The hands and the face are the only 2 areas of the body which are continuously exposed to the environment and the public. We are all aware of the aging face but little attention has been paid to the aging hand. In fact, the hand is one of the first areas to show signs of aging. As the hand ages volume is lost, the veins and tendons become more prominent and the spaces between the fingers on the back of the hand deepen. The skin appears thinner and the joints appear larger. In addition to this we develop hyperpigmentation or "age spots".
This imbalance is further exaggerated after a facial rejuvenation procedure. This lack of harmony is particularly obvious with daily maneuvers such as raising a glass to take a drink. The contrast of a 45 year old face and a 60 or 70 year old hand can be dramatic. I have had women tell me they intentionally keep their hands out of view because they are unhappy with their appearance. After the surgery, they are thrilled because they can begin wearing their jewelry again without concern about the appearance of their hands.
The aging process affects the skin as well as the deeper tissues and all elements must be evaluated and addressed for a complete rejuvenation. Surgical and nonsurgical techniques can be combined to accomplish this goal.
The surgical procedure involves the transfer of fat cells from one area of the body to the dorsum (back) of the hand. The fat is harvested by liposuction and can be done under sedation or under general anesthesia in conjunction with other surgery. The surgery can be done in 2 hours or less. It is an outpatient procedure and normal activity can be resumed by 7 days with some restrictions. The procedure is very safe with minimal complications and little post operative discomfort. I have performed this procedure on 45 year old and 75 year old women with equal efficacy. They are all pleased with their results.
Once the volume is adequately restored attention can be turned to the discoloration of the skin. Topical treatments of retinoic acid and hydroquinone can be very effective for mild to moderate hyperpigmentation. More severe hyperpigmentation generally requires either chemical peel or Intense Pulsed Light. Balancing the skin tone and thickening the dermis compliments the volume restoration yielding the ultimate aesthetic result.
Few people are aware of the surgical and nonsurgical interventions available to improve the appearance of the hand. In fact, the procedure was only described within the last 10 years and only a few plastic surgeons have a significant experience with it. The surgical procedure will restore fullness to the hand giving it a more youthful appearance. Topical lightening agents, chemical peel or IPL may be required to reverse the pigmentary changes of the skin. This procedure restores harmony between the face and hands. You can wear your jewelry again.
Depending on your unique findings one or a combination of all of the techniques described may be necessary. This will be determined by your board certified plastic surgeon.