Lipoaugmentation for aging hands: A comparison of the longevity and aesthetic results of centrifuged versus noncentrifuged fat

BACKGROUND. Fat augmentation has long been utilized by cosmetic surgeons for volume restoration of the face and hands. However, it is not clear which methods of fat preparation optimize survival and aesthetic results. The need for centrifugation of the fat prior to augmentation has been debated in the literature. OBJECTIVE. To evaluate the long-term efficacy of fat transplantation to the hands using centrifuged versus noncentrifuged fat. methods. Fourteen patients underwent fat augmentation to the hands utilizing 10 ml of centrifuged fat in one hand and 10 ml of noncentrifuged fat in the contralateral hand in a randomized, double-blind comparison study. Evaluation intervals were at 1, 3, and 5 months at which time aesthetic results, vein prominence, and depth of metacarpal space were evaluated. RESULTS. At 1 month the subjective and objective preference was the hand with the noncentrifuged fat in 75% of patients, even though vein prominence and depth of metacarpal space were higher in that group. By 3 months the preferred result was centrifuged fat in 62.5% of patients; 25% had equal results and 12.5% preferred the noncentrifuged fat. By 5 months the subjective and objective preference was for the centrifuged fat in 100% of patients. This preference was supported by a lower score in vein prominence and depth of metacarpal space in that group. CONCLUSION. This preliminary study supports the use of centrifuged fat compared to noncentrifuged fat for longevity and improved aesthetic results at 3 and 5 months for fat augmentation of the aging hands.