
and is a robust volumizer,” said
Kimberly Butterwick, M.D., a dermatologist in private practice in La Jolla, Calif.
“One syringe can fill one hand very easily and sometimes both hands.”
Although most patients require one session, a second injection might be scheduled one to two months later. The effect
should last about one year. Dr.
Butterwick advocates even distribution
of Radiesse and massaging the product
down to avoid bumps.
Dr. Butterwick has also had success
injecting patients with autologous fat. But
she dissuades practitioners from using
ArteFill from Artes Medical (San Diego,
Calif.) because hand skin is so thin. “If
there’s any sort of lump or bump, ArteFill
would really show,” she said. However,
any of the hyaluronic acids, such as
Restylane from Medicis Aesthetics
(Scottsdale, Ariz.) or Juvéderm from
Allergan (Irvine, Calif.), might be appropriate, “if you are only looking for a mild
improvement. But hyaluronic acid can be
quite expensive because you use more
product than on the face.”
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THE Aesthetic Guide Primary Care Edition Autumn 2008 www.miinews.com
THE Aesthetic Guide Primary Care Edition Autumn 2008 www.miinews.com
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Expert Opinions
Sculptra from Sanofi-Aventis (Bridgewater,
N.J.), “flows very well and gives you good
volumization,” noted Neil Sadick, M.D., a
clinical professor of dermatology at Weill
Medical College of Cornell University in
New York, N.Y. “We see generation of
new collagen and thickening of the skin.”
Dr. Sadick’s treatment protocol is three sessions, spaced four to six weeks apart.
“Inject deep, massage well and dilute
well,” he advised. “The duration of effect
is two to three years.”
Juvéderm Ultra “is extremely easy to
inject and the product is very smooth,”
said Gregory Buford, M.D., a plastic
surgeon in private practice in Denver,
Colo., who generally uses just topical
anesthesia for the single-session procedure, which consists of two or three
syringes per hand. “The entire procedure takes 15 to 30 minutes. Patients
have very little downtime, if any.
Juvéderm Ultra is also extremely soft
and supple. It doesn’t tend to become
very firm, so you achieve a very natural
result. In my patients, I have seen dramatic results that truly take years off of
the hand. And the effect should last at
least one year.”
EVOLENCE Breeze from ColBar (Zug,
Switzerland), “is a collagen product that
provides very good form on the back of
the hand and the fingers,” said
Christopher Inglefield, M.D., a plastic
surgeon in private practice in London,
U.K. Most patients require two or three
treatments, spaced approximately four
weeks apart. A session lasts 30 to 45
minutes for both hands. “The effects last
between 12 and 18 months.” In addition, “there is very little swelling or bruising following a treatment, so there is
hardly any downtime.”
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THE Aesthetic Guide Primary Care Edition Autumn 2008 www.miinews.com