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It's a first: FDA approves HA filler for backs of hands

On May 21, the FDA approved the hyaluronic acid (HA) dermal filler Restylane Lyft (Nestlé Skin Health) to correct age-related volume loss on backs of the hands. It’s the first FDA approval for an HA dermal filler off the face.

But it’s not the first dermal filler approved for cosmetic treatment of the hands. Synthetic calcium hydroxylapatite dermal filler Radiesse (Merz Aesthetics) was approved in 2015 for hand augmentation to correct volume loss in the dorsum of the hands, according to the FDA.

Restylane Lyft has been on the market for more than a decade. It’s also FDA approved for the midface/cheek area and nasolabial folds.
The latest FDA approval was based on a multi-center, randomized, evaluator-blinded, split-hand study, including 89 patients, ages 22 and older. Investigators studied Restylane Lyft’s safety and efficacy, reporting a clinically meaningful improvement in the correction of volume deficits of treated hands for up to six months. Restylane Lyft with Lidocaine is indicated for injection into the subcutaneous plane in the dorsal hand to correct volume deficit in patients older than 21.

Injection site swelling, tenderness, redness, bruising, pain, itching as well as impaired hand function were, for the most part, mild and transient, according to a press release by Nestlé Skin Health.

NEXT: 10 Tips for Better Outcomes

Ellen Marmur, M.D., a dermatologist in New York City and clinical trial investigator for Restylane Lyft for hands, offers the following tips to The Aesthetic Channel readers for optimal outcomes.

For the Patient:

1. Ask the patient which areas are their top priorities. You'd be surprised — sometimes it's the valleys between the tendons, sometimes it is the prominent vessels specifically in one area that they are most focused on.

2. Advise the patient to hydrate well.

3. Advise the patient to stop all vitamin supplements, ibuprofen, other anti-coagulants, and no booze the night before — to avoid bruising.

4. Advise the patient to avoid hand intensive exercises for 1-2 days afterwards including cycling, tennis, and yoga — to prevent swelling.

5. Show them how to elevate their hand and elbow for a few minutes several times a day for 2-3 days if needed for swelling.

For Technique:

1. Evaluate volume loss and consider average use might be more than one syringe per side — counsel the patient in advance.

2. Cleanse well and prime the syringe of air before injection.

3. Tent the skin and lift away from the underlying anatomy.

4. Insert the needle facing the wrist at the distal hand at an acute angle between the skin and the underlying anatomy and inject in retrograde threads.

5. Spread the filler evenly with medium pressure.