Hand Aesthetics

To add fullness beneath the skin, synthetic fillers (hyaluronic acid derivatives) can be applied to the back of the hand, and the person's own fat can also be used as a filler. In treatments performed with fat injections, the filling effect of the fat is used to replace the volume lost in the hand, and skin quality is also improved through the transfer of the stem cells within the fat tissue. To make this effect even more pronounced, the fat to be applied can be enriched with a stem cell cocktail also obtained from the person themselves. Similarly, subcutaneous connective tissue can be increased by applying cells called fibroblasts, which produce connective tissue in the body, after multiplying them in suitable environments (cells obtained from fibroblast culture). In addition, PRP solutions obtained from the person's blood can also be given to the patient, beneath the skin or mixed into the fat to be applied, to increase the regenerative capacity of the skin.

Throughout a person's life, the hands encounter many external factors, above all exposure to sunlight. As a result of all these effects, brown and red spots, also called age spots, form on the back of the hand at older ages. All these skin spots can be removed with chemical peeling using diluted acids or with abrasion (peeling the skin) using special sandpaper-like tips rotating at high speed. Thanks to developing technology, fractional carbon dioxide laser treatments allow both more controlled skin peeling and the stimulus needed for the subcutaneous connective tissue to renew itself. The optimal result is obtained after laser treatments applied in several sessions.

Hand rejuvenation procedures can be performed on all patients who have signs of ageing on their hands.

The changes that occur in the hands with age are as follows:

• Loss of subcutaneous tissue: Due to the loss of fat tissue beneath the skin, the skin on the back of the hand becomes loose and wrinkled, and the veins and bones become prominent.
• Thinning and wear of the skin: The skin dries, wrinkles and thins, becoming like parchment paper that can tear easily.
• Spots on the skin: Brown and red spots, also called age spots, form on the back of the hand. These form as a result of sun damage, and some of them carry a risk of turning into skin cancer.

Hand rejuvenation procedures can be grouped under three headings: replacing the fat tissue lost beneath the skin, improving skin quality and removing spots.

• Fat injections: Fat tissue taken from the body is put through certain processes, concentrated and given to the back of the hand. While the soft tissue loss is repaired with the injected fat tissue, the stem cells in the concentrated fat tissue enable the tissues to repair and renew themselves.
• Filler treatments: Instead of fat injection, a filler treatment, which is an easier procedure, may be preferred. Hyaluronic acid treatments are performed in an office setting and last longer than one year.
• Skin moisturising procedures: Pure hyaluronic acid injections (Hydrate) are given to moisturise from within and strengthen the skin that thins and dries over time. These treatments are performed 4 times at two-week intervals, and repeating them once a year is important for preserving the youthfulness of the hands.
• PRP treatments: Growth factors are extracted and purified from blood taken from the patient and injected beneath the skin. This procedure enables the tissues to renew themselves. PRP treatments can be performed alone or used together with fat and hyaluronic acid treatments.
• Micro-abrasion: Spots on the back of the hand are removed with the help of special tips rotating at high speed. This procedure, which is not very painful, is performed in office conditions using numbing creams.
• Chemical peeling: The back of the hand is peeled with diluted acids, and spots and fine wrinkles are removed.

Fat injections are performed in an operating theatre under local anaesthesia and sedation. All other procedures are performed in office conditions with local anaesthetics.

Fat injections take about 1 hour. Procedures performed in office conditions take half an hour.

Hand rejuvenation procedures are not painful and can be performed under local anaesthesia.

After fat injections, patients are sent home on the same day. There may be swelling and bruising for a few days. The patient can shower the next day. After filler, PRP and Hydrate treatments there may be mild swelling and bruising, but the patient's daily activities are not affected. After micro-abrasion there may be some redness and sometimes crusting. Patients need to use plenty of moisturiser and sunscreen after the procedures.

The fat injection and filler treatments performed may not provide sufficient fullness. In such cases, additional treatments may be needed.

The permanence of the results of hand rejuvenation procedures varies according to the method applied. The effect of most synthetic fillers applied to add volume is temporary. As the applied polymer dissolves in the body, the volume effect it provides is also lost. Similarly, the effect of PRP treatments is also temporary. The procedure needs to be repeated at intervals. Although some of the injected fat is lost after fat injection, the targeted fullness is generally achieved in a single session and the result is permanent. The stem cells given during fat injection also provide permanent renewal in the skin of the hand.