HAND AND FOOT REJUVENATION
Although Dr. Talei is a specialist in facial cosmetic and reconstructive surgery, he has also developed several methods of hand and foot rejuvenation, as this is a common request amongst his patients. Classic signs of aging, which become bothersome to most people, typically include atrophy of the soft tissues in the hand along with pigmentary changes in the skin, often called “sun spots.”
TREATING ATROPHY OF AGING IN THE HANDS AND FEET
The atrophy, or shrinkage of tissues, involves a reduction in volume of mainly fat and muscle. This causes a depression between the bones with a resultant prominence of veins, tendons and bones. Patients complain that this gives them an aged, “skeleton-like” appearance that is very noticeable during their day-to-day activities.
Fortunately, new non-surgical and non-invasive treatments are available to rapidly and easily counteract these signs of aging. Volume augmentation between the bones can be performed using a variety of grafts or fillers. When fat is used, it is harvested easily from the abdominal region in most patients and injected into the hands. This is not as commonly performed as filler injections, however. Filler injections are much easier to perform and have a lower chance of having any irregularities or a recovery period. In order to perform the procedure without any pain or bruising, more advanced techniques such as blunt cannula insertion are used.
Volume augmentation immediately reduces the prominence of veins, tendons and bones and restores a healthy, softer appearance to the hands and feet. The type of procedure performed depends on your skin type and tissue characteristics but would be evaluated during consultation. These treatments take very little time to do, and they require no down time.
TREATMENT OF AGING SPOTS
Sun spots, also known as liver spots, age spots, solar lentigines, lentigo senilis or senile freckles, are spots on the skin of the body which occur with aging and exposure to sunlight. The color can vary from person to person, but they can range anywhere from salmon colored to light brown, red or black. Several effective treatments are available such as creams, laser or IPL (intense pulsed light), excision, cryotherapy, dermabrasion and chemical peels, amongst other modalities. Usually, the simplest treatments are the best.
Creams are of utmost importance. A preventative and a treatment cream should almost always be used. The prevention can be performed using a broad-spectrum sun block (SPF of 30) and moisturizers. Treatment can be performed with creams, which change the quality of the skin. Retinoids (tretinoin) can be combined with mild steroids or synthetic corticosteroids (triamcinolone) to help fade the spots.
Hydroquinone is a bleaching cream and is very important, as it helps fade the spots and ultimately can help keep them from recurring following treatment. Initially, these creams may cause itching, redness, burning or dryness. However, it resolves for most patients after a little time. Steroids should not be used in every patient or for a long period of time, as they can thin the skin in aged hands.
Various lasers and intense pulsed light can be used to target the lesions as well. Any laser, which is highly absorbed by melanin and is absorbed superficially, can be used to ablate the lesions. Following treatment, the lesions typically turn red or dusky then slowly peel off. Intense pulsed light (IPL) is not a laser but is used in the same manner. IPL is one of the most popular treatments as it is widely available and causes little discomfort. Several treatments are usually required. Chemical peels are also very useful in reducing blemishes in the face and hands.
Chemical peels such as trichloracetic acid (TCA) are the most commonly used. The strength of the preparation depends on the skin type and practitioner, but high concentrations should be used only in certain situations. Stronger solutions will produce a deeper peel and require some downtime for recovery. Results will be seen as soon as the superficial layer of skin begins to peel off, and it will improve over the next 1-2 months as the skin reactively forms collagen and other parts of the soft tissue matrix. The risk of skin discoloration is low, but it is higher in darker skinned patients.
Freezing of the lesions (cryotherapy) is also performed by some practitioners. Liquid nitrogen or other agents are used to destroy pigment just as cautery or lasers would. Dermabrasion can be used on other parts of the body, but it is not recommended on the thin skin of the hands and feet in aging patients.
Contact us today to schedule a consultation with Dr. Ben Talei at the Beverly Hills Center for Plastic & Laser Surgery.
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