Hand plastic surgery

The lipofilling technique involves the use of autologous (taken directly from the patient) adipose tissue to correct aesthetic defects of the face and body, as well as limbs. Volumetric plastic surgery with fat grafts is aimed at replacing subcutaneous fat lost during involutional changes. Skin atrophy leads to aging, the signs of which are mitigated by adipocyte replenishment.

Hands are one of the body parts that become the first indicator of signs of aging and are most susceptible to wear and tear. Over time, under the layer of skin on your hands exposed to chemicals, various weather conditions and sunlight, soft tissue decreases, spots and freckles appear on the surface of the skin, and the skin becomes thinner. The beauty of the body is one whole, so hands, which are significantly ahead of our age in this aesthetic form, can again regain their lost shape. For hand plastic surgery, i.e. hand rejuvenation, in our Estetik International clinics solutions are created according to hand problems.

Preparation

At the stage of preparation for lipofilling of the hands, the doctor selects the most suitable recipient area for taking lipoaspirate. As a rule, preference is given to areas where there is a sufficient amount of adipose tissue - these are the abdominal area, the inner thigh and the “breeches” area, as well as the shoulders and upper back.

Biomaterial collection is carried out in the absence of contraindications. To assess the patient's health, blood tests (general, biochemical, blood group, Rh factor, coagulability and sexually transmitted infections - HIV, syphilis, hepatitis and others) and urine are taken. To monitor the functioning of the cardiovascular system, an ECG is prescribed. It is also necessary to do an X-ray or fluorography of the chest, and an ultrasound scan of the lower extremities.

Lipofilling for plastic surgery of hands

To eliminate possible problems that occur on the hands, we use the fat injection method. A certain amount of fat, taken from an area of the patient's body where local obesity occurs, is injected from the back of the arm after enrichment with stem cells. The back of the hand gains volume using all the benefits of stem cells, and the process of restoration and regeneration of soft tissue begins. Instead of the volume obtained as a result of the injection of fat, the surface of the skin is lightened, visible blood vessels fade into the background and, as a result, the skin is toned and refreshed. The hard, bone-hugging structure of the hands softens and instead of bonyness takes on a soft richness. Arm fat injection surgery is performed in our clinics under local anesthesia. The procedure itself lasts about thirty minutes and in just one session allows you to get impressive results. After this operation, some patients undergo a bandage, but despite this they can use their hands and return to social life within one day.

Carrying out the procedure

For preliminary tissue infiltration, Klein's solution is used (1 ml of anesthetic solution is calculated per 1 cm of adipose tissue). After this, the skin is cut with a scalpel. Fat is sucked out under negative pressure using special cannulas and subjected to centrifugation, during which blood, Klein's solution and other substrates are separated from the mass.

After cleansing, adipocytes in the required quantity are injected into the skin of the hands. An anesthetic is applied to relieve pain. The puncture sites are covered with plasters and an aseptic bandage is applied. The average duration of all surgeon's manipulations can reach 1.5-2 hours. The result of the operation can be assessed after 4-6 months, when the adipose tissue has finally taken root.

The effect of the procedure lasts for a long time, but it is important to note that the implanted autologous fat will subsequently undergo aging processes, so after a few years it may need to be reintroduced.

Sergei Nikolaevich Blokhin

comments on the features of the technique

Advantages of lipofilling for hand plastic surgery

• Irreversible surgery • Extremely positive results in every patient for severely aging hands • Fairly short-term operation that lasts half an hour • Used on the entire back of the hand from fingertips to wrist • Can be used immediately after hand surgery • Successful results in just one session • Painless surgery • Return to social life 1 day after surgery • Healing effect and cell renewal • Improved tissue quality • Moisturizing • Beneficial effect on freckles and spots on the face of the hands

Rehabilitation

The rehabilitation period after lipofilling of the hands proceeds much faster than after other, more large-scale surgical interventions. On the first day, there may be a feeling of fullness and slight pain in the injection area. In case of severe pain, the doctor will prescribe analgesics. To make the swelling go away faster, you need to avoid putting stress on your hands for at least a few days. It is also recommended to limit skin exposure to aggressive chemicals and temperature changes - do all housework only with gloves.

