title: A prospective, noninterventional study of the treatment of the aging hand with Juvéderm Ultra® 3 and Juvéderm ® Hydrate.
abstract: BACKGROUND
  Hand rejuvenation aims to restore volume and produce smooth, elastic skin. A combined treatment has been proposed: Juvéderm Ultra® 3 for filling and smoothing the skin and Juvéderm® Hydrate to rehydrate and restore skin quality.
  
  
  METHODS
  Twenty physicians enrolled 99 subjects (i.e., 198 hands). At the first visit, hands were injected with Juvéderm Ultra® 3. At the second visit (day 15) hands were treated with Juvéderm® Hydrate. A final assessment was made at day 30.
  
  
  RESULTS
  Ninety-eight percent of subjects were female (mean age=60.3 years). Mean volumes injected were 1.02 ml Juvéderm Ultra® 3 per hand at day 0 and 0.91 ml Juvéderm® Hydrate per hand at day 15. Mean grading on the Hand Aging Scale was 3.18 preinjection, which decreased to 1.73 on study completion (p<0.0001). Injections were rated as "very easy/easy" in 99.4 and 98.9% of cases for Juvéderm Ultra® 3 and Juvéderm® Hydrate, respectively. Most physicians found both products "very easy/easy" to massage. Physician evaluation based on the Global Aesthetic Improvement Scale (GAIS) showed that the proportion of "very much/much improved" was significantly higher at days 15 and 30 compared to baseline (63.7 and 70.3 vs. 41.8%). Patient GAIS scores showed that the proportion of "much improved" was significantly higher at day 30 than at day 15 (53.1 vs. 43.9%). Over 94% of physicians and approximately 90% of subjects would recommend treatment. The adverse event rate was 8.2 %, including edema, hematoma, redness, and pain.
  
  
  CONCLUSIONS
  Combined Juvéderm Ultra® 3 and Juvéderm® Hydrate treatment is effective and safe for rejuvenating the aging hand.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.
authors.affiliation: Centre Laser Dermatologique Laser MD, 8 Rue de Londres, 67000, Strasbourg, France. jm.dallara@free.fr
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Dallara
mesh_terms: D000368:Aged; D005260:Female; D006225:Hand / Q000473:pathology*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D015595:Skin Aging / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: C526061:Juvederm Ultra; C526062:Juvederm Ultra Plus; D006820:Hyaluronic Acid