I love to put fat everywhere we lose it over time. There is a volume effect and a skin rejuvenation effect. The back of the hand isn’t a place you think about at all when you are young, but as you age, you start to see it more. The veins show. The tendons prominent for all to see. A treatment to soften the hands is to inject fat into the back of the hand. It is not new: I went to a course by Dr. Coleman almost 10 years ago about it.
This is a study out of Italy. “Lipomodeling: An Innovative Approach to Global Volumetric Rejuvenation of the Hand.” It was in the August 2015 issue of the Aesthetic Surgery Journal.
They describe the anatomy of the hand with three levels of fat. The superficial level is safe to inject fat. The deeper layers have more of what they all the “noble structures:” vessels and sensory nerves in the middle level, and tendons in the deepest level.
They harvested fat, centrifuged it, and then injected it using 1cc syringes. They made 6 access points, one at the wrist, and the rest in the folds between the fingers. They did about 15cc of fat into each hand, staying in the superficial layer. They also did .5cc of fat into each aspect of the fingers as well. Immediately after, the hands appeared overfilled. Postoperatively they had their patients elevate their hands for 2 days and avoid manual activity for 1 week. They put a foam dressing over the area for 10 days to reduce bruising and prevent fat migration.
Findings:
- 22 patients
- Average age 56
- Follow up was at 3 years on average
- Complications for them were none, other than a temporary numbness in 13% and swelling which lasted 2 weeks
- Patient self assessment indicated 80% were happy with results.
Thoughts?
This study validates treating the aging hand as part of rejuvenation. It is another study supporting fat transfer. It differs from some other hand rejuvenation by addressing the individual fingers as well, advocating they need fat too.