Beyond the face, the hands often clearly display signs of aging due to volume loss, which can lead to prominent veins, visible tendons, and thin, crepey skin. Effectively treating this area enhances overall aesthetic harmony and patient satisfaction. Restylane® Lyft™ (by Galderma) stands out as a key tool for this indication, being the first hyaluronic acid (HA) dermal filler FDA-approved specifically for correcting age-related volume loss on the dorsum (back) of the hands.

Understanding Volume Loss in the Hands

Similar to the face, the dorsal hands lose volume over time due to:

• Subcutaneous Fat Atrophy: The natural fat padding diminishes, making underlying structures more visible.
• Collagen and Elastin Degradation: Leads to thinner, less elastic skin that doesn’t conceal vessels and tendons as effectively.
• Sun Damage: Can exacerbate skin thinning and textural changes.

The result is a bony, “skeletonized” appearance with prominent extensor tendons and dorsal veins.

Why Restylane® Lyft™ for Hand Rejuvenation?

Restylane® Lyft™ (formerly Perlane-L®) possesses specific characteristics derived from its NASHA® (Non-Animal Stabilized Hyaluronic Acid) technology that make it well-suited and FDA-approved for this indication:

• High G’ (Elastic Modulus) & Firmness: NASHA® technology creates a firmer gel with significant lift capacity. This is crucial for providing adequate volume and support over the bony structures of the hand, effectively masking veins and tendons.
• Structural Support: It provides robust underlying support, restoring a smoother, more youthful contour to the dorsal hand.
• FDA Approval: Its specific approval for dorsal hand volume correction provides practitioners with confidence in its demonstrated safety and efficacy for this precise use in patients over the age of 21.
• Integrated Lidocaine: Contains 0.3% lidocaine for enhanced patient comfort during the procedure. A lidocaine-free version is also available for patients with sensitivities.

Critical Anatomy of the Dorsal Hand

Treating the hands requires meticulous anatomical knowledge due to the superficial location of vital structures:

• Skin & Subcutaneous Tissue: The skin is thin, with variable amounts of superficial fat. The target injection plane for Restylane Lyft™ is typically the subcutaneous layer, deep to the dermis but superficial to the extensor tendons.
• Veins: Large, superficial dorsal veins (branches of cephalic and basilic veins) are highly visible and must be carefully avoided. They lie within the subcutaneous tissue.
• Extensor Tendons: These are easily palpable and visible, especially with finger extension. Filler must be placed above the tendons and their sheath (peritendon). Injecting below risks function impairment and nodule formation.
• Nerves: Superficial sensory branches of the radial and ulnar nerves run in the subcutaneous plane and should be avoided.
• Fascial Layers: Understanding the superficial and deep fascia helps delineate the correct injection plane.

Patient Selection and Consultation

Ideal candidates for Restylane® Lyft™ hand rejuvenation typically exhibit:

• Moderate to severe dorsal hand volume loss.
• Visible extensor tendons and veins.
• Adequate skin elasticity (to accommodate volume).
• Realistic expectations regarding outcomes and longevity.

Contraindications must be reviewed as per the product’s US Prescribing Information (IFU), including allergies to HA or lidocaine, active infection, bleeding disorders, etc. During consultation, assess the degree of volume loss, skin quality, and clearly explain the procedure, expected results (smoother contour, less visibility of structures), potential side effects, and typical longevity (~6 months per FDA studies).

Injection Technique: Safety and Precision First

Treating the dorsal hand requires specific techniques distinct from many facial procedures:

• Anesthesia: While Lyft contains lidocaine, topical anesthetic is often applied beforehand for initial comfort.
• Tool Choice: Blunt-tip cannulas (e.g., 22g or 25g) are strongly recommended over needles for dorsal hand injection. Cannulas significantly reduce the risk of penetrating veins and causing bruising or intravascular injection. Multiple entry points may be needed.
• Injection Plane: Target the subcutaneous plane, directly above the peritendon (tendon sheath) but below the dermis. Maintaining a consistent depth is crucial. Tenting the skin can help identify the correct plane.
• Technique: Use slow, retrograde linear threads or a fanning pattern with the cannula. Deposit small aliquots evenly across the dorsum, avoiding direct injection over prominent veins or tendons.
• Volume: Typically requires around 1-2 ml per hand, depending on the severity of volume loss. A conservative approach, potentially staged, is often wise. Do not overfill.
• Massage: Gentle massage immediately post-injection helps distribute the product evenly and smooth contours.

Managing Expectations and Results

• Immediate Effect: Volume improvement is visible immediately but will be accompanied by swelling.
• Swelling & Bruising: Can be significant on the hands due to loose tissue and vascularity. Advise patients accordingly.
• Longevity: FDA clinical trials demonstrated results lasting approximately 6 months for many patients. Individual results vary. Touch-up treatments may be desired.
• Outcome: The goal is a smoother dorsal hand contour with reduced visibility of tendons and veins, leading to a more youthful appearance.

Potential Side Effects & Safety Considerations

While generally safe when performed correctly using the FDA-approved product for its indication, potential side effects include:

• Common: Swelling, bruising, tenderness, redness, itching, temporary firmness or palpable lumps (related to the firm NASHA gel). These are usually mild to moderate and resolve within 1-2 weeks.
• Less Common/More Significant:
  • Nodule formation (can be minimized with proper technique and massage).
  • Temporary stiffness or restricted tendon movement (if injected too close or below tendons).
  • Infection.
  • Hypersensitivity reactions.
  • Vascular Occlusion (VO): Though potentially less common than in certain facial areas if using a cannula correctly, intravascular injection into dorsal hand veins remains a risk. Practitioners MUST be able to recognize signs (pain, blanching, livedo pattern) and have VO protocols and hyaluronidase immediately available.

Sourcing Authentic Restylane® Lyft™

Using genuineRestylane® Lyft™ sourced from authorized distributors or reputable licensed suppliers is critical for ensuring patient safety, product efficacy, and achieving predictable results, especially when treating an FDA-approved indication like dorsal hand volume loss.

Health Supplies Plus is committed to providing licensed medical professionals with access to authentic aesthetic products, including Restylane® Lyft™, handled and stored according to manufacturer specifications.

Conclusion: A Reliable Solution for Hand Rejuvenation

Restylane® Lyft™ offers a valuable, FDA-approved solution for addressing age-related volume loss on the dorsum of the hands. Its NASHA® technology provides the necessary structural support to effectively camouflage underlying veins and tendons, restoring a smoother, more youthful contour. Success relies on thorough anatomical knowledge, careful patient selection, meticulous injection technique (preferably with a cannula), appropriate patient education regarding expected results and aftercare, and the use of authentic product. By mastering these elements, practitioners can confidently offer Restylane® Lyft™ as a safe and effective treatment for hand rejuvenation.

Doris Dickson

About the Author: Doris Dickson is a specialist writer for Health Supplies Plus, focusing on the aesthetic medicine industry. She diligently researches cosmetic treatments and products to provide clear, concise information relevant to licensed medical professionals. Her work supports Health Supplies Plus’s commitment to being a reliable informational resource and trusted supplier for the aesthetic community.

 

Disclaimer: The content provided in this article is intended for informational purposes only and is directed towards licensed medical professionals. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment, nor does it constitute an endorsement of any specific product or technique. Practitioners must rely on their own professional judgment, clinical experience, and knowledge of patient needs, and should always consult the full product prescribing information and relevant clinical guidelines before use. Health Supplies Plus does not provide medical advice.