With so much focus on facial rejuvenation, we frequently lose sight of our hands. Our hands are aged by sun exposure and of course, time and gravity is a big factor in showing aging over other areas of the body. These sign of aging include age spots and loss of fat under the skin resulting in a bony appearance. More recently, placing fat in the dorsal aspect of the hands for hand rejuvenation is becoming more in vogue. A variety of injectables are being used for rejuvenation of hands. I have found that, rather than using synthetic material, I prefer to use a person's own fat, which is called autologous fat grafting, to the hands. During this procedure, small amounts of fat are placed carefully with small needles over the dorsal aspect of the hands. Often, the patient prefers to have an anesthesiologist standing by in order to lessen the discomfort from the procedure.
This procedure is done usually in multiple sessions spaced three months apart. It is best to use small amounts of fat on the dorsal or top part of the hand and do it in several sessions spaced, as mentioned, three months apart in order to get optimal results. The results from hand rejuvenation using fat have been very encouraging. When done properly in multiple sessions, the thin skin over the hand is rejuvenated to become thicker and younger, and veins and a variety of tendinous structures are more hidden, which is obviously more desirable than the atrophy or thinning that you see on the top portion of their hands as patients get older. There is some swelling involved postoperatively, but for the most part, patients have been so encouraged by the results that they come back for the second and third sitting to complete the process.
Fat transfer is a very interesting and new approach to all types of rejuvenation. It seems that fat, when placed under the skin, actually helps increase circulation and thickness and youthfulness to the skin. We think this is because we are adding a layer of subcutaneous tissue which has been atrophying as people get older, and the fat actually adds to fat absorption, which happens to all of us as we age. I will continue to give proper informed consent to those individuals who wish to move forward and consider hand rejuvenation using their own fat taken usually from the abdomen or thigh area.