There are few parts of the human body that work as hard as the hands. They are employed in nearly every daily task, from personal care, to work, to regular communication. Throughout time, the hands have played an important role in aesthetics. We wear jewelry on our wrists and fingers, and some people choose to tattoo their hands or wear nail polish. Time and daily use, however, can begin to age the hands. Though the general focus of anti-aging medicine tends to involve facial features, the doctors at Plastic Surgery Clinic of Eau Claire recognize the need to rejuvenate other parts of the body that have begun to show signs of age and wear. Some patients feel their aging hands betray their otherwise youthful look, and elect to have a cosmetic rejuvenation.
What is Hand Rejuvenation?
Hand rejuvenation is a plastic surgery procedure that is aimed at restoring a youthful look to the hands through autologous fat transfer. By replacing lost fat, the skin on the top of the hand (the dorsum) is plumped, evening out wrinkled, sagging skin and concealing the bones, tendons, ligaments, and blood vessels that become visible during the aging process. The added fat smooths the top of the hands and helps rejuvenate the skin for a supple look and feel.
The hands require rejuvenation for different reasons. While many people are diligent about applying sunscreen, they often fail to rub it into their hands. With the exception of very cold weather, the hands are generally exposed to the elements. As a result, the harmful UV ray penetration damages collagen and elastin cells, which are important in the formation of firm and healthy layers of skin. The hands require dexterity to function, and do not contain much fat at any time during a person’s life. While weight gain can increase the fat content in the hands, the expansion of the area is minimal in comparison to the rest of the body.
*Each patient is unique and individual results may vary.
Why Undergo Hand Rejuvenation?
A person’s hands may begin to age as early as their 20s, and by the time there are noticeable changes, cosmetic intervention is necessary for youth restoration. Many people feel self-conscious about the look of their hands as their fingers may begin to look bony and arthritic, providing obvious clues to their age. Due to preconceived ideas about the aging population and discriminatory treatment, some people prefer to maintain their privacy about how old they are.
People may find that their aging hands cause them to feel embarrassed in social or professional situations. Musicians, educators, beauty experts, those in the media, and other professionals use their hands constantly during their work, and may find that their appearance detracts from their looks.
Patients with very thin fingers or damage to tissues of the hands can also benefit from hand rejuvenation. They may be lacking normal tissue volume in the hands, and could benefit from a fat transfer, gaining confidence and self-esteem.
How is Hand Rejuvenation Performed?
Restoring the look of the hands using fat transfer is a multi-step process. First, the fat is harvested from the patient’s body to use during the procedure. Then, it must be purified and processed for transfer. Finally, it is injected into the hands for natural-looking volume.
There are a number of benefits to performing the procedure as an autologous fat transfer. Fat is naturally occurring in the human body, and exists well amongst the other tissues. Its consistency and appearance can provide the most natural aesthetic changes to the hands, with realistic contours that can camouflage the recognizable signs of aging. Additionally, the body recognizes the patient’s fat as its own, and therefore it will not reject the fat graft.
The synthetic dermal filler, Radiesse is the only cosmetic injectable that has been FDA-approved for the purpose of rejuvenating the hands, though some doctors are able to safely use other fillers off-label. While fillers provide temporary improvement to the look of the hands, fat transfer results should last the patient’s lifetime. Though some fat will dissipate, the doctor will typically slightly overfill the area to ensure a great final result.
Fat Grafting to the Hands – The Detailed Procedure
The first step in autologous fat transfer to the hands is the extraction of fat from the patient’s body. The tissue is generally removed from the abdomen, lower waist, hips, though other areas of the body with extra fat may be viable options. Both men and women tend to accumulate extra pounds in their midsection, so most patients will find that this general region serves as a good harvest site. A benefit is that most common regions with extra bulk are easily camouflaged, so there should not be noticeable scars. Though fat is removed from the body, the area will likely not show noticeable slimming; liposuction is a better procedure for patients seeking to sculpt the body.
Under local anesthesia, the harvest site and the hands are numbed for patient comfort. The doctor will utilize a syringe and harvesting cannula to remove the excess fat. The fat is then treated to purify the tissue. It can be run through a centrifuge, which circulates the container at high speeds to separate the fat from any blood or other materials extracted. Some fat cells may be damaged during these processes, and they are discarded from the fat source. It is because of this that the doctor generally removes slightly more fat than is necessary for the final graft.
