Face your hands: complications after hands rejuvenation

Objectives: The rejuvenation of aging hands is becoming very popular. Just like the face, hands and neck could show significant signs of age. Anatomical features such as thin skin, subcutaneous fat, quantity and quality of collagen, tendons and vessels, as well as extrinsic factors such as sun damage, permanent contact with cleansing and disinfection reagents make this area an indicator of age. Unfortunately sometimes we can see unpredictable complications after hands rejuvenation. We would like to present 3 clinical cases of complications ( skin reactions, tendovaginitis and delayed granuloma) Introduction: Like the face, hands are a visible part of the body. They age more quickly and reveal comparable change with time such as sun damage, permanent contact with chemical washing products and smoking. Reduced fat compartments and elastosis leading to visualization tendons, veins and bone prominence. Hand rejuvenation with HA dermal fillers and collagen stimulated products is an effective way with a high rate of patient satisfaction and low risk for complications. But, sometimes we can see unpredictable skin reactions Materials / method: We would like to present 3 different cases in our practice with complications after dorsum hands rejuvenation. Case 1. Urticaria acute reaction after skin revitalization with HA product ( combined high/low molecular weight of non-crosslinked HA) Case2. Delayed oedema after dorshm hands rejuvenation with HA dermal filler Case 3. Delayed non-inflammatory granuloma after skin rejuvenation with non HA collagen stimulated product Results: The dorsum of the hands has three distinct fatty areolar laminae: the dorsal superficial, the dorsal intermediate and the dorsal deep lamina.The intermediate and deep lamina are separated from the lamina superficial. The sensory nerves and dorsal veins are located within the dorsal intermediate lamina. No structures are apparent in the dorsal superficial lamina. Thus, this layer is a safe area for injection and restoring the volume. Although the author supports the proximal-to-distal fanning technique, we have found out, that tenting the skin, injecting superficial avoiding the deep layer Conclusion: For most of the doctor’s, rejuvenation of hands is a simple procedure with a high level of patient satisfaction and low risk of complications. Long-lasting result and easy rehabilitation make this kind of injection popular. Educating patients to not only take care of the face, but also of the hands make this kind of treatments more and more popular. But sometimes we can see rare complications and know how to manage them as quickly as possible