The use of filler in plastic surgery of the hands

To eliminate possible signs of aging on the hands and solve existing problems, filler materials containing hyaluronic acid can be used. Such fillers moisturize the hands from the inside, giving the shine and shape inherent to the hands in youth. Treatment sessions are carried out at a certain interval depending on the condition of the hands. The application of hand fillers is performed using topical anesthesia creams. The procedure lasts about half an hour and the hands undergo at least 2 sessions depending on the degree of damage. If you do not want to affect your daily life and intend to immediately return to your social life, then you may consider a procedure that involves the use of fillers.

Prices

Code	Procedure name	Cost, rub.
F35.06.03.0.002	Plastic surgery of subcutaneous fat tissue using the method of moving one’s own fat (lipofilling) (1 zone)	16500
F35.06.03.0.003	Plastic surgery of subcutaneous fat tissue by moving microparticles of one’s own fat (nanolipofilling) (10 ml)	19500
F35.06.03.0.004	Plastic surgery of subcutaneous fat tissue using the method of moving one’s own fat (lipofilling with the Body-Jet apparatus) (1 zone)	19500
F35.06.03.0.005	Plastic surgery of subcutaneous fat tissue using the method of moving one’s own fat (lipofilling) of the mammary glands	165000
F35.06.03.0.001	Plastic surgery of subcutaneous fat tissue using the method of moving one’s own fat (lipofilling) of the buttocks	198000

Lipofilling of the hands: removing all signs of aging

Already in our early 30s, and for some even earlier, our hands begin to rapidly lose their attractiveness: smoothness is replaced by wrinkles, and bulging veins appear on the surface. But plastic surgeons say: everything is fixable and it is quite possible to restore fading beauty.

Hand lipofilling is a rejuvenating plastic surgery that involves transplanting the patient’s own fat. With its help, you can replenish the volume in the area from the wrist to the first knuckles and thereby smooth the surface of the skin. How effective is this technique and how painful is the process itself? Is general anesthesia necessary? Are there any contraindications, what complications and side effects may there be? TecRussia.ru gives the most detailed answers:

↑ When should you see a surgeon? Main indications

The appearance of our hands depends not only on the condition of the skin and nails, but also on the amount of fatty tissue, which makes the surface of the hand smooth and even. With age, its volume rapidly decreases, which leads to unpleasant changes:

folds/wrinkles are visualized on the outer part of the hand: this is the first bell indicating that the aging process is in full swing;
the contours of large vessels, tendons and joints become not only distinguishable to the touch, but also clearly visible upon visual inspection (a capacious term has even appeared to denote this condition - skeletonization).

In these cases, the lack of fat cells can be compensated by transplanting them from another area of the body, for example from the abdomen or knees. Plastic surgeons claim that the earlier the procedure is performed, the higher the effectiveness of lipofilling. If at 30-35 years old good results can be expected after the first session, then at 50 and older the manipulation will need to be repeated 2-3 times.

Important: this operation restores volume, but does not improve skin quality. With its help, it is impossible to remove pigment spots and restore a healthy color - shallow peels - laser or mechanical - are much better suited for these purposes.

↑ Features of working with brushes

Even with significant age-related changes in this area, the situation can be corrected with the help of ~5-20 ml of fat. This is quite a bit even for women with a fragile, thin build, who may simply not have the required number of cells for other, more voluminous corrections (for comparison, with lipofilling of the buttocks, from 500 to 2500 ml are transplanted).
It is advisable to combine the operation with liposuction or liposculpture of other parts of the body. Also, due to its low morbidity, it can be performed simultaneously with almost any other plastic surgery.

The only alternative to lipofilling of the hands is injections of dense fillers based on hyaluronic acid, or even more “long-lasting” drugs, such as Radiesse. This is a much simpler procedure, performed in a beauty salon, but at a comparable cost, its result does not last long, about 1 year.
If the main problem is not volume loss, but initially large protruding veins, they can be corrected by a phlebologist using sclerotherapy or endovenous laser obliteration (EVLO).

