Abstract
Background
Hand rejuvenation is an increasingly popular cosmetic procedure for hand atrophy and aging. The objective of this study is to systematically evaluate the techniques, outcomes, and complications of surgical hand rejuvenation.
Methods
A systematic review was undertaken using a computerized search. Publication descriptors, methodological details, techniques, outcomes, and complications were extracted. Articles were assessed using the MINORS and Cochrane instruments.
Results
Thirty-one studies were included. Most studies were published in the last five years (51.6 percent) and were prospective case series (35.5 percent). The mean age of patients was 56 (range 21–82), while the mean sample size was 47 (range 10–220). The most commonly examined interventions were Radiesse (32.2 percent) and fat grafting (32.2 percent). Major complications were not observed in any study, while minor complications such as edema and pain were temporary. Injection techniques varied, however, the proximal to distal fanning technique and using a cannula was associated with a lower risk of complications. Both Radiesse and fat grafting had robust long-term esthetic outcomes.
Conclusions
Hand rejuvenation is a safe and efficacious surgical intervention to reduce dorsal hand atrophy. Further studies are needed to compare the long-term outcomes of common interventions.
Level of Evidence III
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References
Sadick NS, Anderson D, Werschler WP (2008) Addressing volume loss in hand rejuvenation: a report of clinical experience. J Cosmet Laser Ther 10(4):237–241
Fathi R, Cohen JL (2016) Challenges, considerations, and strategies in hand rejuvenation. J Drugs Dermatol 15(7):809–815
Branchet MC, Boisnic S, Frances C, Robert AM (1990) Skin thickness changes in normal aging skin. Gerontol 36(1):28–35
Butterwick KJ (2005) Rejuvenation of the aging hand. Dermatol Clin 23(3):515–527
American Society of Plastic Surgeons. Appearance of hands can reveal your age, study finds. ScienceDaily. www.sciencedaily.com/releases/2006/06/060605115838.htm
Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 151(4):W65–W94
Nguyen A, Mahabir R (2011) An update on the level of evidence for plastic surgery research published in plastic and reconstructive surgery. Plast Reconstr Surg Glob Open 4(7):798
Slim K, Nini E, Forestier D et al (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73:712–716
Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savović J, Schulz KF, Weeks L, Sterne JA (2011) The cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928
Agostini T, Perello R (2015) Lipomodeling: an innovative approach to global volumetric rejuvenation of the hand. Aest Surg J 35(6):708–714
Azzam EZ, Elmidany WM, Zidan AA (2020) Micro-autologous fat transplantation (MAFT) for dorsal hand rejuvenation. Egypt J Plast Surg 43(3):517–525
Brandt FS, Cazzaniga A, Strangman N, Coleman J, Axford-Gatley R (2012) Long-term effectiveness and safety of small gel particle hyaluronic acid for hand rejuvenation. Dermatol Surg 38(7):1128–1135
Busso M, Applebaum D (2007) Hand augmentation with radiesse® (calcium hydroxylapatite). Dermatol Ther 20(6):385–387
Busso M, Moers-Carpu MA, Storck R, Ogilvie P, Ogilvie A (2010) Multicenter, randomized trial assessing the effectiveness and safety of calcium hydroxyapatite for hand rejuvenation. Dermatol Surg 36:790–797
Conlon CJ, Abu-Ghname A, Davis MJ, Ali K, Winocour SJ, Eisemann ML, Winocour J. Fat Grafting for Hand Rejuvenation. In: Seminars in plastic surgery 2020 Feb (Vol. 34, No. 01, pp. 047-052). Thieme Medical Publishers
De Padova MP, Bellavista S, Iorizzo M, Tosti A (2006) A new option for hand rejuvenation. Pract Dermatol 8:12–15
Edelson KL (2009) Hand recontouring with calcium hydroxylapatite (Radiesse)®. J Cosmo Dermatol 8(1):44–51
El Kahky H, Diab H, Helal HA (2017) Half-side comparison between adipose tissue stem cell-enriched fat versus standard fat injection for hand rejuvenation. J Egypt Women Dermatol Soc 14(1):25–30
Fantozzi F (2017) Hand rejuvenation with fat grafting: a 12-year single-surgeon experience. Eur J Plast Surg 40(5):457–464
Frank K, Koban K, Targosinski S, Erlbacher K, Schenck TL, Casabona G, Braz AV, Pavicic T, Cotofana S (2018) The anatomy behind adverse events in hand volumizing procedures: retrospective evaluations of 11 years of experience. Plast Recon Surg 141(5):650e-e662
Gargasz SS, Carbone MC (2010) Hand rejuvenation using radiesse. Plast Recon Surg 125(6):259e-e260
Goldman MP, Moradi A, Gold MH, Friedmann DP, Alizadeh K, Adelglass JM, Katz BE (2018) Calcium hydroxylapatite dermal filler for treatment of dorsal hand volume loss: results from a 12-month, multicenter, randomized, blinded trial. Dermatol Surg 44(1):75–83
Graivier MH, Lorenc ZP, Bass LM, Fitzgerald R, Goldberg DJ (2018) Calcium hydroxyapatite (CaHA) indication for hand rejuvenation. Aest Surg J 38(1):S24–S28
