Hand rejuvenation using autologous fat

When you are introduced to someone the first body part you engage with is the hands when you shake them.
One of the most common attributes of ageing is that we lose volume - be that in the face, breasts, buttocks or hands.  Volume loss can make us look gaunt, and many people try maintain a certain weight to keep at a particular BMI.  Unfortunately as we get older we have little control over the fat loss - lipoatrophy.
Most patients in tune with trying to keep younger looks concentrate on their face, neck and decolletage.  Hands are often neglected and not seen as vital in maintaining.
We have started using lipo-filling or autologous fat transfer as a rejuvenation technique for the hands.
Most candidates have some fat they can donate for this purpose.  The most common are we harvest from is the thighs, as we can harvest fat without leaving any visible asymmetry or disproportion.  Alternative areas are - abdomen or flanks.
This procedure can obviously also be combined with larger liposuction techniques and added onto the end of the procedure.

On its own the procedure is performed under local anesthetic  and takes approximately 1 hour.  I tend to overfill the hands as some volume is lost over the first few weeks.
Recovery is very straight forward with only minor swelling of the hands.  The harvest sites again remain swollen for 1-2 days and occasionally minor bruising does occur.

Click here for a recent article in the Daily Mail on fat transfer case I performed.

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Update on MLD and foam inserts, compression garments after Lipo or VASER

Our experience in postop care has improved tremendously in the last few years.  I suppose with the vast number of patients we are treating (I'm treating on average 9-12 patients a week) we come across all types of torsos and body types.  This helps us understand many different types of healing and recovery times.
As all patients are different in terms of how rapidly they heal and can return to normal activity, we can give most patients an accurate idea of what to expect.

Our instructions on postop garment wearing has not changed much.  Furthermore, the MLD routine has also not changed much.  I think the awareness of MLD in the post lipo patient aftercare has become much more commonplace, although I still get the odd patient that comes to see me for advice after being treated elsewhere.  This is usually in connection with what to do about lumpiness.

Abdo insert

I have also started using foam inserts or vests which create a  more even spread of pressure and compression.  These pieces of foam are inserted between the garment and the skin (available from Macom-medical).  They fill the negative spaces which are often not filled be the compression garment.  Also, they tend to force upright posture which will prevent skin creasing which is an occasional concern in patients that have fluctuated in weight and have some skin laxity.  See abdominal insert (top) and flank insert (lower).  For any form of definition I create it is vital to use the full abdo insert vest which contours the negative and positive spaces.

Flank insert

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