↑ How the operation is performed

Fat transfer to the hand area is a relatively simple and low-traumatic, but still full-fledged surgical intervention. Therefore, the preparation for it is appropriate. The patient must be examined by a plastic surgeon, and if over 40 years old, also by a therapist. Next, blood tests (general, biochemical studies, coagulogram) and urine tests are prescribed; in some cases, an ECG is indispensable. Since general anesthesia is not used, a separate consultation with an anesthesiologist is not necessary. However, an allergic history must be collected: the doctor finds out whether the patient has had intolerance reactions, to which drugs, and how he relieved the attacks.

If there are no contraindications, the date and time of the operation will be determined. It is done as follows:

Stage	What's happening?
Adipose tissue harvesting	The pre-specified donor area - usually the abdomen or thighs - is numbed with a local anesthetic. When the product takes effect, a cannula is inserted into the subcutaneous tissue and the required amount of fat is sucked out.
Adipocyte purification	The resulting biomaterial is separated from excess impurities: damaged cells, blood elements and connective tissue, and is also specially processed to obtain the most uniform consistency without large lumps.
Transplantation	An anesthetic is applied to the hands, and then prepared lipid tissue is injected into them using a syringe or thin cannula. For the most natural and lasting effect, adipocytes are placed in several dermal layers at different depths.

The whole process from start to finish takes about 1.5-2 hours. Then the patient’s hands are once again treated with an antiseptic, and the punctures are covered with sterile plasters or an aseptic bandage is applied to the hands.

Photos before and 9 months after lipofilling (patient 41 years old):

↑ What to expect during rehabilitation?

The recovery period is much easier than after other plastic surgeries; there are also noticeably fewer restrictions:

On the first day, almost all patients note a feeling of fullness and throbbing pain of varying intensity in the areas of fat tissue injection. The discomfort goes away within a few days; if at first it is difficult to bear, it is possible to use analgesics.
In addition, the injections will cause your hands to swell a little. To reduce fluid stagnation, you will need to keep your hands in a horizontal or elevated position, and completely eliminate the load on them (at least for 1-2 days).
In the future, for 7-10 days, you should not expose your hands to high and low temperatures, chemicals (wash dishes only with gloves), aggressive cosmetic products, and refrain from physical activity.
The hands do not require any other specific care (including wearing compression bandages) after lipomodeling.

↑ How long does the result last and do I need to repeat the procedure?

How successful the lipofilling was can be assessed no earlier than in 4 months, when the adipose tissue is finally distributed throughout the hand, and it also becomes clear what part of the transplanted cells have taken root in the new location.

Hand skin rejuvenation - alternative ways to solve aesthetic problems
Learn more about what lipofilling is and what other areas of the body it is performed on

The resulting effect lasts forever. But this does not mean that in the future the hands will not change in appearance - the aging process, unfortunately, will continue. To compensate for them, after a few years a new transplant may be needed; technically and in cost, it is usually no different from the original one.

Comparative result - as part of the experiment, the patient only had one hand treated:

↑ Contraindications, possible complications and side effects

Transplantation of adipose tissue into the hands is not performed in the following cases:

disorders of the blood coagulation system;
the presence of a tumor process of any localization;
inflammation or rash in the area of future manipulations;
chronic pathologies in the stage of decompensation or exacerbation;
mental disorders;
diabetes;
the presence of varicose veins on the hands;
deep atherosclerotic changes in the vessels of the upper extremities.

Due to the low invasiveness of this type of lipofilling, adverse consequences are extremely rare. They are mainly associated with damage to the donor area during fat collection or to the recipient area during transplantation. It can be:

Infection, hematomas, swelling and other complications of surgical liposuction - except for those that are typical for particularly large-scale operations (i.e., when transplanting several ml of fat, you should not be afraid of thrombosis or pulmonary embolism).
Prolonged swelling of the hands - the problem can persist for up to 2 months, depending on the individual characteristics of the patient’s body, but in the end everything returns to normal. An additional risk factor is transplanting an excessively large amount of fat (in the expectation that not all cells will take root in the new location).
Mass death of transplanted adipocytes with the development of necrosis and purulent complications. As a rule, a consequence of poor-quality cleansing of the transplant. Symptoms: swelling and redness of the hands, their pain, as well as local and/or general increase in temperature. Requires immediate medical attention; depending on the severity, it is treated either with an intensive course of antibiotics or surgery.
If fat is incorrectly distributed over the area of the arms, their asymmetry, lumpiness, and other shape distortions are possible. Depending on the specific situation, the problem is solved either by spot liposuction of excess cells, or by transplanting a small (1-2 ml) amount of additional cells.

