Ultrasound Analyses of the Dorsal Hands for Volumetric Rejuvenation

Abstract

Background Volumetric hand rejuvenation of the dorsal hands is increasingly applied for aged, skeletonized dorsal hand skin, with prominent veins, tendons, and joints due to volumetric loss of subcutaneous fat. However, the aging process of the fatty laminae remains unexplored. Objectives We aim to investigate the impact of aging and potential determinants on the fatty laminae to improve the therapeutic effect of volumetric injection. Methods This cross-sectional study enrolled 105 Taiwanese participants aged ≥20 years, divided into five age groups per decade. Thicknesses of the dorsal superficial lamina (DSL), dorsal intermediate lamina (DIL), and dorsal deep lamina (DDL) were measured via ultrasonography by a single-blinded practitioner. The potential determining factors of the laminae thickness (age, sex, body mass index, and hand dominance) were analyzed. Results The thicknesses of the three laminae decreased with aging, with the mean decrease in thickness from the 20s to >60 years in DSL, DIL, and DDL being 0.21 mm (30.0%), 1.38 mm (63.89%), and 0.31 mm (20.95%), respectively. DIL thickness decrease was the greatest and most significant since the 30s. Multiple linear regression analysis showed age as the only determinant for thicknesses of the 3 laminae (all P<0.001), whereas DIL was significantly thicker in men (P<0.001). Conclusions Volumetric fat loss was noted in the three fatty laminae of dorsal hands during aging; DIL has the greatest progressive fat loss since the 30s. Volumetric rejuvenation of the 3 laminae may result in the most esthetic appearance, especially in women.

Calcium Hydroxylapatite (CaHA) and Aesthetic Outcomes: A Systematic Review of Controlled Clinical Trials

“…For instance, a recent study revealed that although volumetric fat loss occurs across all layers of the hands with aging, certain layers like the dorsal intermediate lamina exhibit more significant losses. This would suggest that the therapeutic impact of volumetric injection may depend on both the depth of injection and the specific anatomical layer being targeted [ 54 ].…”