Next, the fat is packed into a smaller syringe, and through a series of injections, is relocated throughout the dorsum of the hand. The special cannula minimizes the risk of tissue damage to these areas of the hand. The fat is carefully distributed above the tendons on each hand in the amount of 4-10ccs, or up to a third of an ounce. For visualization purposes, this is less than a tablespoon. The doctor may choose to slightly overfill the area because some of the fat will be reabsorbed into the body. After the fat has been implanted in the designated areas, it will be gently massaged into place until the doctor has achieved satisfactory, natural contours.
The procedure is done in about an hour in one of Dr. Rucker’s clinic rooms or in his in-office operatory suite in Eau Claire, WI.
Other Hand Rejuvenation Techniques
The sun also causes the hands develop age spots (also called brown spots or liver spots). Age spots, which are actually the result of skin that has been repeatedly exposed to the sun without adequate protection, can cause unwanted discoloration to the hands. In addition to undergoing fat transfer, patients may also seek laser skin resurfacing to correct dark spots. An added benefit of this treatment is that the laser heat will stimulate collagen and elastin cells to grow, and the skin will look better as a result. Though each technique can be performed on a patient, the doctor may explain the best timing for each to ensure an optimal final look.
Hand Rejuvenation Candidates
Good candidates for hand rejuvenation are people who would like to add volume to the tops of the hands, and are realistic about the results the procedure can achieve. There are other areas of the hands, like the thickness and vertical ridges of the nails or wrinkled palms that also age over time, though significant corrections for these areas have not yet been established in cosmetic medicine.
While younger patients may notice subtle changes to their hands as they age, there are more conservative procedures, like laser skin resurfacing, available to maintain youthful-looking hands. Hand rejuvenation is best for patients with obvious signs of aging in their skin, most notably, the loss of volume.
Hand rejuvenation is a minimally invasive procedure, which is why most interested patients qualify for the treatment. Some skin conditions, health problems, and low body fat may prevent a patient from undergoing fat transfer. These patients may benefit from Radiesse dermal injections instead.
Dr. Rucker will determine individual candidacy at the time of the consultation. This is a great opportunity for patients to understand their options and ask questions.
Recovering from Hand Rejuvenation
Patients are free to return home after the procedure has been completed. Most people are discharged to their home, though others may return to work, depending on the type of job they perform. While there is no downtime associated with this type of fat grafting, there may be obvious bruising and swelling after the treatment at both the harvest site and the injection sites of the hands. No incisions are created during hand rejuvenation, though puncture marks at the harvesting and injection sites may be visible for the next few days. Most side effects of the treatment will have subsided within 3-5 days.
Possible Risks and Complications
The main risks of hand rejuvenation are swelling, possible bruising, hematoma and infection. The use of the blunt tipped cannula reduces the risk of bleeding or injury to important structures like veins and tendons. Oral antibiotics help reduce the risk of infection in susceptible patients.
Patients who undergo Radiesse hand rejuvenation injections may develop a sensitivity to the injection, an allergic reaction, or rejection. They may also experience swelling, bruising, tingling, or numbness to the injection sites. A spot test may be performed prior to the full injection.
Fat Transfer to the Hands – FAQs
Other than some residual soreness that can impede strenuous use of the hands for a few days after hand rejuvenation is performed, there should be no negative impact on function. The fat injections occur on the back, or top side of the hand, not the palm side. Additionally, extra precautions are taken, including the use of a blunt-tipped cannula, to preserve existing structures and tissues of the hands.
Patients should discontinue the use of any harsh treatment products they use on their hands for up to two weeks prior to undergoing the procedure. One week before their appointment date, patients will be advised not to drink alcohol or take certain medications like ibuprofen, aspirin, and certain vitamins or herbal supplements, which will help decrease post-treatment bruising. Those prescribed high blood pressure medications should speak with their doctor about stopping or decreasing their dose for a week prior to their scheduled treatment.
Many areas of the face and body suffer volume loss during the natural aging process. The hands may appear bony with thickened joints, the skin can look wrinkled and loose, and the parts of the hand below the skin may be visible. By adding a layer of fat under the skin, the hands will look younger. Many plastic surgeons recommend this procedure to patients seeking fixes for a maturing face for comprehensive anti-aging.
Rucker MD Plastic Surgery – Eau Claire, WI Plastic Surgeon
Trained in the Midwest, Dr. Joseph Rucker earned his medical degree through Michigan State University College of Human Medicine and has been in private practice in Wisconsin for more than 30 years. Dr. Rucker serves his patients at Plastic Surgery Clinic of Eau Claire or Enza Medispa in Eau Claire. The doctor has extensive experience, and has performed more than 10,000 plastic surgery and reconstructive procedures for patients. Dr. Rucker is board certified by the American Board of Plastic Surgery, and maintains membership status with prominent groups in American medicine.