The present study was performed to evaluate the efficacy of injecting both nondiluted and diluted calcium hydroxyapatite filler into the dorsal surface of the hands in the same session, in addition to repeating the same approach along two different postoperative intervals (2 and 4 months). The study included 40 female patients who complained about the visibility of the veins and tendons, and loss of skin elasticity in their hands. First, 0.5 mL of nondiluted calcium hydroxyapatite filler was injected in each hand using a cannula through a single entry point (total of 1 mL for both hands), and the next step was injecting a diluted calcium hydroxyapatite. The same protocol was repeated at 2 and 4 months postoperative. All patients were followed up at the following intervals for recording their satisfaction score: 14 days, 2 months, 4 months, and 6 months. Postoperative measurements of the patient satisfaction score at 14 days follow-up showed a significant increase in their satisfaction; this was maintained up to 6 months postoperative. Combining both nondiluted and diluted calcium hydroxyapatite filler injections for hand rejuvenation in the same session may provide more stable results than using each formula alone or in different sessions.
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