Hand rejuvenation with fat grafting: A 12-year single-surgeon experience

Abstract

Background: Fat grafting has been successfully used for reconstructive and esthetic surgery of the breast, face, and other body parts. In this article, we present our protocol for hand fat grafting and over a decade of clinical experience.

Methods: Fat tissue is obtained from the flanks, peri-umbilical region, or internal side of the thigh or knee. No centrifuge machine is used to prevent fat damage. After decantation, fat is injected into the dorsum of the hand using a cannula from the wrist and not from the fingers. Fat is distributed gently above the dorsal deep fascia to avoid perforation of the vessels.

Results: The proposed technique was applied to 65 patients. The amount of fat injected ranged from 10 to 30 cm³. No allergic reactions were noticed. Each patient's progress was followed-up for a minimum of 12 months. Over this period, contour changes and the effects of the procedure(s) on the skin were analyzed. Fifty-six patients (84%) were satisfied with the results during the observation period, 7 patients (12%) were somewhat satisfied and needed one more fat grafting procedure to achieve complete satisfaction, and 2 patients (4%) were dissatisfied with the results. Three cases of temporary swelling of the hands resolved naturally. No long-term complications were seen.

Conclusions: This study covers over a decade of practical experience in applying fat grafts to hands. The procedure is effective in reshaping and rejuvenating the hand as it shows long-lasting results after 1-year follow-up.

Keywords: Fat grafting; Hand lipofilling; Hand rejuvenation; Hand reshaping.

Fig. 1

Aesthetic aspects of the elderly hand:deterioration of skin quality, presence of skin flaccidity, abscense of subcutaneous fat tissue, alteration of cutaneous pigmentation and visible veins and tendons on the dorso.

Fig. 2

For anaesthetization, 5 mL of the anesthesia solution is injected into the dorsum of the hand

Fig. 3

Anesthetic infiltration of the region from where fat tissue is extracted

Fig. 4

A minimum of 30 cm³ of fat tissue is collected

Fig. 5

The fat is decanted to allow separation from contaminants such as blood, serum, and oil

Fig. 6

Point of entrance and lines of filling: fat is injected into the dorsum of the hand using a cannula from the wrist

Fig. 7

A 41-year-old female patient (right hand): a preoperative and b postoperative view at 9 months

Fig. 8

A 41-year-old female patient (left hand): a preoperative and b postoperative view at 9-months

Fig. 9

A 80-year-old female patient (right hand): a preoperative and b postoperative view at 1 year

Fig. 10

A 80-year-old female patient (left hand): a preoperative and b postoperative view at 1 year

Fig. 11

A 72-year-old female patient (right hand): a preoperative and b postoperative view at 10 months

Fig. 12

A 72-year-old female patient (left hand): a preoperative and b postoperative view at 10-months

Fig. 13

A 22-year-old female patient who suffered from burn injury to her right hand: a preoperative and b postoperative view at 1 year after three rounds of lipofilling and 30 mL of transferred fat in total