Fat or filler? Find out which volumizer will work best for your hands.
In our first installment of the hand rejuvenation series, we touched on (no pun intended) the three ways that age impacts the appearance of your hands: contour, color, and texture. But like a good, overly dramatic daytime television show, we gave you the tools to point out your flawed fingers — but left you hanging with no solutions on how to fix them.
Whether it comes from your stomach or a bottle off the shelf, both fat injections and fillers like Radiesse (59 percent Worth It rating) are a good way to restore volume to your shriveling, boney, aging hands. Our three expert doctors had different ideas on what method they feel achieves the best result, so we asked them to break down the pros and cons of both procedures.
Dr. Nelson Novick runs his practice on the Upper East Side of New York City and sees a lot of busy patients who want quality results in a timely manner. After years of doing hand rejuvenation techniques, he prefers fillers to fat injections.
RS: What is your preferred method to add volume to aging hands?
Dr. Novick: At the advent of hand voluminzation, originally what was used was fat grafting with micro lipo injection. You took the fat from the hips or the abdomen, sucked it out, spun it down and then reinjected it in the hands. That worked OK, but it didn’t last as long as we had hoped, the fat often didn’t take, there was often a lot of lumpiness, and it was very difficult to take the fat back out once it was put in. So how do you address the volume loss without having to go through the whole procedure of suctioning out of the fat and all this and that. We have so many different volumizing agents today that work extremely well, that there’s no longer a need to do basically a double surgical procedure.
RS: How do the injections work?
Dr. Novick: You can literally take a volumizing agent off the shelf, such as Radiesse, mix it with a little bit of lidocaine, and voila! The before and after takes about ten minutes each hand, it’s not really uncomfortable and you’ve given volume to it’s appearance so it doesn’t look like a scrawny hand. You’ve also stretched out the overlying skin by giving it volume so the wrinkles and crinkles don’t stand out.
The only downside with this procedure is that the bruising and swelling is particularly prominent on the back of the hands. Although a patient I just did a couple of days ago called me to say, “You know, you really over exaggerated, I only had a tiny bit of bruising and no swelling at all.” So I said better to over exaggerate then have people be surprised by something but what im trying to say is that now we can put in something.
RS: How long do they last?
Dr. Novick: I combine the Juvederm with the Radiesse, which prolongs the life span of the fillers. So I’ve been getting between a year and two years of longevity. The back of the hands are not subject to a great deal of movement, and it’s the physical movement of skin that impacts the longevity of the materials that are put in. For example, if you put the same amount of materials in the smile lines, which are subject to a great deal of mechanical stress from the constant motion of the muscles, it lasts hopefully for about a year. But if you put in an area like underneath the eyes, the box says 1-2 years maximum, but experience says three years or more. It is just like in real estate, it’s about location, location, location. Where you put it, has a very significant impact on the filler’s longevity.
Before and After of Dr. Novick’s hand rejuvenation using a combination of Radiesse and Juvederm Ultra Plus XC. The shots are a before and IMMEDIATELY after treatment (five minutes later) of the right hand of a 57 year old woman.
While Dr. Novick prefers to use artificial fillers, Dr. Jennifer Reichel who practices in Seattle says she believes that patients get better results if they use fat injections.
RS: What is your preferred method of adding volume back to aging hands?
Dr. Reichel: If the patient is willing to undergo the fat transfer, I certainly prefer it as a filling agent. I do use a lot of radiesse in the back of the hands because it’s very easy to do, the patient just comes in and you don’t have to worry about doing the liposuction procedure. It can look nice as well, but I personally prefer the fat.
RS: How is it done?
Dr. Reichel: For fat transfer in the hands you do a mini liposuction procedure where you remove the fat from the individual that you’re going to treat. Usually I remove it from the abdomen, it’s an easy place to get really nice fat for transfers. You insert a large volume of local anesthetic to numb the area, andyou remove the fat using a very small canula and a syringe. Then you take the fat cells, and we have a special process where we spin them down and so it gets just the fat and you don’t have all the extra fluids. We store can store the fat in a freezer system for up to two years, and then for injecting it into hands it’s really easy to undergo.
I numb the back of the hand with a little bit of lidocaine, and then I attach the syringe with the fat in it to a small canula and insert the fat. The fat moves really easily through the tissues, and you can spread it throughout the hand. It’s a really great filler for hands, because unlike some of the other fillers it’s very malleable. Fat is the same viscosity as our underlining tissues, whereas the other fillers are a little more thicker and don’t move around quite as easily. You just inject it in there and it’s pretty instant. You may get a little swelling for about three or four days and that’s as far as side effects go.
RS: How long do they last?
Dr. Reichel: It depends on the individual. So the first time I usually do it I tell people they are going to need to return for a second transfer done somewhere between 3 and 6 months later, and then maybe a third at the same interval. Then at the end of the two year period of time we contact the patient before their fat expires and ask them how they’re doing and invite them back in for a final transfer. So usually people undergo somewhere between 2 and 4 treatments in that two year period of time. If you look at the text books they say that fat can last anywhere between 2 and 8 years. I’ve seen it where it’s been 10 years later and that patient still has really nice filled hands, then some other patients it only lasts about a year or so before they need to undergo the process again.
Before and after photo of one of Dr. Reichel’s patients who used fat transfer to restore volume to her hands. The after photo is taken three months after the procedure.
Watch the video below to see more of Dr. Reichel’s fat transfer before and afters
Click here to read The Guide To Younger Looking Hands Part 1: Evaluate Your Needs
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