How is hand rejuvenation performed, and what are my options?
Hand rejuvenation is typically an outpatient procedure. Whether you require volume replacement, correction of sun damage, or removal of lines and wrinkles, there are numerous treatment options to choose from. Most procedures are minimally invasive, but if you have very loose, wrinkled skin, your surgeon may also recommend surgery to remove excess skin. Your aesthetic plastic surgeon will recommend an approach tailored to your specific concerns and aesthetic goals.
Some hand rejuvenation procedures to consider are:
Volume Enhancement and Vein Reduction Treatments
If you have protruding bones, tendons, or veins, your surgeon may recommend one of the following treatments.
Fillers
Fillers, such as poly-L-lactic acid, hyaluronic acid, or calcium hydroxylapatite, add volume to your hands and fill in around protruding bones and veins (see fillers).
- The surgeon injects the filler into your hand at multiple locations.
- The filler is placed in layers at multiple levels to reshape and augment your hands.
Fat Injections
With fat injections, also known asfat transfer or autologous fat grafting, the surgeon re-injects your own natural fatty tissue into your hands to add volume, cover underlying vessels and tendons, and improve the quality of your skin over time (see fat transfer). It is important to note that you have poor circulation from vascular disease, diabetes, chemotherapy, HIV/AIDS, or smoking, you may not get as much of the graft volume to take as other patients.
- Your surgeon performs liposuction with suction tubes (cannulas) to remove fatty tissue from areas of your body with excess tissue, such as the abdomen, hips, back, or thighs.
- Your surgeon then processes the fat and re-injects it into your hands.
- The fat is grafted in layers at multiple levels to ensure that a smooth, linear deposit of fatty tissue is left to reshape and augment your hands.
- Your surgeon closes the liposuction incisions with sutures and places tape on the treated skin.
- You’ll need to keep your bandages on for three or four days as a protective barrier.
Sclerotherapy
Sclerotherapy treats noticeable or protruding veins.
- Sclerotherapy is effective for medium-sized blood vessels (greater than 3 mm in diameter).
- Your surgeon injects the sclerotherapy solution into your vein with a micro-needle.
- The vein turns white (blanches) and gradually disappears.
- There is little if any discomfort when undergoing treatment, and there is no downtime.
Spider Vein Treatment
Spider vein treatment (laser vein treatment) also addresses noticeable or protruding veins (see spider vein treatment).
- This treatment is effective for small to medium-sized blood vessels (1-3 mm in diameter).
- Your surgeon passes a handpiece over your skin, and your blood absorbs the laser light, causing the vessels to coagulate and be absorbed by the body.
- There is little downtime.
Wrinkle Repair and Discoloration Treatments
If you have fine lines, wrinkles, discoloration, sun damage, or irregular pigmentation, your surgeon may recommend one of the below treatments.
Superficial Chemical Peels (see chemical peels)
- Your surgeon applies a chemical solution to your hands with a sponge, cotton pad or swab, or brush.
- Your surgeon decides how long to leave the solution on your hands by carefully observing any changes in the appearance of your skin.
- With certain types of chemical peels, the solution may "neutralize" after an appropriate amount of time has elapsed.
- You will not need a covering or after-peel ointment afterwards, and you can expect little downtime.
Intense Pulsed Light (IPL) and Photodynamic Therapy (PDT) (see IPL photorejuvenation)
- You will cover your eyes for protection.
- Your surgeon will place the IPL handpiece directly over your treatment area, and the handpiece will emit light waves.
- After a series of treatments, the spots and discolorations on your hands will fade and ultimately disappear.
- PDT is a solution your surgeon will apply to your skin before using the IPL device, allowing for more aggressive treatment.
- Recovery from IPL is similar to recovering from a mild sunburn.
Laser skin resurfacing (see laser skin resurfacing)
- You will cover your eyes to protect your corneas and retinas from the laser.
- Your surgeon will pass a wand over your skin, and the resurfacing laser emits a very brief pulse of high-intensity light that damages the upper layers of your skin.
- As your skin heals, healthier, younger-looking tissue emerges.
Surgical Treatments
If you have very loose and wrinkled skin, you may need surgery to achieve your desired results.
Skin excision
Skin excision is a surgical procedure that removes loose, excess skin on the hands.
- You will either have general anesthesia or local anesthesia with sedation.
- Your surgeon will generally make an incision on the top of your hand by the wrist, remove loose skin, and suture your skin back together.
- You will likely experience some swelling and pain afterward, but you can easily manage the pain with medication.
Many of the above procedures require multiple treatments to achieve the best result. You should allow time between treatments to permit swelling and bruising to dissipate. Your board-certified aesthetic plastic surgeon will help guide you on the best treatments for you and the appropriate sequencing.