Fat Grafting for Hands

Fat Grafting for Hands: Hand Rejuvenation Surgery in Delhi

When it comes to ageing, the face is what everyone is focused on. The hands say it all.

Loss of volume in the hands first appears around the age of 30 and increases by decade. When fat has been removed from beneath the skin of the back of the hand, the tendons become visible, the veins rise to the surface and the skin is no longer soft and smooth. That's topped with some sun pigmentation. This creates an impression of a hand that can be older than the one on the sides of her face, even in patients who have undergone facial procedures.

The root cause is directly targeted with fat grafting on hands. Only it is the treatment that does.

Why Fillers Are Not the Full Answer

The dermal fillers temporarily plump up the hands. They function and are acceptable for patients not desiring surgery. Limits include time (usually 12 to 18 months before the volume fades) and the cost of maintenance going forward.

Autologous fat grafting is performed using fat obtained from the patient's body fat from the abdomen, thighs or flanks. Any fat that remains post transfer is permanent and not a temporary substitute. A properly performed fat grafting technique also enhances the quality of skin on the hands over time since fat carries adipose-derived regenerative cells that promote the production of collagen and promote skin texture. This is not the way fillers work.

How the Procedure Works

• This is performed under local anesthetic but typically as a day case. It requires two locations; one for the donor site (the location from which the fat is harvested) and another for its injection on the dorsum of the hand.
• Harvest: A small cannula is inserted into the incision made at the donor site (3mm to 4mm). Gently sucking out fat. The decision on the donor site depends on the availability of sufficient amount of fat, which is mostly from the abdomen and inner thighs.
• Processing: This involves a decantation or centrifuge process to remove all the fluid, blood and debris and to purify the fat that is harvested and to remove any living fat cells. This is an important step that can make a big difference in the amount of fat that can be retained following transfer.
• Injection: Fat is injected into the back of the hand in very small amounts and evenly with a fine needle (cannula) inserted from the wrist, not the fingers. This injection is administered in an area above the deep fascial layer, which prevents damage to the vessels of the hand. The amount of fat injected varies from 10-30 mls per hand, which depends on the level of fat loss.
• There is some fat absorbed by the body within the weeks after the procedure. There is no fixed amount to be kept, patients vary, so skilled surgeons tend to inject a little more than they think they will need. The remaining fat is there forever.

What Improves After Fat Grafting to the Hands

As swelling is resolved in 2-3 months, patients notice the following four changes:

The dorsal fat pad returns and prominent tendons and veins are less noticeable. Skin quality is enhanced by the regenerate cells in the taken fat, which encourage new collagen. Hand becomes smoother and fuller in contour. It looks like it has been restored in bulk rather than any procedure has been done.

Typically one session is sufficient. If extra volume is desired in a particular area, a touch-up grafting can be carried out after 3 months.

Recovery

The initial discomfort is from the donor site, not the hand. The hand may swell; this is normal and will subside over the next few weeks. The majority of patients are able to return to light daily activity within 5–7 days. Patients are not allowed to drive or grip for 2 weeks. Swelling is diminished during the first 3 months, when the final outcome is discernible.

Consult Dr. Anup Dhir

Fat grafting is performed at Dr. Anup Dhir Medical Practice, Senior Consultant, Plastic & Cosmetic Surgery, Indraprastha Apollo Hospital New Delhi, with the techniques of fat grafting using ADRC enriched fat transfer to the hands. Based on an assessment at consultation, donor site suitability, likely fat retention and the best option for fat grafting or a combination approach will be determined.

• Call: +91 93123 77554
• Email: dranupdhir@hotmail.com
• Clinic: Image Medical Centre, 101 Ansal Tower, 38 Nehru Place, New Delhi
• Consultation fee: Rs. 2,000 (in person or online)

Medically reviewed by Dr. Anup Dhir, MBBS, MS, MCh (Plastic and Reconstructive Surgery), FECSM.