ABSTRACT
This chapter discusses the hand anatomy, and the rationale for using calcium hydroxylapatite (CaHA) for hand augmentation, before discussing a new technique for optimal hand rejuvenation. CaHA has a number of characteristics that make it an ideal agent for hand augmentation. In a two-step mechanism of action, the CaHA microspheres are first distributed at the injection site by their soluble carrier gel, which also provides immediate volume replacement. CaHA also has an optimal balance of viscoelasticity allowing it to deform enough to be injected without an excessive extrusion force and to be molded, nevertheless, it is elastic enough to provide a durable correction via its ability to resist external pressure once implanted. Statistically significant improvements in the CaHA-treated hands were observed using validated hand grading scales, at 6 and 12 months, with only minor and short-lived adverse events. Clinical improvement can be expected no earlier than three months posttreatment.
