By Parviz Hiroshi Goshtasby, M.D., F.A.C.S., a.k.a. “Dr. Go”
Cosmetic surgery has become a very popular and accepted fixture in our society today with a myriad of techniques and products available to help rejuvenate and enhance the face and body. The face is the #1 most exposed portion of our bodies that people immediately recognize and observe, and as a result, there is a large spectrum of procedures aimed to maximize its aesthetic appeal, from the less invasive neurotoxins, soft tissue fillers, chemical peels, and lasers, all the way up to the more aggressive and effective surgical facelifts. However, the second most commonly exposed region of our bodies that most people overlook are our hands.
Your Hands May Give Away Your Age
Although patients can spend thousands of dollars trying to rejuvenate their face, I cannot tell you the number of patients who, despite having a wonderful facial outcome, their hands give away their age immediately. Studies have been published in the scientific journal, Plastic and Reconstructive Surgery®, concluding that just based on examination of the hands, most people can accurately guesstimate a person’s age. Therefore, in order to obtain a balanced aesthetic outcome after facial or body rejuvenation, it is recommended to also treat the hands, especially if you have advanced signs of aging that may display your true age.
As a brief overview, there are several well-defined changes that occur to the hands due to aging. If you examine your child’s or grandchild’s hands the next time you see them, you will notice a youthful fullness to the back of their hands with smooth, unblemished, elastic skin, and a lack of prominent veins or wrinkles. As we age, there is a gradual thinning of the dermal layer of the skin with formation of fine wrinkles, age spots, and even skin cancers. There is also gradual atrophy of the subcutaneous fat layer and intrinsic muscles with the prominence of underlying veins, tendons, and joints. In addition, you can develop bony deformities from the occurrence of arthritis or other pathologies. These signs of aging can be exacerbated by factors such as smoking, excessive sun exposure, and lifestyle or occupational insults to the hands. Our hands are critically important for our daily activities, both functionally and visually.
What are Your Hand Treatment Options?
Treatments are available to address each of these concerns, many of which require minimal downtime. Dermal thinning and superficial skin dyschromias can be managed with a variety of products. Retin-A, ie. tretinoin, is the only cream proven to thicken the dermis and help remove the outer damaged skin layers. Glycolic acid, Jessner’s solution, and trichloroacetic acid (TCA) peels are just a few of the chemical peels available to help exfoliate and rejuvenate the hands. Microdermabrasion performed in the office setting helps smooth the outer skin layer, but will require several treatments for maximal effect. A number of lasers are also available, the most effective of which is the fractional CO2 laser, which can be performed in the office, but does require some post-treatment care and downtime for a few days.
Dorsal hand volume loss can be addressed with volumizing treatments, including augmentation with autologous natural fat grafting, that is typically done in the operating room, or more recently, with soft tissue fillers in the office setting. Prominent veins can also be managed by direct excision (phlebectomy) or by vein coagulation (sclerotherapy). Finally, any deformities that may be present as a result of trauma, osteoarthritis, ganglion cysts, Dupuytren’s contracture, or any of a number of other pathologies can be improved with hand surgery.
Schedule a Consultation with a Board-Certified Plastic and Hand Surgeon
Although many chapters and research articles have been written on the topic, aesthetic hand rejuvenation has not fully caught on yet in our society, whether it is due to a lack of public awareness or the lack of properly trained physicians offering these procedures. The hand is a very intricate and highly technical organ that we use every day to accomplish amazing things, so it is important to have a dedicated consultation and candid discussion with a board-certified plastic and hand surgeon. Those who have completed additional hand surgery fellowship training are well-versed on the delicate hand anatomy and physiology. There are many self-reported cosmetic surgeons these days with little to no training, so I encourage you to explore and evaluate the credentials and training background of every physician you encounter. Your choice of a well-educated plastic surgeon, along with thorough communication of your interests and goals, are critical in achieving an exceptional outcome. If you would like to further discuss your options for acquiring beautiful hands, give us a call today!