Long‐Term Effectiveness and Safety of Small Gel Particle Hyaluronic Acid for Hand Rejuvenation

Background Fillers to reverse the effects of fat atrophy can help restore the hands' youthful appearance. Objective To evaluate the effectiveness and safety of small gel particle hyaluronic acid (SGP-HA) for hand rejuvenation through 1 year. Materials and Methods A prospective open-label study recruited adults with moderate to severe vascular, bony, and tendon prominence. After a topical anesthetic was applied, SGP-HA (maximum dose of 4.0 mL) was injected into the dorsum using a threading technique and distributed by massage. Results There were 16 patients with a mean ± SD age of 60.1 ± 5.3. Two weeks after treatment, vascular, tendon, and bony prominence and skin turgor were improved by 60.9%, 65.2%, 73.7%, and 26.3%, respectively. Substantial or complete global aesthetic improvement was rated in 75% of patients by investigators and in 56% by self-report; 81% of patients were satisfied or very satisfied. Five needed a touch-up (maximum 1.0 mL/hand). Improvements were largely maintained at 6 months, with 85% patient satisfaction, and assessments approached pretreatment levels at 1 year, with 50% patient satisfaction. One patient reported itching on one hand, which was judged to be unrelated to treatment. Conclusion SGP-HA produced lasting improvements in aging hands and was safe and well tolerated.