Dr. Bunkis will be regularly featured in this Cosmetic Surgery, Ask the Doctor Q&A column. We invite you to call Dr. Bunkis at 949-888-9700, or email your questions to [email protected] . Enjoy!
I’m 46 y old; I have been a sun worshiper until recently. I now take care of my skin real well and I manage to keep a healthy looking face. The only area that really shows my age is my hand. I have very skinny hands that show my veins and some brown spots as well. Is there anything I can do to improve the appearance of my hands? Linda D. Newport Beach, CA
Hand rejuvenation is becoming a very interesting topic that draws attention nationwide. The hand is an important tool that we use to interact with the society but it has long been ignored by aesthetic surgeons. This trend has now changed and we can offer our patients some options. There are two main problems that we can address with regards to aging of the hands:
- Thinning of the skin with increased visibility of the veins: The best way to improve this situation is by filler injections. Radiesse is a commercial filler that can be used for this purpose. Radiesse is the first and only filler FDA approved for hand rejuvenation. A minimum of two syringes would be necessary and the improvement lasts 6-9 months. Another option is microfat grafting. With this technique, I harvest your own fat, which is handled very gently to maintain the viability of the fat cells, and transfers it beneath the skin of the hands. The fat globules add volume into thin hand, camouflage the veins and restore the hand volume to a younger looking texture and feel. The most frequent question regarding this technique is “How long will the improvement last with fat grafting?” This is difficult to answer because longevity varies from person to person (lasts longer in heavier patients who are not burning fat as well, shorter periods of time in thin people who exercise and diet. In order for the fat grafts to survive, the individual small clumps of fat must have a blood vessel that attaches to a vessel in the recipient site – if this happens, the fat will continue to live forever, but if adequate blood supply is not available, the grafts will atrophy and disappear within a six to nine months. Fat grafting is our preferred method of hand rejuvenation if the patient is already asleep for surgery elsewhere in the body but if you do not have other surgery planned, the Radiesse is a better option.
- Brown spots (hyperpigmentation). IPL or chemical peel can lighten these spots. Multiple sessions are usually required to accomplish this goal. It is also necessary to protect the hands with sun blocks whenever you are outdoors; otherwise the damage will just continue occurring.
(Actual patient of Dr. Bunkis) 60 year old female, before and a year after a single treatment with microfat grafting.
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