A refined fat transfer technique provides good cosmetic outcomes for patients who want a more youthful appearance of their hands, according to a report in the December issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

In a special "Ideas and Innovations" article, Dr. Rod J. Rohrich and colleagues of University of Texas Southwestern Medical Center, Dallas, share their fat grafting technique for rejuvenation of the hand. The researchers write, "This approach addresses the prominent aged anatomy of the hand, providing excellent contour and aesthetic outcomes." Dr. Rohrich is also Editor-in-Chief of Plastic and Reconstructive Surgery.

Simple Fat Transfer Procedure for Younger-Looking Hands

Plastic surgeons are seeing increasing demand for procedures to produce a younger appearance of the hand. Many patients undergoing facelift surgery are also interested in hand rejuvenation.

"Our facial rejuvenation patients are increasingly aware of the dichotomy between the youthful face and the aged hands," Dr. Rohrich comments. "Interestingly, one can estimate a person's age by viewing the hands alone, adding to the desire for these procedures."

Fat transfer techniques—taking a small amount of fat from one area of the body and transferring it elsewhere—have found a wide range of uses in plastic surgery, including cosmetic breast and facial procedures. Techniques using fat grafting for hand rejuvenation have been reported, with long-lasting results. However, they have potential drawbacks in terms of final appearance and time-intensiveness.

Dr. Rohrich and colleagues have developed a refined, "minimal access" technique of hand rejuvenation using fat grafting. The surgeon harvests a small amount of the patient's own fat tissue, usually from the inner thigh—about 20 to 25 milliliters per treated hand.

Through a few small incisions on the back (dorsum) of the hand, the surgeon gently makes room under the skin, then injects the harvested fat cells. The injected fat is gently massaged to create a smooth contour, filling in the "deflated" appearance and prominent bones and veins of the back of the hand. Important technical considerations for plastic surgeons are illustrated by a supplementary video on the Plastic and Reconstructive Surgery website.

In the authors' experience, the fat transfer technique provides an improved, natural appearance through at least six months after the procedure. Recovery is quick, with no complications or safety issues over a five-year experience.

Additional fat transfer or injection of dermal filler products can be performed to "fine tune" the results, if needed. Dr. Rohrich and colleagues note that their simple technique adds only 15 to 20 minutes to the procedure time for patients undergoing facelift surgery.

In the researchers' experience, about five percent of facelift patients choose to add hand rejuvenation. They believe that many more would do so if the offered the procedure was made available to all.

"Hand rejuvenation with autologous fat grafting is a safe and effective method to create a youthful appearance of the dorsum of the hand," Dr. Rohrich and colleagues conclude. They emphasize that longer studies in a larger patient population are needed to assess the long-term outcomes.

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

About PRS Global Open

Plastic and Reconstructive Surgery—Global Open (PRS Global Open) is an open access, rigorously peer-reviewed, international journal focusing on global plastic and reconstructive surgery. PRS Global Open educates and supports plastic surgeons globally to provide the highest quality patient care and maintain professional and ethical standards through education, research, and advocacy.

About Wolters Kluwer Health

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About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. 

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