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W H I T E P A P E R

aestheticmed.co.uk HAND REVOLUMISATION

ABSTRACT Conclusion: PCL injections are a reliable method for hand
Background: Dorsal hand volume loss results in the volumisation. Results persisted for up to three years in
perception of ageing appearance. Several volumising fillers some patients. Laser vein viewer and cannula delivery
have been used for this correction. ensure uniform injections and avoid intravascular injuries.
Objective: To report restoration of dorsal hand volume using
cannula delivery of polycaprolactone (PCL) microspheres INTRODUCTION
and to assess efficacy, duration, and safety up to three Loss of subcutaneous volume in the dorsal hands are a
years post-treatment. visible sign of ageing, resulting in interphalangeal hollows
Method: 15 patients with volume loss of their hands were and “bony” appearance of the hands. Veins become more
evaluated by clinical examination, photography and a hand- visible with this loss of dorsal hand volume. 1-5 Hands also
volume grading scale. PCL was injected by 25G cannula exhibit ageing as a result of photodamage with loss of
after locating dorsal veins using a viewing laser to avoid skin elasticity, rhytids, skin laxity, and dyspigmentation.
intravascular injections. Patients’ satisfaction and grade of There has been increased use of injectable hyaluronic acid
severity were re-evaluated at early (three to six months) and and hydroxyapatite fillers for hand re-volumisation.
1–6
late (12 to 18 months) timepoints following the procedure. A Polycaprolactone microsphere (PCL) injections were
second treatment was offered if desired by the patient. introduced in Europe for skin volumising approximately
Results: Eight participants required one treatment session seven years ago. 9
to achieve satisfaction. Five had two treatments. Patients A pilot study of hand volumisation in five patients
requiring a second treatment were reassessed after 12 treated with PCL filler has been reported. 10 The PCL
months. All patients had improvements on the severity microspheres are 25–50μm size, suspended in a vehicle of
score by the end of the evaluation period. Side effects were carboxymethylcellulose (CMC), consisting of gel carrier
minimal and transient. No patients developed bruising. and PCL filler. PCL microspheres are smooth, spherical, and

Aesthetic Medicine • June 2020 57