Hands Giving Your Age Away? Alice Tries A New Rejuvenation Technique

Think your hands have started to ‘give your age away’? Perhaps they look a little more skeletal, feel dehydrated, or have imperfections such as dark spots, any of which are impacting your overall skin appearance. Well you are in luck! This article is all about hands, or more specifically, treatment options to keep your hands looking fabulous. Alice went to meet Dr Lorenzo Garagnani – an expert hand surgeon, who showed his latest techniques using skin boosters, fillers, polynucleotides and IPL. Alice also underwent treatment for her own hands too..

So, what is going on with our hands as we age?

“We see very similar signs of ageing on the hands as we do on the face because ageing happens in parallel throughout our body,” explains Dr Lorenzo. “But because the skin characteristics of the hands are slightly different from the face, ageing can show there a little earlier.”

That said, you’re not alone if you didn’t notice your hands ageing straight away…

“The hands are one of the most exposed parts of our body and they’re always before our eyes, but a lot of the time we do not pay attention to how they look,” continues Dr Lorenzo, alluding to the fact that we tend to focus predominantly on our faces in the mirror. In fact, we tend to notice more after having treatments for our faces and necks, because the discrepancy with our hands then increases and becomes more noticeable.

What signs of ageing should you look out for?

According to Dr Lorenzo, it isn’t just one thing that can contribute to your hands showing their age. The most common culprits are:

Skin appearance factors

• Pigmentation marks: caused by ageing and also sun exposure, so-called age spots, which cause uneven pigmentation and discolouration.
• Scars: as a result of an injury or from surgery that you may want to mask or cover
• Skin thinning, dehydration and reduced elasticity: just like in the face, skin quality changes can make your hands look less plump and youthful

Structural changes 

• Hand boniness: caused by changes in the shape and width of the bones that happen over time as we make use of our bodies
• Thinning of subcutaneous tissues: this can make veins, tendons and the other underlying structures (which also change over time) show more clearly on the back of your hands

What is Dr Lorenzo’s unique B-FAB®  hand rejuvenation technique?

Dr Lorenzo’s signature approach to rejuvenating your hands is called B-FAB® short for Booster and Filler Anatomically Based injection technique. His technique is based on his 20 year experience as a hand expert and his deep knowledge of anatomy as a teacher on the subject. Dr Lorenzo’s approach focuses on finding the optimal and, most importantly, safest places to inject, in order to respect the delicate anatomy of the hands and also to drive improved aesthetic outcomes.

Benefit 1: more natural-looking results

“Traditionally, we’ve injected the hands superficially, above the veins and tendons, using the concept that anything injected on top will mask the boniness and reduce the appearance of tendons and veins,” Dr Lorenzo explains. “That is true, but my research shows that there’s a deeper layer that can also be safely treated. Injecting here reduces the risk of products showing or migrating through the skin, and this layer is just beneath the veins and nerve layer, so it is safe from an injection point of view.”

Benefit 2: the ability to combine filler and skin boosters

“Another value of the B-FAB®  technique is that it can combine deeper filler placement for contouring of the hand with more superficial injections of skin boosters or polynucleotides for improved tissue hydration and elasticity,” reveals Dr Lorenzo. “That’s possible because you are targeting two different and very well separated layers, and the products used stay in their respective layers. This means you can treat both contouring and skin concerns at the same time.”

What exact products is Dr Lorenzo using for his hand rejuvenation treatments?

The traditional choice of fillers for contouring still plays a huge part in Dr Lorenzo’s practice. These products also volumise and are great for older & slimmer patients, especially.

He also uses skin boosters and products like Plinest, a polynucleotide-based injectable product. Some products improve skin hydration, while others help stimulate collagen production in order to increase skin firmnes and protect it from daily stressors, such as attending the gym or carrying out day-to-day activities.

Other hand treatments that Dr Lorenzo offers are Lumecca IPL for age spots and pigmentation and Morpheus8 for skin tightening. Also, spoiler alert… another treatment to watch is the one by Seffiline, launching soon in the UK!

