Fat grafting into the hands is a great way to rejuvenate the way your hands look in the aging hand.  When you age you tend to lose the thickness of the skin and also the fat tissue within your hands. This eventually exposes the veins and the tendons in your hands.  Many people feel, surgeons and lay people, that the face and the hands are the easiest way to figure out how old a person is.  The options for rejuvenating the hands include fat injections, temporary fillers or other grafts including alloderm, whole fat grafts, special skin grafts, radiesse, restylane, sculptra, etc.  Using implants that are not part of the body can cause problems and sometimes can have an unnatural feel.  Fat grafting is a great option to rejuvenate the aging hands while using your own tissue.  When you come in we try to determine what you are looking for when it comes to rejuvenating your hands.  We then discuss some pictures of hands to get an idea where you would like to be.  Then we discuss where we will place the fat in your hands.  At this point we can determine if we want the fat just between your tendons or also around your knuckle area to disguise these better.  We also discuss where we will take the fat from.  We harvest fat from almost anywhere in your body, including the abdominal area, the hips, butt, flanks, back, inner and outer legs and arms depending on your desires.  This is the same process that we go through when we discuss fat grafting in your facial area.  We also discuss what kind of anesthesia you would like including 1. just local anesthesia, 2. oral sedation with local anethesia, 3. iv sedation with our registered nurse with local anesthesia, and 4. more heavy iv sedation with our certified registered nurse anesthetist.    The process of fat harvesting and implantation I use is termed “Serial Timed Fat Harvesting and Transfer”.  This is a technique that I developed to maximize fat survival incorporating the latest techniques that are found across the world.  I harvest the fat with small cannulas through a very small puncture/incision under low pressure.  Then the fat is then spun in a centrifuge at the lowest speed and for 3-5 minutes.  This separates the fat into 3 layers.  The fat is then refined removing the top and bottom layers which are lysed fat cells in the top and liquid and anesthesia in the bottom layer.  The middle layer which is the most important layer of fat cells is preserved and used for fat transferring.    We then inject the fat through tiny puncture holes that heal like mosquito bites and this is done in a careful layering process to insure survival (Figure 1).  Our “Serial Timed Fat Harvesting and Transfer” is our secret which we have found has markedly increased the survival of our fat and we employ this with our fat grafting to the hands and the YoungLift for the Face.  For each hand we typically harvest 60-80 cc or milliliters and then inject approximately 10-30cc into each hand with the average being around 20 cc. One US Teaspoon is approximately 5 cc’s or milliliters. You can see a video of this on our YouTube account. When you go to our website www.drphilipyoung.com you can click the YouTube icon and it will bring you to all of our videos. Or you can use this link: http://www.youtube.com/watch?v=_Pgs7XGiWWs.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Figure 1