In parallel with aging, increasing skin laxity and subcutaneous atrophy occur in many regions of the human body. Apart from the most obvious facial region, where most aesthetic operations for rejuvenation are done, also the dorsum of the hand is continuously visible in daily life. This region exhibits skin laxity, subcutaneous atrophy and age-related pigmentations in a comparable manner to the face. Autologous transplantation of fatty tissue (structural fat grafting, lipofilling) enables subcutaneous regeneration by refilling the subcutaneous space and hence reducing some of the age-related degenerative process. This paper illustrates the special operative technique on the hand in the form of a case report. Furthermore, 3D surface laser scanning permits an objective evaluation of the permanent volume effect over time. In the presented case a volume effect of 69% of the injected volume was measured after 6 months follow-up time. This amount of injected tissue seems to be integrated as a graft and results in a reduction of subcutaneous atrophy in terms of a true regeneration. Structural fat grafting of the dorsum of the hand is thus a method of regenerative medicine. Together with other methods which reduce the age-related pigmentations, it plays a key role in our treatment concept for rejuvenation of the hand.
(c) Georg Thieme Verlag KG Stuttgart-New York.