Correction of Skin Depressions of the Hands and Décolletage With VYC-17.5L: A Prospective, Single-center Study

December 2020 | Volume 19 | Issue 12 | Original Article | 1219 | Copyright © December 2020

Published online November 30, 2020

Daniela Greiner-Krüger MD, Leonie von Grawert MD

MediCorium, Oberursel, Germany

Background: Few studies have assessed the use of hyaluronic acid (HA) fillers for rejuvenating the hands and décolletage. VYC-17.5L is an HA filler with physical properties that may be well suited to these areas.
Methods: This was a prospective study of females undergoing VYC-17.5L treatment in the dorsum of both hands and the décolletage. All had ageing of the hands rated 3–4 on the Allergan Hand Volume Deficit Scale (AHVDS), and of the décolletage rated 3–5 using the Fabi–Bolton Chest Wrinkle Scale (FBCWS). Patients were initially treated with VYC-17.5L up to a maximum of 1.5 mL per hand and 3.0 mL in the décolletage; VYC-17.5L touch up was allowed at 1 month. Subjects were followed up for 12 months. The primary endpoint was the number of responders in each hand and the décolletage at 6 months, defined as a ≥ 1-point improvement on AHVDS or FBCWS.
Results: Thirty-three patients were enrolled (mean age, 56.6 ± 9.9 years). Six-month response rates were 100% in each hand (AHVDS) and 96.9% in the décolletage (FBCWS). Mean improvements were statistically significant at all three sites (P<0.001). At 6 months, patient satisfaction using the Global Aesthetic Improvement Scale was high: 81.3% rated their right and left hands as ‘improved’ or ‘much improved’; 65.6% rated their décolletage this way. Results were durable out to 12 months for all endpoints. There were no unexpected safety findings.
Conclusions: VYC-17.5L was effective and safe for correction of skin depressions of the hands and décolletage.

J Drugs Dermatol. 2020;19(12):1219-1225. doi:10.36849/JDD.2020.5524


The treatment of ageing is usually focused primarily on the face. However, this can lead to a discrepancy in appearance if the face is successfully rejuvenated but other highly visible parts of the body – such as the hands and décolletage – remain untreated.1,2

The hands are continuously subject to external ageing triggers, such as sun exposure and friction forces due to movement. This manifests in the formation of wrinkles, folds and lines, and substantial changes in overall contour with time. In addition, declining levels of collagen and elastin in the dermis lead to skin thinning and laxity; deeper down, atrophy of the subcutaneous fat often results in increased visibility of the underlying bone, tendons and blood vessels on the dorsum of the hands.3,4 Similarly, in the décolletage, ageing and environmental factors (particularly ultraviolet radiation) lead to dermal thinning and lipoatrophy over time, resulting in increased muscle visibility as well as lines and wrinkles that are often particularly deep.1

Patients and aesthetic practitioners therefore increasingly recognize the value of treating the hands and décolletage. A number of options are available, including fillers, intense pulsed light, laser, microfocused ultrasound, fat injections, and chemical peels.1,2,4,5

Hyaluronic acid (HA) fillers may offer a compelling mix of benefits for rejuvenating these areas, including improvements in the appearance of lines as well as volumizing and hydrating effects.6,7 However, compared with the face, there are relatively few trials of HA fillers in the treatment of the hands and décolletage. Among recent studies, most assessed low molecular weight/small-particle HA fillers based on intradermal deposition,8–11 with results typically lasting for up to 6–9 months. In addition, a randomized trial showed the efficacy and safety of a large gel particle (20 mg/mL) HA filler in the treatment of the hands,12 and this led to the first approval by the US Food and Drug Administration of an HA filler for use outside the face.

VYC-17.5L is an HA filler with intermediate elastic modulus (G’) and cohesivity, containing 17.5 mg/mL HA.6 It has demonstrated high levels of aesthetic improvement and patient satisfaction and low complication rates when used in the face, with results lasting up to 18 months.13–17 VYC-17.5L was designed to be sufficiently cohesive for volume restoration and treatment of deep skin depressions, but it retains the capacity to be spread horizontally. Thus, it may have significant potential for use in the hands and décolletage. However, to the best of our knowledge, there are currently no published data on the use of VYC-17.5L in either of these areas. The purpose of this study was to evaluate