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The Dead Giveaway to Your Actual Age
by: Dr. Bunkis
Youthful hands will have people underestimating your age.
Youthful hands will have people underestimating your age.

Q: I’m 46-years-old and I have been a sun worshiper until recently. I now take care of my skin and I manage to keep a healthy looking face. The only area that really shows my age is my hand. I have very skinny hands that show my veins and some brown spots as well. Is there anything I can do to improve the appearance of my hands?

-Linda D., Newport Beach, CA


A: Hand rejuvenation is becoming a very interesting topic that draws attention nationwide. The hand is an important tool that we use to interact with the society but it has long been ignored by aesthetic surgeons. This trend has now changed and we can offer our patients some options.

There are two main problems that we can address with regards to aging of the hands:

1. Thinning of the skin with increased visibility of the veins: The best way to improve this situation is by Microfat injections. With this technique, the plastic surgeon harvests your own fat, which is handled very gently to maintain the viability of the fat cells, and transfers it beneath the skin of the hands. The fat globules add volume into thin hand, camouflage the veins and restore the hand volume to a younger looking texture and feel.

So how long will the improvement last? Fat grafting has been done for many years. Early attempts at fat grafting did produce only temporary improvement. However, present Microfat injections differ from the older technique because it uses finer instruments and deals with the fat in a very gentle way to preserve the viable cells and separate them from dead cells and oil, thus improving graft take. In order for the fat grafts to survive, the individual small clumps of fat must have a blood vessel that attaches to a vessel in the recipient site – if this happens, the fat will continue to live forever, but if adequate blood supply is not available, the grafts will atrophy and disappear within a few months.

2. Brown spots (hyperpigmentation). IPL or chemical peel can lighten these spots. Multiple sessions are usually required to accomplish this goal. It is also necessary to protect the hands with sun blocks whenever you are outdoors; otherwise the damage will just continue occurring.

60-year-old female, before and a year after a single treatment with microfat grafting

949.888.970 | 30212 Tomas Ste. 275, Rancho Santa Margarita, CA 92688 |  

As Medical Director of Orange County Plastic Surgery, Juris Bunkis, M.D., F. A.C.S. brings 30 years of surgical expertise to our communities. Dr. Bunkis is a Harvard trained, Board Certified Plastic Surgeon and Member of numerous prestigious organizations including the American Society of Aesthetic Plastic Surgeons, The International Society of Aesthetic Plastic Surgery, the American Society of Plastic Surgeons and the California Society of Plastic Surgeons. Dr. Bunkis, a former faculty member at the University of California, San Francisco, has published more than 40 scientific publications, abstracts and book reviews, and 17 book chapters in plastic surgery text books. For questions or advice, please contact Dr. Bunkis directly at

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