LAM FACIAL PLASTICS

Hi Dr. Lam,

I've had temporary fillers (Restylane & Perlane) added to my face due to hollowness I recently started noticing. I'm 46 years old and am not liking the aging process! I love the results from the fillers but now my hands really stand out . . . what can I do to help my hands "match" my more youthful looking face - can Restylane or Perlane work in this area?

Thank you - by the way, your website is amazing!
Susan

Hi Susan,
Great question. As you may probably surmise from reviewing my before and after galleries, I focus almost entirely on the face except for also rejuvenating the hands. Like you, I place quite a bit of importance on hand rejuvenation for the simple reason that in almost all social encounters only the face and hands remain exposed or unclothed and can give away one's age and simply make you look not as fresh as possible.

Whenever I work on facial rejuvenation, I almost always offer the individual the option for paired hand rejuvenation as well, as I did my own mother's hands and face a couple of months ago (check out the staff makeover section for her results).

When looking at the hands for rejuvenation, there really are two major components to the aging process: loss of volume and sun damage to the skin. My focus is principally on the former, i.e., on volume loss for two reasons. First, the volume loss truly makes one's hands look considerably older than skin damage. Second, the skin looks much better when the hand is plumped out. However, I do offer bleaching products and fractionated laser treatments to improve the skin as needed.

I have found that there are 3 principal methods to help restore the form and shape of the hands to a rejuvenated state easily and safely. The ideal choice in my opinion is fat grafting in which I can combine that procedure with facial fat grafting to create a balanced rejuvenation. The benefit of fat grafting for the hands is two fold: permanence (relative to ongoing aging) and ability to fully contour every aspect of the aging hand from fingers all the way across the back of the hand. Also, fat grafting to the hands can (but not a guarantee) improve the texture and tone to the skin through a stem cell response over time (typically that takes a year if it should happen).

Two other methods for hand rejuvenation are more temporary and can be done easily in the office without any discomfort: restylane or radiesse. Restylane treatments are more affordable, costing on average $1500; whereas Radiesse is $2500 on average. Btw, fat grafting to the hands is $4000 plus related facility charges. Restylane would on average have a slightly shorter lifespan of probably 8 months or so whereas Radiesse may last a few more months than Restylane. Both have very limited downtime in general of perhaps a day or two with no real discomfort during the procedure owing to the method that i use.

One more thing: to get a great result with fat grafting for the hands, I must overfill a bit (unlike the face) where your hands will look puffy for a month or so (most people don't really notice this at all; check out the recovery videos for examples of hand fat grafting immediately following a procedure and you will see what I mean) and also I MUST have enough donor fat to be able to do this. If you are very thin and athletic I will have to rely on temporary fillers instead.

Hope this answer helps you and I look forward to meeting you in person to evaluate your candidacy for one of these methods.
Best,
SML