A Double-Blind, Comparative Study of Nonanimal-Stabilized Hyaluronic Acid versus Human Collagen for Tissue Augmentation of the Dorsal Hands

Abstract

Cosmetic surgery to counteract the aging process is an evolving field. Most procedures have concentrated on the face; however, the hands are an often-neglected area. Current methods of hand rejuvenation include autologous fat injection, sclerotherapy, intense pulsed light, chemical peel, and microdermabrasion. Only autologous fat injection restores dermal thinning. We compare the use of hyaluronic acid (Restylane, Medicis Aesthetics Inc.) versus collagen (Cosmoplast, INAMED Aesthetics) for soft tissue augmentation of the dorsal hands. Ten female patients who demonstrated dermal thinning of the dorsal hands were randomized to receive 1.4 mL of hyaluronic acid or 2.0 cm(3) collagen to alternate interphalangeal spaces of dorsal hands. Patients returned at 1 week, 1 month, 3 months, and 6 months for digital photography and completion of a patient/physician questionnaire. Hands were scored by two separate blinded physicians on scales of 1 to 5 for clearance of veins. Patients scored both tolerability and satisfaction on a scale of 1 to 5. Analysis showed a mean difference of 0.95 (0.004), median difference of 0.9 (0.008) for clearance, and a mean difference of 0.90 (0.010) with a median difference of 1.0 (0.031). The satisfaction difference was not significant with a mean difference of 0.80 (0.070) and median difference of 1.0 (0.117). Aging of the hands is a common problem that is often overlooked. The use of soft tissue fillers is a viable tool in hand rejuvenation. In this study hyaluronic acid proved to be superior in efficacy to collagen.