Hi Dr Kelly:

I had a facelift and I love the result but now my hands give away my age. Is there anything you can do to make my hands match my beautiful face?

That is a great observation and since I do a lot of facelifts, it is a question I hear often.

Hands age just like the rest of the body and they age in a similar fashion to the face. Just like the face, they lose volume with time. The skin becomes thinner and the fat layer between the skin and tendons shrinks.

As this process occurs, the tendons become more visible with actual depressions between each tendon. This loss of fat also causes the veins to become more visible as well.

Youthful hands are full and the veins are minimally visible. Aged hands are thin with prominent tendons and veins. Cosmetic rejuvenation of the hands requires the restoration of volume. This can be done with either fat or synthetic fillers.

Fat is the best filler as it is what is being lost. In surgery, fat is harvested from another part of the body (such as the abdomen) with liposuction. The fat is centrifuged and the blood and serum is removed.

Then it can be reinjected into the hand as a graft via a single small incision at the wrist. The fat lives happily in its new home and this produces a lasting result of many years.

Alternatively, synthetic fillers such as Radiesse can be injected into the hand to restore volume. This can be done without the need to go to surgery and the result looks natural. The synthetic fillers gradually dissolve so the improvement typically last about 18 months.

To summarize, fat lasts longer, but is a more involved procedure. Radiesse doesn’t last as long, but is much simpler to inject. Finally, to complete the procedure, peels and and/or laser treatments can help improve the color and texture of the skin itself.

When all of these techniques are combined, it is possible to really rejuvenate the hands, just like the face. Once your face looks great after surgery, don’t let your hands give away your secret.

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