Hand Rejuvenation — Dorsal Volume Restoration

Hand rejuvenation at S-thetics Beauty restores lost volume to the backs of the hands using hyaluronic acid injections — the same Stylage filler technology used for facial volumisation. Age-related volume loss in the dorsal hand causes the skin to thin, the tendons to become prominent, and the veins to stand out visually, giving the hands an aged appearance that often contrasts with a refreshed face. Restoring volume with HA filler smooths the surface, reduces tendon and vein visibility, and improves skin texture. Two millilitres of filler per session typically covers both hands. MDDr. Darina Šanšašvili performs the procedure using a cannula or fine-needle technique, distributing the filler evenly to avoid lumpiness and achieve a natural result. Results last twelve months or more in the hand dorsum.

The hands are one of the body's most reliable age indicators, often revealing a person's age — or adding years — when the face has been successfully rejuvenated. The dorsal hand loses fat volume progressively from the fourth decade onward, a process accelerated by sun exposure and weight loss. As the subcutaneous fat layer diminishes, the extensor tendons and dorsal vein network become visually prominent — a recognisable marker of chronological age that no topical skincare can fully reverse. Hyaluronic acid filler injection is the most established minimally invasive treatment for dorsal hand volumisation. At S-thetics Beauty, Stylage XL or Stylage L (high-density, long-lasting HA formulas from the Vivacy range) are used to rebuild the subcutaneous layer across the back of the hand, smoothing the surface, reducing the visibility of the tendon and vein network, and improving the overall texture and appearance of the skin. MDDr. Šanšašvili performs the injection using either a fine cannula technique (which allows product to be distributed in a single entry point through a small tunnel across the dorsum) or a serial-puncture needle technique — the choice depends on the anatomy and volume required. A cannula approach reduces bruising and the risk of inadvertent vascular injection in the richly vascularised hand dorsum, making it the preferred technique for larger volumes. The filler is massaged into position after injection to ensure even distribution and avoid any visible lumpiness. The result is visible immediately: the dorsal surface is smoother, more rounded, and the tendons and veins are less prominent at rest. Any initial swelling resolves within two to five days, after which the settled result reflects the final outcome. Results in the dorsal hand tend to last twelve months or more — longer than many facial filler applications — because the hands have a lower metabolic activity in the area and less repetitive dynamic movement compared to facial expression muscles. Hand rejuvenation pairs well with other anti-ageing strategies: topical retinoids to improve skin texture, photoprotection to prevent further sun damage, and laser or chemical peel treatments for pigmented sun spots (available through other Prague aesthetic providers). At S-thetics Beauty, the injectable volume restoration is the primary focus. Contraindications include active skin infection or active eczema on the dorsal hand, known HA allergy, current anticoagulant therapy, Raynaud's phenomenon, and any circulatory condition affecting the hands. Pregnancy is also a contraindication. Blood-thinning medications should be paused five to seven days before to reduce bruising risk in this highly visible area.