Dr. Little’s Philosophies
A remaining area in which structural fat grafting has presented a significant clinical breakthrough is in rejuvenation of the hands. While a woman’s face remains the clear and obvious site of exposed aging, the backs of her hands often reveal a second such site, one that is equally exposed during day-to-day activities. The aging hand presents an overall loss of substance that brings the veins and tendons to the surface in an obvious way (that contrasts with the intervening hollows and depressions between them). The goal in rejuvenation of the hand is not to create a fat hand that completely obscures the veins and tendons, but rather to bring back an increased substance beneath the skin that decreases the prominence of these necessary structures, as it also evens out the depressions and fills out the hand slightly. Structural fat grafting of the hands can be included during overall facial rejuvenation or performed as a separate procedure.
Illustration: detail from Leonardo da Vinci, “Study of Hands for Mona Lisa,” Royal Library, Windsor