Hand Rejuvenation

Very commonly I will hear from patients how they believe they look and feel great but, as they say, “My hands give away my age.”

This is a complaint and concern of many patients and one that I understand and can very well see. It is also something that has many options to make it better, and I will help you with this issue.

Features typical to aging hands are several-fold and present to different degrees, all of which can be addressed. Most commonly patients do not like the wasted look of very visible tendons and veins. Also, there are concerns with age spots, pigmentation, loose skin, and prominent, thick veins. The anatomy that gives rise to the core of these features basically involves loss of subcutaneous fat and loose skin. I will coordinate the features of your anatomy with your expectations, formulate a plan with you, and guide you through this process. There are very specific techniques for addressing each one of these features that I will review with you. Surgery involves a light general anesthetic and is performed where I do surgery, which is in a hospital setting. The surgery is safe and predictable. There is a mild–to-moderate degree of swelling after surgery. All of the stitches are small and are removed in four to seven days. You can return to work in as little as two to three days and to some physical exercise in the second week. My practice of rejuvenation of the hands centers around the following different categories, not necessarily in this sequence:

• Topical: Skin treatments, peels, or laser to fade out pigment spots.
• Fat Grafting: This is the gold standard and the procedure that makes the biggest difference. It fills in the top of the hand from the wrist to the mid-fingers, and it is permanent. (Please review the section on Fat Grafting—Body for further details).
• Excess Skin Correction: The excess skin on the top of the hand can be taken up through some small incisions or by the skin-shrinking capacity of the Thermage machine, which Dr. Romano uses frequently for this purpose.
• Vein Removal: This is done by laser or injection into the veins to shrink and obliterate them.

The key to success in hand rejuvenation is to identify which anatomic features contribute to the aging look, decide which of the four possible interventions are needed and in what sequence, and have a plan for this evaluation. I spend a great deal of time with you discussing your anatomy, listening to your expectations, and interpreting for you what your anatomy and tissues will safely and predictably allow me to do. In addition I consider your body as a whole, and I build a system into all hand rejuvenation surgeries that, initially, allows you to recover much more quickly and, secondly, preserves your surgical results. This system includes a special diet, special attention to blood clotting, vitamins, supplements, special garments, skin products, physical training, and knowing what to avoid. Together all of this allows me to create results that are consistently very beautiful, quick to heal, and exceptionally natural. I use minimal incisions. I am delighted to surgically provide you with such profound yet natural body-image changes, ones that have so consistently pleased my patients and changed their lives.

You are invited to read Dr. Romano’s article on fat grafting FAQs in the Educational Articles section of the website.

You can also view video footage on hand rejuvenation—featuring Dr. Romano and produced by the Discovery Channel—in the Video section.