Old-looking hands? Consider a hand-lift

Curious about a person's age? Check out the hands.

"There's this old adage that you can always tell someone's age by their hands," said Dr. Brian Pinsky, a plastic surgeon and hand surgeon with Long Island Plastic Surgery Group. In addition to the age spots and sun damage that appear on the surface of the skin, he said, veins and tendons become more visible as fat under the skin begins to atrophy. Less elasticity in the skin adds to the more wrinkled, bony look.

Unless, of course, the person has had a hand-lift.

Just like with the face or breast or other parts of the body that no longer have the desired look or shape, the hands can be reshaped by cosmetic procedures known as hand rejuvenation or hand lifts (even though the procedure is not like a face-lift).

Because aging in the hands can make them look a bit hollow, "people are often unhappy with the appearance," Pinsky said. "They come in and say, 'I feel my hands are so veiny.' "

But there's another factor that explains why people worry about the appearance of their hands. "Aside from the face and neck, the hands are the only part of the body that are routinely left unclothed," said Dr. Jason Ganz, an assistant professor of plastic and reconstructive surgery and hand surgery at Stony Brook University Medical Center.

Although young people sometimes seek the hand procedures, Pinsky said that "many are in their 60s."

In many cases, laser treatment and skin peels can improve sun damage and changes in pigment. But it takes more to make hands look less skeletal.

INJECTABLE FILLERS . . .

"Hand-lift is perhaps a misnomer, as the technique of excising excess skin and tightening the skin envelope, as performed in a face-lift, has proved disappointing in the hand," Ganz said.

Instead, injectable fillers are used to plump up the hands so veins and tendons are less noticeable. The procedures, in which parts of the hand are injected with a mix of filler and anesthesia, are relatively painless and take 10 to 15 minutes per hand, Pinsky said.

"The only downside is that it's not permanent," he said. "The medication lasts on average about 12 months." After that time, the effect goes away and more injections are necessary to preserve the appearance. And, depending on the type of filler, results may be visible immediately or take some time to show up, and sometimes more injections are needed, Pinsky said.

Besides the hands being swollen, "you may be a little sore and bruised for 24 hours, maybe with bruising for two days, but nothing too considerable," he said.

. . . OR USING YOUR OWN FAT

Ganz said that "fillers which have been used successfully consist of hyaluronic acid, a component of cartilage, and hydroxyapatite, a component of bone." Anyone considering such injections should "ask about the safety and efficacy of any injectable filler that is proposed, and ask for proof of their safety and efficacy from scientific literature."

A more permanent solution is to inject fat from another part of your body into your hand.

"After the surgeon obtains a small amount of fat from liposuction, this fat is processed and then injected into the hand," Ganz said. "The procedure can be performed either under full anesthesia or using local anesthesia only."

Sometimes, multiple procedures are needed, and complications can include an odd-looking hand (the fat may settle in the wrong places) or an infection or bleeding, though that's rare, Ganz said. In severe cases, however, such problems could harm the function of the hand.

"Despite these risks, aesthetic hand surgery patients are most often extremely happy with their results," he said. "They can expect a change from a hand that appears wasted and skeletal to a hand that appears full and youthful."

Ganz strongly recommends that patients turn to a board-certified medical doctor for these procedures and that they not allow other staff members to make the injections. Besides plastic surgeons, dermatologists are also an option.

Injections with fillers can cost about $1,000 per hand, and fat injections generally cost several thousand dollars, Pinsky said.

Insurance rarely covers hand rejuvenation procedures because they're considered cosmetic.