Micro-Autologous Fat Transplantation (MAFT) for Dorsal Hand Rejuvenation

Abstract

Introduction: The dorsal surfaces of our hands are highly visible parts of the body. However with ageing, the aesthetic aspects of the hand deteriorate both in skin quality and contour with obvious appearance of dorsal blue veins and extensor tendons and loss or absence of subcutaneous fat tissue. The literature reports multiple options for addressing this problem, yet, all of these choices come with their own complications. Micro-autologous fat transplantation (MAFT) can be used in hand rejuvenation by a combined effect. First, it is possible to augment the dorsum of the hand and enabling visible blue and tortious veins as well as extensor tendons to be covered, resulting in a hand with uniform contour. Second, the fat cells have a beneficial effect on deep and superficial skin tissue via adipocytes derived stem cells (ASCs), thereby rejuvenating the hand. In this study, we performed (MAFT) technique to the three dorsal subcutaneous laminae for the rejuvenation of dorsal hand surfaces and determined its clinical results. Patients and Methods: MAFT was performed in 10 female patients. Fat was harvested by performing liposuction from different body sites, then processed, and refined by decantation. Purified fat was micro-transplanted to the dorsal surface of the hand in parcels of small volume. Post treatment checkups were performed at 24h, 7 days, 1 month, 3 months, and 6 months after treatment to evaluate the healing cascade of the hand. Patient-rated satisfaction was reported during the patient's final visit (at least 6 months after MAFT) using a 5point scale. The Merz Hand Grading Scale (MHGS) was used to grade the appearance of the dorsal hand preoperatively and 6 months after MAFT. Results: The mean age was 46 years (range, 36-60 years). The time taken for MAFT injection of both hands was in an average of 30min. On average, the fat volume delivered was 20 and 18.5mL for the right and left hands, respectively. No major complications were reported, only mild to moderate swelling was noted, which subsided after 7 to 10 days postoperatively. Favorable outcomes were noted in patients which was reflected on the patient satisfaction rate (very satisfied, 60% and satisfied, 30%) and the remarkable up grading in the Merz Hand Grading Scale. Conclusion: In conclusion, the clinical results obtained using MAFT have demonstrated the feasibility and effectiveness of this approach in creating a younger and more beautiful 517 dorsal hand appearance. However, longer studies in a larger patient population are required to assess long-term outcomes.