Hand Rejuvenation and Sclerotherapy – Hand Vein Removal and Reduction Miami FL

By Dr. Adam Gropper, Founder at North Beach Vascular & Aesthetics in Miami

Recently, the FDA approved Radiesse, a dermal filler similar to restylane, for approval in the use of hand rejuvenation.  This got me thinking about hand rejuvenation in general.

Here in our Aventura Miami office we see a lot of female patients requesting a hand rejuvenation procedure, usually for “large hand veins” which they feel are unsightly.  Most visit our vein and aesthetics clinic requesting sclerotherapy of these hand veins.  These requests generally fall into 2 broad groups:

a)    A younger subset with enlarged hand veins, and;
b)    A slightly older subset with fat and collagen loss in the hands

Younger Patients

In reality, hand sclerotherapy is not for everyone. Younger patients with prominent veins but who still have their full complement of collagen and fat are good hand sclerotherapy candidates.  This procedure can usually eliminate or vastly minimize these veins and it is the best approach for these patients.  That said, hand sclerotherapy should not be undertaken lightly. I always start out by warning the patients that in the event of a prolonged illness or hospitalization they may regret having those veins sclerosed as they are easy IV access points for nursing staff.

In addition, the patient must be fully invested in maintaining adequate compression on the backs of the hands for at least 48 hours without a break, and then ideally another 5 days with short breaks only to wash the hands.  We recommend compression gloves placed over cotton balls for this.  Many patients do not want to purchase the compression gloves because of the expense but as the saying goes “if you are going to do it, do it right” and so it’s really important to make the investment of money and time. However we find a lot of poor compliance in patients who have to reapply coban or tape.

An often overlooked factor which can affect post-procedure appearance outcome is hand swing. If a patient is walking around all day and holding their arms down at their sides and swinging, that will force blood into the treated veins despite even great compression. I always ask patients to be cognizant of this and recommend a sling for the first 48 hours.  If the patients are not compliant, intravenous thrombus can form inside the hand veins, which can lead to skin staining and a prolonged bruised appearance.

When patients are compliant with instructions, results can be beautiful.  Here is a nice example after 3 sclerotherapy treatments.

Older Patients

The second subset of patients for hand rejuvenation is the older patient with soft tissue loss in the hands.  Usually, the patient perceives that the veins have become too prominent giving the hands an aged appearance.  However, in reality the visual effect of these aged looking hands is primarily due to the hollowed out appearance of the hand rather than the veins themselves.  These patients, in most cases, should not receive treatment with sclerotherapy but rather should have injection of dermal fillers. Properly placed fillers will restore the youthful plumpness of the hand and minimize the appearance of the veins.  Reduction in the prominence of the hollowed out areas between the extensor tendons will dramatically reduce the aged appearance of the hands and avoids any kind of surgery.  Here are some nice results from filler injection:

Get a Consultation About Improving Your Hand’s Appearance:

If you would like to explore your options on improving the appearance of your hands, call us at (305) 957-7277 or fill out the form on this page. If you complete the form, we usually get back in 24 hours or less, often the same day to answer your questions or schedule an appointment.