Younger Looking Hands: Filler vs. Fat Grafting

Taken from a RealSelf interview with Dr. Jennifer Reichel

Dr. Jennifer Reichel who practices in Seattle says she believes that patients get better results if they use fat injections.

RS: What is your preferred method of adding volume back to aging hands?

Dr. Reichel: If the patient is willing to undergo the fat transfer, I certainly prefer it as a filling agent. I do use a lot of radiesse in the back of the hands because it’s very easy to do, the patient just comes in and you don’t have to worry about doing the liposuction procedure. It can look nice as well, but I personally prefer the fat.

RS: How is it done?

Dr. Reichel: For fat transfer in the hands you do a mini liposuction procedure where you remove the fat from the individual that you’re going to treat. Usually I remove it from the abdomen, it’s an easy place to get really nice fat for transfers. You insert a large volume of local anesthetic to numb the area, and you remove the fat using a very small canula and a syringe. Then you take the fat cells, and we have a special process where we spin them down and so it gets just the fat and you don’t have all the extra fluids. We store can store the fat in a freezer system for up to two years, and then for injecting it into hands it’s really easy to undergo.

I numb the back of the hand with a little bit of lidocaine, and then I attach the syringe with the fat in it to a small canula and insert the fat. The fat moves really easily through the tissues, and you can spread it throughout the hand. It’s a really great filler for hands, because unlike some of the other fillers it’s very malleable. Fat is the same viscosity as our underlining tissues, whereas the other fillers are a little more thicker and don’t move around quite as easily. You just inject it in there and it’s pretty instant. You may get a little swelling for about three or four days and that’s as far as side effects go.

RS: How long do they last?

Dr. Reichel: It depends on the individual. So the first time I usually do it I tell people they are going to need to return for a second transfer done somewhere between 3 and 6 months later, and then maybe a third at the same interval. Then at the end of the two year period of time we contact the patient before their fat expires and ask them how they’re doing and invite them back in for a final transfer. So usually people undergo somewhere between 2 and 4 treatments in that two year period of time. If you look at the text books they say that fat can last anywhere between 2 and 8 years. I’ve seen it where it’s been 10 years later and that patient still has really nice filled hands, then some other patients it only lasts about a year or so before they need to undergo the process again.


Before and after photos of Dr. Reichel’s patients who used fat transfer to restore volume to their hands.

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