When you want to look for age, as a bouncer at a bar once told me, you look to the eyes and the HANDS. Yes hands. If you didn’t have your ID, and he wanted to see how old your were, your hands gave him the answer. Fat grafting to the hands has been shown to help *BLOG HERE*. In the office it can be done with filler. *BLOG HERE*
I had discussed fat transfer to the back of the hands with a patient, and she sent me an email. As she stated, “My hands are wrinkled and the veins pop out.” She had many questions. So I thought I would answer them here in a blog.
- Is fat transfer the best option? Yes and no. When you hands get wrinkled and vein-y, it is because you have lost volume. In the office, I have used HA fillers like Restylane Lyft with a cannula injection (to lower the bruising) to plump up the back of the hands. The issue with a filler is it takes a fair amount (usually 4 syringes) and it lasts for about 6-12 months (It varies from person to person), which means you need to keep doing it. I don’t use Sculptra in the hand if you ever would do fat transfer in the future.
-
- With fat, I use your body’s fat, centrifuge it, and inject with a cannula. Just like all fat grafting *please read my blogs on fat HERE*, there is variable survival. But whatever fat gets a new blood supply can be there for years, and it has the lovely stem cells, which improve the skin quality.
-
- What are the other options? We don’t have many. The issue in the hand here is volume, so you add volume with fillers or fat. I don’t love to use Sculptra in the hands, because if you ever think you will do fat in the future, fat grafting after Sculptra does not work well.
- How long does it last? As with all fat transfer, not all the fat you transfer survives. Survival rates vary from 0% to 70%. Every person seems to have a different “quality of your soil” when you plant the new fat. When the fat gets a new blood supply in the new area, it should be there for years. You will continue to age though, so however much we “reverse” time, expect to age from there again.
- How long does it take in the office to transfer fat? This is a surgical procedure done in the OR under general anesthesia. It takes about an hour.
- Will there be injury in the area where the fat was removed? I do liposuction to remove the fat from the donor site. I do this with small cannulas, so it is usually smooth. Most people love the body contouring they get from the liposuction.
- What is recovery time? Your hands are mildly bruised and swollen for about two weeks.
- Is it done along the entire hand including fingers? Most of the fat transfer is done on the back of the hand. It may extend slightly over the part of the finger closest to the hand. It really needs to go where the issue is seen.
- What are the long lasting side effects? I don’t know, as I don’t tend to see side effects. The fat either survives, with resultant improvement in skin quality and volume, or it doesn’t. I haven’t seen issues with fat necrosis, sensation, etc, though those have been described as issues with any fat transfer procedure.
It is a great procedure. As with all fat grafting procedures, the results vary from person to person. I have TONS of blogs about fat grafting, stem cells, and how I love it. I do a lot of fat transfer to the face, as I have done for a decade now, and I truly believe fat grafting does something to make skin look youthful, dewy, and fuller in a way no laser/peel/product can do.