Zusammenfassung
Mit zunehmendem Alter kommt es zu einer Erschlaffung der Haut und zur Atrophie des
Unterhautfettgewebes in vielen Körperregionen. Neben dem Gesichtsbereich, in dem der
Alterungsprozess am auffälligsten ist und wo auch die häufigsten plastisch-chirurgischen
Operationen durchgeführt werden, ist der Handrücken im Alltag ständig exponiert und
weist ähnliche Alterungsphänomene auf. Die autologe Fettgewebstransplantation („Structural
Fat Grafting”) zur Augmentation des Unterhautfettgewebes ermöglicht eine dauerhafte
Abmilderung des sichtbaren Alterungsprozesses am Handrücken. Die vorliegende Arbeit
fasst in einem Fallbericht die Operationstechnik des Structural Fat Grafting zusammen
und kann mittels 3-D Körperoberflächenerfassung objektiv quantifizieren, dass über
6 Monate hinaus ein dauerhafter Volumeneffekt mit Reduzierung der subkutanen Atrophie
zur Verjüngung der Hand erreicht werden kann. Im vorliegenden Fall konnte gezeigt
werden, dass etwa 69% des injizierten Volumens nach 6 Monaten messbar sind. Structural
Fat Grafting ist eine Behandlungsmethode der regenerativen Medizin, die gemeinsam
mit Methoden zur Beseitigung von Altersflecken ein erfolgreiches Therapiekonzept zur
Verjüngung der Hand darstellt.
Abstract
In parallel with aging, increasing skin laxity and subcutaneous atrophy occur in many
regions of the human body. Apart from the most obvious facial region, where most aesthetic
operations for rejuvenation are done, also the dorsum of the hand is continuously
visible in daily life. This region exhibits skin laxity, subcutaneous atrophy and
age-related pigmentations in a comparable manner to the face. Autologous transplantation
of fatty tissue (structural fat grafting, lipofilling) enables subcutaneous regeneration
by refilling the subcutaneous space and hence reducing some of the age-related degenerative
process. This paper illustrates the special operative technique on the hand in the
form of a case report. Furthermore, 3D surface laser scanning permits an objective
evaluation of the permanent volume effect over time. In the presented case a volume
effect of 69% of the injected volume was measured after 6 months follow-up time. This
amount of injected tissue seems to be integrated as a graft and results in a reduction
of subcutaneous atrophy in terms of a true regeneration. Structural fat grafting of
the dorsum of the hand is thus a method of regenerative medicine. Together with other
methods which reduce the age-related pigmentations, it plays a key role in our treatment
concept for rejuvenation of the hand.
Schlüsselwörter
ästhetische Chirurgie - plastische Chirurgie - Verjüngung der Hand - Structural Fat
Grafting - Stammzellen aus dem Fettgewebe - 3-D Körperoberflächenerfassung
Key words
aesthetic surgery - plastic surgery - hand rejuvenation - structural fat grafting
- adipose-derived stem cells - 3D surface imaging
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Korrespondenzadresse
Priv.-Doz. Dr. Riccardo E. Giunta
Klinik und Poliklinik für
Plastische Chirurgie und Handchirurgie
Klinikum rechts der Isar
Ismaninger Straße 22
D-81675 München
Email: R.Giunta@lrz.tu-muenchen.de