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Hand, finger lipomodeling restores volume, reduces skin laxity with lasting results
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Almost all patients who underwent lipotransfer for total hand rejuvenation were “satisfied” or “very satisfied” with the procedure.
Researchers evaluated 22 women who underwent the procedure by a single surgeon. The mean age of the patients was 56 years, and their procedures included rejuvenation of the radial and ulnar aspects.
Results were assessed by serial photography and by patient self-assessments.
The patients underwent conscious sedation with local anesthesia via Klein’s solution at the donor site and with median and ulnar blocks at the receiving sites.
Intraoperatively, patients received a single dose of antibiotics.
Harvested fat came from the abdomen through an umbilical incision using a blunt cannula attached to a 10 mL syringe, centrifuged at 3,600 revolutions per minute for 3 minutes.
The surgeon used six surgical accesses via a 16-gauge needle.
The first access was at the wrist for access to the entire dorsum, and an additional five accesses were made in the interphalangeal folds to allow lipotransfer to the radial and ulnar aspects of the fingers.
Patients elevated their hands for 2 days postoperatively and avoided manual activity for 1 week.
Patients were dressed with a Reston foam pad (3M) over the dorsum of each hand to protect the area without restricting mobility. The dressing was removed 10 days after surgery.
No patients indicated postsurgical concerns and they tolerated the dressing well, according to researchers.
All patients had postoperative edema which resolved within 15 days.
No patient disclosed dissatisfaction with the results.
One patient was considered unsatisfied as she indicated a neutral level of satisfaction.
Three patients were satisfied and 18 patients were very satisfied.
It is common for rings to no longer fit following lipomodeling. Eleven of 16 patients with increased volume which prevented wearing rings, were not bothered by the potential inconvenience.
The surgeon recommends a crisscrossed pattern for fat exchange to encourage uniformity and enhance graft acceptance. The technique is associated with positive aesthetic results and only minor complications, according to researchers. – by Abigail Sutton
Disclosure: The researchers reported no relevant financial disclosures.
Perspective
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Lara Devgan, MD, MPH
After age 30, most women's hands look older than their faces. In fact, plastic surgeons often regard the hands as the easiest way to determine a person's age, as aging hands tend to appear more sinewy, veiny, pigmented and thinner than younger hands. This article describes a popular technique for hand rejuvenation: autologous fat grafting.
In my practice, I employ both autologous fat grafting as well as injectable fillers to rejuvenate aging hands. While fat grafting has the advantage of being durable and using one's own tissue, injectable filler (such as Radiesse, Juvederm, or Restylane) is quicker, less expensive, and has a faster recovery. Both techniques are an essential part of a plastic surgeon's armamentarium, and each technique has a role in hand rejuvenation. The authors also draw attention to a valuable finer point in hand rejuvenation: that both the dorsum of the hand and the fingers deserve attention.
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