Restoring Aged Hand by
Stem Cells Enriched Fat Grafting

Today, with large number of women and men have taken steps to keep their face and neck looking youthful that no one can really guess their real age but, by looking at the back of the person’s hand where the tell-tale signs of aging become apparent.

Women especially complain of the appearance of the backs of their hands. This can often start as early as a person’s mid-40s, particularly if they have increased sun exposure can be earlier in mid 30s. Genetics also play role in the shape of the hand dorsum or being very skinny (low body weight).

Over time, the skin over the dorsum of the hand become thinner and “crepe-like”, while the veins, tendons and the joints show more prominently through the thinner skin. The plumpness and smoothness of the back of the hands goes away as the skin thins and the soft tissue under the skin atrophy, plus, to volume loss, an aging spot (brown spots) caused by aging process &/or sun overexposure tend to manifest prominently on the back of the hands for many people. Although numerous hand creams make claims of restoring the much sought-after youthful appearance, none have been successful at restoring volume to the hands or significantly reducing the aging stigma from the hand dorsum.

Whatever the cause behind the changes; age, sun over-exposure, genetic, very low body weight, being a woman having a hand veiny, wrinkled with or without sun-damaged skin changes can makes you look older even if you are in mid 20s.

Until recently, there has not been a good way to “rejuvenate” the hands. These days with increase the concern about hand rejuvenation, also known hand enhancement many effective techniques to rejuvenate the hands, improving the quality and texture of the skin, while decreasing the wrinkling and prominent veins.

Fat Transfer to revitalize the hand dorsum

As the aging of the hand is skin changes & soft-tissue deflation, that causes rhytides, dermal atrophy, & prominent hand anatomy then, the soft tissue deflation has to be e corrected with volume augmentation using dermal fillers or lipofilling. Fat transfer volumizes the hand with prolonged durability and efficacy, autologous tissue replacement to effectively & naturally augment the soft-tissue compartments of the hand plus the ability of the fat to give significant dermal regeneration & rejuvenation.

This first line to rejuvenate the hand is always by fat transfer with or without stem cells enrichment as it is a natural volumizing  way using our own natural filler that is long-lasting, and it typically lasts for years. It can effectively deliver significant result that re-plump and replenish the volume to the back of the hands, thereby “hiding” the tendons, veins, and joints that were so visible before and feeling it soft and smooth. With stem cells enriched, the rejuvenated effect of stem cells therapy can create higher quality of skin tone and better youthful aesthetic appearance.  This is very easy, office procedure, can be done with topical analgesic cream or mild sedation. It may need a second stage typically spaced few months or even few years apart and very unusual to see patient in need for a third session.

Pros: The hand will be smoother and fuller, and the vein will be far less prominent. Hand will have again youthful appearance.

Cons: May need more than a session. Hands may be swollen, bruised and stiff after the treatment, which will limit activity.

How long it takes to see the result? 

Patients need to follow all instruction given to them about type of activity that can be done by the hands plus hand home care as all will be given to them.  Recovery period is very individual and variable depending on the procedure, patients age and physical condition but, can usually recover normal activities with hours or several days.

What you expect to see after the procedure?

First 2 weeks: bruising, stiffness, and swelling gradually disappear. Hands appear more youthful, over filled-out and smooth, with little or no brown spots or veins.

2-8 weeks: skin may still pink, skin tones and hand size will begin to be more natural and not overdone.

How are the incisions and scars will be from fat transfer to the hands?

The incisions used to inject fat into the hand regions are small (2-3 millimetres), few in numbers may be seen in first few weeks especially if they exposed to sun without sunblock and get brownish discolouration which can take months to fade.

Good candidate for “Hand Rejuvenation”: Good candidate with good general health, have a realistic expectation

  1. Prominent veins and tendons because of volume loss.
  2. If the hand dorsum skin thin and wrinkled.
  3. Hand having aging spots
  4. Loss of supple touch of the hand dorsum

Not a good candidate: Those patients may show less dramatic initial result and may need a second stage in shorter interval period. If the patient has history of :

  • Impaired healing
  • Diabetes Mellitus
  • Ongoing sun exposure
  • Smokers

What are the other options for hand rejuvenation other than Fat Transfer

Although fat grafting still considers the first and best option for hand rejuvenation, but other modalities of treatments are available.

  • Platelet-rich Plasma (PRP) alone or mixed with fat transfer, very helpful in rejuvenation of the hand. 
  • Fillers such as hyaluronic acid or polylactic acid, can be used to add volume to the hand and fill in around protruding bones and veins
  • Chemical peels, IPF, Laser Resurfacing (Ablative or fractional): may used to treat fine wrinkles, skin discolouration, sun damage or age spots.
  • Sclerotherapy or laser vein treatments: can treat noticeable or protruding veins

Most of these treatment, requires multiple treatment to give best result and none of them can cover more than one symptoms of aging hand.

References:

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  13. Nathan Newman, Hand Rejuvenation. In: Shiffman MA, editor, Stem cell in aesthetic surgery. Berlin:Springer; P. 703-709.
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  15. Tiryaki t, Findikli N, Tiryaki D.Steged stem cells enriched tissue (SET) injection for soft tissue augmentation in hostile recipient areas: a preliminary report. Aesthetic palst Surg.2011;35(6):965-71
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