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Anatomic, histologic, and ultrasound analyses of the dorsum of the hand for volumetric rejuvenation

Authors
 Jung-Ah Park  ;  Shin-Hyo Lee  ;  Seung-Jun Hwang  ;  Ki-Seok Koh  ;  Wu-Chul Song 
Citation
 JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, Vol.74(7) : 1615-1620, 2021-07 
Journal Title
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
ISSN
 1748-6815 
Issue Date
2021-07
MeSH
Aged ; Aged, 80 and over ; Cosmetic Techniques* ; Fascia / anatomy & histology ; Fascia / diagnostic imaging ; Female ; Hand / anatomy & histology* ; Hand / diagnostic imaging ; Humans ; Male ; Middle Aged ; Rejuvenation* ; Skin / anatomy & histology ; Skin / diagnostic imaging ; Skin / innervation ; Ultrasonography ; Veins / anatomy & histology ; Veins / diagnostic imaging
Keywords
Anatomy ; Dorsum of the hand ; Hand rejuvenation ; Layer
Abstract
Background: Volumetric rejuvenation of the dorsum of the hand with fat grafting or injectable fillers has increased in popularity in recent years. It has become widely accepted that the dorsum of the hand contains three fatty laminae: superficial, intermediate, and deep laminae. The dorsal venous plexus and dorsal cutaneous nerves are known to reside in the dorsal intermediate lamina. However, the superficial vein and cutaneous nerve might not be located in the same layer of subcutaneous tissue, as is the case in other body regions.

Materials and methods: Eight hands were dissected in a layer-by-layer fashion from the skin to the extensor tendons. In another 13 hands from among 21 investigated cadavers, samples from the dorsum of the hand were harvested and stained using trichrome stains for histologic analysis. B-mode ultrasound was also performed for identifying structures of the dorsum of the hand.

Results: Anatomic dissection and histologic analysis of the dorsum of the hand revealed the presence of an unknown fascia in addition to the three known fascial layers. The additional fascia was located in the dorsal intermediate lamina and separated it into two compartments: one containing the dorsal venous plexus superficially and the other containing the dorsal cutaneous nerves deeply. Ultrasound showed corresponding structures including three hyperechoic fascial layers, three hypoechoic laminae, and additional hyperechoic fascia in dorsal intermediate lamina.

Conclusions: Accurate anatomic knowledge of the dorsum of the hand will help practitioners determine the optimal and safe locations for performing fat grafting and injecting dermal fillers.
Full Text
https://www.sciencedirect.com/science/article/pii/S1748681520306331
DOI
10.1016/j.bjps.2020.11.017
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anatomy (해부학교실) > 1. Journal Papers
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190858
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