Objectives: Aging hands present specific characteristics that require a carefully designed combinational treatment for a successful clinical outcome from a practitioner's and patient's perspective.

Introduction: Clinicians are rigorously trying to strategically plan and stage treatment plans for their patients that encompass several months and involve distinct therapeutic devices in order to ensure efficacious and safe long-term outcomes. Results of these efforts has led to mounting evidence that combination approaches to hand rejuvenation can address patients needs leading to greater patient satisfaction, increased patient retention and overall better quality of patient care.

Materials / method: A Medline search was performed on hand rejuvenation from 1990 to 2018, and results are summarized. The authors' personal experiences with specific technologies are discussed.

Results: Review of available clinical studies revealed successful rejuvenation of the epidermis and dermis of the hands with topicals, chemical peels, intense pulsed light, and laser energy devices. Reports of sclerotherapy and laser veins ablation for dorsal hand veins were identified. Several studies on hand volume restoration with injectable volumetric fillers such as hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, autologous fat transfer including the authors' personal experience with them are described.

Conclusion: A plethora of noninvasive treatment options for hand rejuvenation have been thoroughly studied as monotherapy, but there is insufficient number of studies evaluating the best combination of therapies for this indication. It is likely that their strategic combination and sequence of application by a trained clinician will ensure a favorable outcome in addressing patient concerns.

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Objectives: To improve our results and avoid complications rejuvenation and volume treatments for the dorsum of the hands

Introduction: The hands are the most visible part of the body, just as the face, and reveal the true age of a person. We believe it is important to know the precise anatomy of the dorsum, and the characteristics of the different products.

Materials / method: Technical points and results are presented and explained, to avoid the unsightly results or long term complications that are presented

Results: The results are presented up to 2 years post procedure

Conclusion: Respecting the anatomy of the dorsum oçf the hand is mandatory to achieve good results and avoid most of the described complications.

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这项工作的完成感谢以下机构的支持： Consultant and Senior Medical Advisor to SInclair Pharmaceutical

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