Hoang D, Orgel MI, Kulber DA (2016) Hand rejuvenation: a comprehensive review of fat grafting. J Hand Surg 41(5):639–644
Inglefield C (2009) Nonsurgical hand rejuvenation with Dermicol-P35 30G. Aest Surg J 29(3):S19-21
Khosravani N, Weber L, Patel R, Patel A (2019) The 5-step filler hand rejuvenation: filling with hyaluronic acid. Plast Recon Surg Global Open 7(1):e2073
Kühne U, Imhof M (2012) Treatment of the ageing hand with dermal fillers. J Cuta Aest Surg 5(3):163
Leclere FM, Vögelin E, Mordon S, Alcolea J, Urdiales F, Unglaub F, Trelles M (2012) Nonanimal stabilized hyaluronic acid for tissue augmentation of the dorsal hands: a prospective study on 38 patients. Aest Plast Surg 36(6):1367–1375
Lowe NJ, Ghanem AM (2020) Volume restoration of hands with polycaprolactone by cannula delivery; a prospective single center consecutive case series evaluation. J Cosmo Laser Ther 22(2):55–59
Man J, Rao J, Goldman M (2008) A double-blind, comparative study of nonanimal-stabilized hyaluronic acid versus human collagen for tissue augmentation of the dorsal hands. Dermatol Surg 34(8):1026–1031
Moradi A, Allen S, Bank D, Marmur E, Fagien S, Glaser DA, Maguire C, Cohen JL (2019) A prospective, multicenter, randomized, evaluator-blinded, split-hand study to evaluate the effectiveness and safety of large-gel-particle hyaluronic acid with lidocaine for the correction of volume deficits in the dorsal hand. Plast Recon Surg 144(4):586
Redaelli A (2006) Cosmetic use of polylactic acid for hand rejuvenation: report on 27 patients. J Cosmo Dermatol Surg 5(3):233–238
Rivkin AZ (2016) Volume correction in the aging hand: role of dermal fillers. Clin Cosmo Invest Dermatol 9:225
Sattler G, Walker T, Buxmeyer B, Biwer B (2014) Efficacy of calcium hydroxylapatite filler versus hyaluronic acid filler in hand augmentation. Aktuelle Dermatologie 40(11):445–451
Sterodimas A, Boriani F, Nicaretta B, Pereira LH (2018) Hand rejuvenation by stromal enriched lipograft. J Plast Recon Aesth Surg 71(10):1507–1517
Teimourian B, Adham MN (2000) Rejuvenation of the hand: fat injection combined with TCA peel. Aest Surg J 20(1):70–71
Tremaine AM, Friedmann DP, Goldman MP (2014) Foam sclerotherapy for reticular veins of the dorsal hands: a retrospective review. Dermatol Surg 40(8):892–898
Wu DC, Goldman MP (2018) Randomized, double-blinded, sham-controlled, split-hand trial evaluating the safety and efficacy of triamcinolone acetate injection after calcium hydroxylapatite volume restoration of the dorsal hand. Dermatol Surg 44(4):534–541
Yun-Nan L, Shu-Hung H, Tsung-Ying L, Chih-Kang C, Yu-Hao H, Hidenobu T, Chung-Sheng L, Sin-Daw L, Tsai-Ming L (2018) Micro-autologous fat transplantation for rejuvenation of the dorsal surface of the aging hand. J Plast Recon Aest Surg 71(4):573–584
Zhou J, Xie Y, Wang WJ, Herrler T, Hang RL, Zhao PJ, Zhou SZ, Li QF (2018) Hand rejuvenation by targeted volume restoration of the dorsal fat compartments. Aest Surg J 38(1):92–100
Fabi SG, Goldman MP (2012) Hand rejuvenation: a review and our experience. Dermatol Surg 38:1112–1127
Cohen JL, Carruthers A, Jones DH, Narurkar VA, Wong M, Cheskin LN, Trout JR, Howell DJ (2015) A randomized, blinded study to validate the Merz hand grading scale for use in live assessments. Dermatol Surg 41:S384-388
Bertucci V, Solish N, Wong M, Howell M (2015) Evaluation of the merz hand grading scale after calcium hydroxyapatite hand treatment. Dermatol Surg 41:S389-396
Giunta RE, Eder M, Muller DF, Kovacs L, Machens HG (2013) Structural fat grafting of the hand: How much volume do we get? Curr Ther Regen Med 10:287–296
Eviatar J, Lo C, Kirszrot J (2015) Radiesse: advanced techniques and applications for a unique and versatile implant. Plast Recon Surg 136:164–170
American Society of Plastic Surgeons. Plastic Surgery Statistics Report (2019). Available online: https://www.plasticsurgery.org/documents/News/Statistics/2019/plastic-surgery-statistics-full-report-2019.pdf
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CMG contributed to study design, data acquisition, data extraction, analysis of results, drafting of the manuscript, final approval of the manuscript, and agrees to be held accountable for all aspects of the work. CB contributed to study design, data acquisition, data extraction, analysis of results, drafting of the manuscript, final approval of the manuscript, and agrees to be held accountable for all aspects of the work. DT contributed to study design, analysis of results, drafting of the manuscript, final approval of the manuscript, and agrees to be held accountable for all aspects of the work.
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McGuire, C., Boudreau, C. & Tang, D. Hand Rejuvenation: A Systematic Review of Techniques, Outcomes, and Complications. Aesth Plast Surg 46, 437–449 (2022). https://doi.org/10.1007/s00266-021-02519-6
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DOI: https://doi.org/10.1007/s00266-021-02519-6