↑ How much does it cost?

Lipofilling – prices in Moscow (RUB):
Minimum, for 1 zone	10,000 rub. (Dr. Surovykh Svetlana Viktorovna)
Maximum, for a complex procedure	450,000 rub. (Dr. Tumakov Gleb Igorevich)
Average for all surgeons	63.052
* all prices listed are synchronized with the TecRussia.ru price list database and are current as of the current date.

Experts' opinions:

Golovanev Pavel Sergeevich Plastic surgeon, MontBlanc clinic

Hands are a serious indicator of age, so complaints about lack of volume in this area are quite common. The operation allows you to achieve an expressive effect: wrinkles and skin folds are smoothed out, prominent veins and tendons are hidden, and the overall proportionality of the limbs is restored.

The adipose tissue obtained using all modern sampling techniques is perfectly tolerated and takes root in the hand area due to the high quality of the resulting lipoaspirate. The body’s own cells are not rejected, the risk of developing infectious complications is reduced, the skin is practically not damaged and no traces of manipulation remain.

The main condition for lipofilling is sufficient body weight and volume of fat to be removed from the patient. We must not forget that up to 30% of the biomaterial is excreted by the body in the first months after transplantation, so the need for repeated correction is assumed. However, the remaining volume lasts much longer than when using fillers. It is also impossible not to note a significant improvement in the quality and texture of the skin of the hands in the early stages after surgery.

Firsov Andrey Valentinovich Plastic surgeon, Beauty Doctor clinic

The procedure is quite in demand, the majority of patients who apply for it are women over 45-50 years old, when after menopause a redistribution of fatty tissue occurs and the “old woman’s hands” effect appears. In addition to restoring the natural volume of tissue, after lipofilling there is an improvement in skin turgor and elasticity. The relative disadvantage is that it is often impossible to introduce the required volume of adipose tissue in one session, and with excessive or incorrect injection there is a risk of the appearance of unevenness and areas of fibrosis. However, it is lipofilling that provides the best effect of rejuvenation and replenishment of the volume of the hands; today there is no worthy alternative to this technique.

Anesthesia

Lipofilling is a full-fledged operation that is associated with operational and postoperative risks. The type of anesthesia is determined by the anesthesiologist during a personal consultation with the patient, taking into account the volume of adipose tissue that needs to be transplanted into the correction area. Lipofilling of the lips, cheekbones, chin or cheeks is in most cases performed under local anesthesia. If the patient requires correction of the entire face or hands, then intravenous sedation is used. For more extensive interventions (lipofilling of the breasts, buttocks, thighs, legs, abdomen), where a preliminary liposuction procedure is required, complex anesthesia is used (inhalation + intravenous anesthesia or intravenous sedation + epidural anesthesia). Thanks to such anesthesia, it is possible to achieve complete muscle relaxation and minimize complications from anesthesia for the patient.

Stages of the procedure

The procedure is carried out according to a medical protocol, which includes 3 main stages: sampling, cleaning and injection of adipose tissue.

The doctor manually removes fat cells from the donor area through a thin cannula.
The resulting adipose tissue is processed and purified using special solutions. For the procedure, only purified, intact fat cells with high viability are used.
The material is introduced into the back of the hand through a minicannula with a diameter of about 2 mm. The doctor simulates the result by linearly distributing the adipose tissue in small portions.

Execution technology

The Medial Clinic has developed its own method for collecting adipose tissue and preparing it for transplantation. Purification technology allows you to preserve more fat cells and increase their survival rate. Donor zones are problem areas. In these areas, adipose tissue has a good blood supply, and its functioning is less dependent on hormonal levels. The fine consistency allows more fat cells to remain intact during the harvesting and transplantation process. The duration of the procedure is about 1 hour.

