Table 1.

Injection tips to decrease the potential for adverse events during hand rejuvenation treatment using fillers

1.	Needles should be as small as possible so that the flow rate of the filler is low.
2.	Fillers should always be injected slowly, gently, and under low pressure. Gentle injection technique may prevent many complications.
3.	The needle should be advanced through the skin slowly and filler should be injected in a retrograde fashion, while the needle is moving out of the skin. This technique safeguards that even if the tip of the needle is inside the lumen of a vessel at some point, only a tiny amount of filler will enter the vessel as the needle will be out in the next moment.
4.	Small volumes of filler should be introduced with each injection.
5.	Use ice prior to injection. Ice decreases pain and shrinks blood vessels making them less likely to be punctured.