The backs of the hands, the knees and the elbows show age before the face does; we approach them by considering volume replacement and skin regeneration together.
The backs of the hands, the knees and the elbows are areas where age shows before the face does. The face is cared for consistently, but the hands and knees are exposed directly to sunlight and friction, and because the subcutaneous fat there is thin, tendons and veins become prominent and the skin loosens with age. Wrinkles in these areas combine loss of volume with thinning of the skin itself, so we approach the two separately.
On the back of the hand, filler restores volume in the hollows between the tendons and bones so that tendons and veins are less prominent, and a skin booster improves the texture and elasticity of thinned skin. The knees and elbows are areas where the skin loosens and roughens, so a skin booster is the mainstay, with filler added where there is hollowing.
Atelier Plastic Surgery checks the position of blood vessels and tendons by the same standards as facial filler, and chooses the product and injection layer to suit the area. Where pigmentation is also present, pico toning is planned alongside.
Filler such as hyaluronic acid is injected into the hollows between the tendons and bones to restore volume. Blood vessels and tendons run shallowly in the back of the hand, so the filler is placed with a cannula in the layer beneath them, not above, and spread evenly after injection. As the back of the hand fills out, you can expect the tendons and veins to become less prominent.
A PDRN/PN-type or hyaluronic acid-type skin booster is injected into the dermis of the back of the hand to improve dryness, fine lines and skin texture. It can be done on the same day as filler or at a separate time, usually as a course of about 3 sessions at 2–4 week intervals.
The skin of the knees and elbows is thick and subject to a lot of friction, so it easily becomes rough and loose. Regenerative ingredients are injected into the dermis to improve the elasticity and texture of the skin and help loose folds crease less. Where the skin is darkened, pico toning is planned alongside.
When the skin above the knee hollows and creases into folds, filler is placed in the hollow so the fold creases less. The knee moves a great deal, so the duration may be shorter than in the face, and where sagging is pronounced the effect of filler may be limited; we explain what can be expected at consultation.
These may vary depending on your condition; we will give you precise details at your consultation.
The backs of the hands look older because several things act together: fat decreases and the tendons show through, the skin thins and becomes dry, and pigmentation develops. We set the balance of filler, skin booster and pico toning according to which is the main cause.
Blood vessels and tendons run directly beneath the skin of the back of the hand, so if the injection layer is wrong the result may be lumpy or a vessel may be damaged. We check the anatomical positions by the same standards as facial filler, place the filler in the right layer with a cannula, and spread it evenly.
The hands and knees move all day long, so filler may not last as long as in the face, and a product that is too firm can feel foreign during movement. We choose a product suited to the movement of the area, start with a small amount and top up as needed.
Loose skin on the knees and elbows does not become taut with injectable treatments alone. The goal is improved skin texture and elasticity and folds that crease less; where sagging is pronounced, we also guide you toward other options.
There is swelling and redness at the injection sites, and the backs of the hands may swell more noticeably than other areas. Do not press or rub the treated area hard.
Swelling and bruising on the backs of the hands are most noticeable during this period. Resting with your hands raised above heart level helps with swelling; reduce heavy lifting and prolonged hand use. Avoid saunas and alcohol.
Most swelling has settled and bruising fades. With hand filler, the tendons begin to look less prominent from this point. For the knees, avoid kneeling for long periods or positions that put pressure on the knees.
The filler has settled into the tissue and the hydrating effect of the skin booster can be felt. The next skin booster session goes ahead, and a touch-up injection of filler is considered if there is any shortfall.
Filler volume gradually decreases. Because these areas move a lot, it may decrease faster than in the face, and we discuss the timing of a top-up as the volume begins to decline.
After filler and skin booster treatment on the hands, knees or elbows, swelling, bruising, redness and pain may occur, and swelling on the backs of the hands may last about a week. If the amount or layer is not right, the area may feel lumpy or differences between the two sides may result, and filler injected too shallowly can show through the skin. Rarely, infection, nodules, delayed inflammatory reactions or migration of the filler may occur. Because blood vessels and tendons run shallowly in the back of the hand, vascular injury or, rarely, skin damage from vascular occlusion may occur; if there is any change in skin color or severe pain after treatment, you must contact the clinic immediately. Hyaluronic acid filler can be dissolved with an enzyme (hyaluronidase). Treatment may be restricted if you are pregnant or breastfeeding, have an active infection or skin condition in the treatment area, or have an autoimmune disease or a tendency to keloids. Results and duration vary by individual, and loose skin itself is not corrected by injectable treatments alone.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
Filler that looks at the structure of the face first and designs for balance
Learn more Related Skin boosterA skin booster with the ingredient chosen by your skin condition
Learn more Related Pico toningPico toning managed according to the type and depth of the pigment
Learn more Related Academic ActivityPapers · books · conference lectures and chairs · society positions · ORCID
Learn moreConsultations are conducted by the Director herself. Schedule one by phone or KakaoTalk, or leave an online consultation request.