What happens during your hand treatment

Alice experienced the  B-FAB® technique treatment herself from Dr Lorenzo.  He  injected a hyaluronic acid -based filler mainly for contouring of  her hands, that was injected with a cannula deeper, underneath the veins and nerves. And then a skin booster injected in the superficial layer, above the veins and nerves. For skin booster injections, Dr Lorenzo reveals he uses “the shortest needle” he can. “The skin booster injections remains very superficial I don’t even enter with the entire needle, only with the tip, in order to inject the product in the correct layer.”

He also makes sure to inject very specific spots on the back of the hand, identified based on his anatomical studies. “This allows the product to be equally distributed without endangering any nerve, blood vessel or other structure,” Dr Lorenzo explains.

One thing to note is that numbing is definitely needed, this can be accomplished with an anaesthetic cream applied beforehand and through local anaesthetic injections when required. Some fillers already contain a local anaesthetic too. Dr Lorenzo also uses the Reform Skincare SPF Mist spray to soothe the hands post-treatment and protect them immediately from the sun’s UV rays. This SPF spray application technique means you can avoid touching the treated areas. This reduces the risk of infection.

What results can you expect?

Results typically include smoother, firmer, more hydrated skin, and subtly plumper hands that still look completely natural. Treatments don’t affect hand movement or function, and there’s a focus on avoiding anything that may overfill the hand — all things that are non-negotiable for Dr Lorenzo. He also doesn’t recommend injecting the fingers with fillers or other gel-like substances: “There’s simply not enough room, and it could restrict motion or cause a sense of tension or discomfort.”

How long do results last? 

Depending on the product used and how active you are, results can last from around six months to a year approximately. “We need to remember that the hands are in constant motion, and depending on someone’s occupation and hobbies, longevity of the treatment effect will vary from person to person,” says Dr Lorenzo. “Patients who do not do physical work or do not exercise will probably have results that last the longest.”

Beyond fillers: energy-based treatments for age spots 

Of course, injectables aren’t the only tweakments available to practitioners in a hand rejuvenation toolkit, and volume loss isn’t the only concern.

“Pigmentation and age spots are extremely common, and the energy devices we can use to treat them nowadays are phenomenal,” Dr Lorenzo adds. “We use Lumecca IPL (by InMode) for removing age spots because there’s a specific protocol that’s perfect for the type of skin on the back of the hand.”

However, ongoing care and realistic expectations are also really important. “Such treatments work brilliantly, but they’re not permanent,” Dr Lorenzo explains. “As age progresses, new age spots may appear, so maintenance sessions would be likely required over time.”

Why you need to see a hand expert for aesthetic hand treatments

“The hand is a very intricate organ because of its sensory, motor and social functions,” reveals Dr Lorenzo. “It needs to move well and it needs to not be damaged by any elective treatment we perform, so treatment it has always to be as safe as possible.”

For that reason, Dr Lorenzo stresses that you should always see someone who has a degree or specific certified qualification in medical hand treatment, such as a postgraduate diploma or an advanced training qualification, with a deep understanding of the anatomy and biomechanics of the hand, who can provide you with the best advice for your specific concerns.

Who is Dr Lorenzo Garagnani? 

Dr Lorenzo Garagnani is the Medical Director of SE1 Medical Aesthetics in London Bridge. At the 2023 Aesthetics Awards, he was voted in the top 7 Consultant Surgeons within the medical aesthetics industry in the UK. Hands are his particular passion (and speciality), and he treats patients for both functional and cosmetic outcomes. He is a dually qualified Consultant Hand Surgeon (practising both in the NHS and privately) and Aesthetic Doctor.

Lorenzo has also developed the world’s first dedicated Diploma in Aesthetic Hand Treatments, which is designed to provide theoretical and practical training for healthcare practitioners in safer, anatomy-based aesthetic hand treatment techniques.

Interested in other helpful tips and tricks for getting the most out of your tweakment experiences? Head to The Guide to view our full selection of articles.