Contraindications for surgery

Contraindications for lipofilling are standard. However, there are also specific restrictions that will not allow a plastic surgeon to perform fat transplantation:

Facial lipofilling cannot be performed until the fillers are absorbed;
Breast augmentation with your own fat tissue is prohibited for patients who have a genetic predisposition to breast cancer or suffer from cancer;
It is prohibited to transplant fat into the breast if the patient suffers from fibrocystic mastopathy and has cysts whose size exceeds 1 cm;
lipofilling of the legs cannot be performed on patients who have severe varicose veins and are diagnosed with lymphostasis.

Indications

The lipomodeling procedure for the hands is recommended for the following age-related changes:

Wrinkles are the main indication for lipofilling. Skin folds appear on the hands, and the contours of blood vessels and tendons become more noticeable.
Thinning skin - the tissue's ability to retain moisture decreases, cell renewal occurs too slowly.
The appearance of age spots - melanin synthesis is disrupted, without medical intervention the situation gets worse.

The surgeon at the selected clinic will help you determine exactly the need for surgery.

Breast lipofilling

The statistics of breast augmentation using lipofilling number thousands of cases. Breast lipofilling has become an independent method.

It has a number of advantages over using implants:

♦ There are no problems associated with the placement of a foreign body into the body (rejection, capsular contracture, etc.). The implant can be felt, and its folds under certain conditions can be visible through the skin. This is not typical for natural fat that has taken root ♦ There are no incisions, no postoperative scars on the skin ♦ There is no problem of displacement or rotation of the implant ♦ In addition to an increase in breast volume, the patient receives a decrease in volume in the places where the fat is taken from

Of course, to noticeably enlarge your breasts, you need a fairly large amount of fat - 300-400 ml. The patient does not always have sufficient fat deposits for this. Moreover, as a rule, breast augmentation is performed on thin women who have difficulty finding excess fat for grafting. But, at the same time, there is a muscular body type, which is also called “heavy bottom - light top”: thin shoulders and torso, small breasts, but voluminous stomach, buttocks and thighs. For such patients, breast lipofilling is an ideal option, especially in cases where they do not want a strong increase in volume, but want a natural result with a minimum of scars. The operation is performed under anesthesia. The duration of the postoperative period is about two weeks, swelling and slight pain can persist for up to a month. But severe pain, such as, for example, after a significant breast augmentation with silicone implants placed under the pectoralis major muscle, does not occur after lipofilling. You will need to wear compression garments for a month after surgery.

In addition to breast augmentation with fat alone, lipofilling is an excellent method for improving the results of breast augmentation with implants. Using fat transfer, we increase the thickness of the covering tissue in those places where the implant can be felt or visible.

Myths about lipofilling

1. All this fat is absorbed This is not true. Indeed, some part of the displaced fat undergoes resorption, that is, it is absorbed by the body. But a significant proportion of fat (70-80%) takes root in a new place and continues to live its own life, maintaining its properties characteristic of the fat of the area of the body from which it was taken by the surgeon. What does fat engraftment depend on? From the ratio of the amount of transferred fat and the amount of adipose tissue in the area of the body whose volume we want to increase. That is, there is no need to be greedy and transplant too much - the excess fat will really resolve. I compare this to the arrival of guests - if ten people come to a small apartment, this is impossible. If a couple of guests come to a big house, it’s a joy.

2. After lipofilling, there may be lumps of tissue and uneven surface of the skin. This is not true. There are a number of technical features of the operation that make it possible to completely eliminate such problems. We use lipofilling to increase the volume of tissue to correct the shape of the breast, eliminate age-related changes in the hands and face, and correct the shape of the legs and buttocks.

Rehabilitation period:

On the day of the procedure, an antibacterial surgical tape will be applied to the filler injection sites, and you can return home immediately afterward.
Within 8-10 hours, some patients feel a slight throbbing pain in the hands - it goes away on its own as the tissues recover. The slight swelling completely subsides within 2-3 days.
For 2-3 weeks, it is advisable to avoid exposure to high temperatures (hot baths, saunas) - this impairs the survival of fat cells. The first results can be assessed after 30 days.