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"I'm a little voice impaired today but I’m going to try to go through an area that's of great interest to a lot of people, and that's hand rejuvenation, something we do a fair amount of here at The Maas Clinic and the Appearance Care Center or Medi Spa.
With hand rejuvenation, there are a lot of changes that occur just like in the face that exercise and diet are not going to change. Amongst those are loss of the soft tissues between the tendons of the hand which makes the tendons quite prominent, we'll see a lot of, sort of contraction or depressions in between the tendon and in addition, we'll see with aging lots of fine lines and wrinkles over the hands. There is an old expression, "if you want to know the age of a woman," well actually it could apply to any person, look at their hands.
We have ways of fixing that so it's not such an obvious change or a reflection of your age. Amongst those are changing the depressions or the valleys in the hand that make the tendons so prominent and also the veins that become very prominent with age, where they're very thick and ropy and with the skin becoming translucent, almost blueish and hue.
So those are intrinsic changes to the hand, the wrinkles, the loss of soft tissue and then the veins themselves which are quite prominent with age, and we can change all those doing a series of treatments that can make a big difference.
In addition to those changes, almost everyone gets changes in their pigment and hands are some areas that are almost always exposed to the sun, I encourage all of our patients to wear sunscreen on their hands because of the age spots that happen there and age spots are no different than freckles, they're just confluent freckles and are all stuck together. We call them senile lentigines or solar lentigines and really they become quite prominent and the fact it is confluent means they are stuck together into big masses and I’ll show you again examples even on me where I’ve treated one hand and not the other to show the examples of how a treated hand can look versus an untreated hand.
So if you have questions about hand rejuvenation, I’m very happy to answer them but in general I’d say there's a 3 treatments strategies, really four if we count all of them, that we use to make hands younger looking.
One is injectable fillers, fill in those areas in between the tendons that looks so hollow and to disguise a lot of the veins, we can make them almost disappear with injectable fillers using HA or one of the HA fillers like Juvederm, Restylane or Belotero or ADS which has just been approved for use in hands very recently. Those can be applied in the office, they're not painful, there's a local anesthesia used with it and there's minimal swelling. In fact, when its swollen it looks quite good so it’s just a little bit of hand care afterward that we ask patients to do.
Once we've got the filling and even some correction of wrinkles with the hands using these fillers, and if there's still wrinkles still present on the skin surface we can do things like fractional laser resurfacing which actually does two things: improves the texture of tone and quality of the skin, improves the wrinkles but it also allows full rejuvenation of the hand itself, thickening in the collagen in a long term result.
If it’s just pigment that we're treating, IPL or photo rejuvenation, IPL stands for intense pulse light, is a very good option for getting rid of the dark spots or solar lentigines on the hands. I don’t care if they're covered with them, or it's just the hands full of them, we can get most or all of them gone. There's a distinction I’ll make between some of the growths that can happen on the hand like seborrheic keratosis where we have to do a little laser ablation or ablation of those, removing them, versus a regular freckle. But for most people, freckles or solar lentigines are the main problem that makes the hand look old.
So we've talked about filling, we've talked about disguising tendons and veins by doing that, we've talked about laser, fractional laser resurfacing and IPL to improve the texture quality and color of the hands and if we've done those things, we've done the major features that we really used to address hand aging.
I’ll show you some examples but again, it’s a big area, it’s one a lot of people have questions about it. It's often one that has been ignored so if we can bring it to your attention and show you what kind of results we get, you're certainly welcome to come and have a consult and talk about hand rejuvenation and hand aging. This is Dr. Corey Maas on "Looking Your Best.""