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

Document Type : Original Article

Authors

1 The Department of Plastic and Reconstructive Surgery, Main University Hospital, Alexandria University

2 The Department of Plastic and Reconstructive Surgery, School Children Hospital, Health Insurance Authority, Alexandria

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 5-
point 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
dorsal hand appearance. However, longer studies in a larger
patient population are required to assess long-term outcomes.

Keywords

Main Subjects

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The Egyptian Journal of Plastic and Reconstructive Surgery
Volume 43, Issue 3
October 2020
Pages 517-525

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