Along with our faces, our hands are constantly on display. Not only are hands subjected to greater environmental pressures from chemical exposure, the sun's rays, exposure to heat and cold, and extra use—they are also one of the few parts of your body that people around you will see. This combination of factors is driving the 300-400% growth in demand for hand rejuvenation surgery in the US. This article examines the various procedures for hand rejuvenation.
As we age, subcutaneous tissue (tissue under the skin) begins to atrophy. This occurs in all skin areas, but is quite noticeable in the hands. As subcutaneous tissue diminishes, the skin becomes more translucent and the color of veins is more pronounced. Tendon anatomy is accentuated and wrinkles become more prevalent. Occasionally blemishes known as age spots start to appear. These changes combine to give an aged appearance to the hands.
The use of fillers is the obvious choice for hand rejuvenation. Of the various filler options, fat harvested from another place on the body, cleaned and purified, is a natural filler that is used to plump hands and approximate the subcutaneous tissue that is lost. Fat transfer can be done under local anesthetic, and requires minimal recovery time. While the 'filler' substance is natural, patients are cautioned that fat may eventually be reabsorbed by the body and the procedure will need to be repeated.
A potentially more permanent hand rejuvenation alternative to fat transfer is dermal fillers. The same dermal fillers that can be used to help fill out wrinkles on the face providing a more youthful appearance can also be used in hand rejuvenation surgery. Popular hand rejuvenation dermal filler solutions contain ingredients such as aqueous carrier gel and a synthetic material such as calcium hydroxylapatite. The ideal dermal filler substance must be fully compatible with the body, hypoallergenic, nonirritating, and nontoxic. Hand rejuvenation fillers are injected in the middle two metacarpal spaces (between your second and third, and third and fourth fingers). The bolus (or lump) of filler will then be manipulated digitally into a thin layer of filler, covering most of the top of the hand. Perhaps surprisingly, it generally takes less than an ounce of filler for each hand.
Like increased translucency and “thinning of the skin,” age spots are another obvious sign of aging in the hands; however, age spots are much easier to correct than a lack of subcutaneous fat. The same treatments that are used for uneven pigmentation can be applied to age spots on the hands. Chemical peels are the most commonly chosen option for their ease of application, price, and effectiveness. Phenol chemical peels are quite effective at removing age spots of the hands, but the choice of chemical peel will be based on the degree of pigmentation in the age spot, the person’s skin tone and skin thickness, and patient preference to a certain degree. Laser treatments, including intense pulsed light (IPL) can be more permanent than chemical peels, but laser hand rejuvenation treatments are usually more expensive and can be more painful than certain chemical peels.