I guess if we were looking in a mirror hanging on the wall how our face projects may be a tell tale sign of how old we are but one thing may be more telling of our age than our face….our hands. There seems to be an increase in patients awareness of their hands and how they look. After all, like our face, they are in plain view of everyone, everywhere all the time. Hands age quickly – the skin on our hands is thin (2 mm). And as we age it loses about 3% of its thickness every year from age 40 on. As we lose volume our hands look thin. We get brown hyperpigmented spots. As the volume leaves our hands look skeletonized. Our bones, our tendons show more.
To increase volume in the hands I prefer to use a patient’s own fat. We harvest the fat with a little liposuction, then mark out the veins on the hand and then with a blunt cannula I will inject fat into the space between the veins to “augment” the soft tissues. Not all of the fat will survive but what fat does survive is yours. A second session may be needed. Usually I will do this in conjunction with another procedure so the patient is already sedated. To treat the skin one could us a good skin care program such as Obagi. Also doing a series of TCA (trichloroacetic acid) peels may help with the dark hyperpigmented spots. A technique I think will work well is to do microneedling with PRP (platelet rich plasma). This involves drawing about 10 cc of a patient’s own blood, spinning it down to get about 7 cc’s or so of PRP. This contains multiple polypeptide nutrients. We put the PRP on the hands and then do a microneedling technique to induce the formation of new collagen. Usually 3 or 4 sessions will be required.
So sometimes it is not always in the face…our hands too can show our age.