High-Resolution Ultrasound Evaluation of Common Dorsal Hand Rejuvenation Techniques: A Multicenter Study

Area of Science:

• Aesthetic Medicine
• Medical Imaging
• Dermatology

Background:

• Hand dorsum volumization is a common aesthetic procedure.
• Ultrasonographic features of injected fillers are not well-documented.
• High-resolution ultrasound with Doppler (HRUD) can potentially standardize and improve safety.

Purpose of the Study:

• To characterize post-procedural HRUD features of dorsal hand volumization.
• To compare ultrasonographic appearances of hyaluronic acid, calcium hydroxylapatite (CaHA), poly-L-lactic acid (PLLA)-hyaluronic acid mixtures, hybrid fillers, and autologous fat grafting.
• To assess the utility of HRUD in verifying filler placement and procedural safety.

Main Methods:

• Multicenter descriptive study involving 12 adult patients.
• Dorsal hand volumization using various fillers and autologous fat grafting.
• HRUD performed at baseline, early post-procedure, and follow-up.

Main Results:

• Distinct HRUD patterns were identified for each material: CaHA (hyperechoic bands), hybrid fillers (lobulated hyperechoic structures), hyaluronic acid (hypoechoic pseudocystic areas), PLLA-HA (diffuse echogenicity), and fat grafts (isoechoic structures).
• All materials were located superficial to extensor tendons.
• Transient vascularization noted on Doppler; no complications observed.

Conclusions:

• HRUD is a practical tool for documenting hand anatomy and confirming subdermal placement of volumizing materials.
• HRUD allows for recognition of distinct sonographic signatures for different fillers.
• This technique may enhance procedural safety and monitoring in hand rejuvenation, though further studies are needed.