title: Minimal-scar handlift: a new surgical approach.
abstract: BACKGROUND
  Removal of excess skin from the aging hand can cause scarring in one of the body's most visible areas, which is highly undesirable for patients. A minimal-scar approach to tightening this skin, in conjunction with the rejuvenating effects of minimally-invasive procedures, is therefore needed.
  
  
  OBJECTIVE
  The authors describe a new technique for limiting scar size and visibility by locating the incision in a unique position on the ulnar side of the dorsum of the hand.
  
  
  METHODS
  Eleven patients were treated with the authors' method between March and September 2009. Both hands were treated for each patient, but these procedures occurred separately, at an interval of two to four months. The surgical approach included skin flap advancement and rotation, and the procedure took place under local anesthesia and sedation. The resultant scar was S-shaped. Changes in postoperative stress ratio were visualized.
  
  
  RESULTS
  Patients reported being highly satisfied with this procedure with regard to scar size, quality, and location. No major complications were observed, such as infection, flap necrosis, and nerve damage. All minor complications were treated conservatively. Patients with Fitzpatrick skin types I-III profited from less scar visibility in their outcomes. All patients experienced quick recovery with minimal downtime, independent of skin type.
  
  
  CONCLUSIONS
  The minimal-scar handlift technique is an effective surgical approach to rejuvenating the hand and can be implemented concurrently with minimally-invasive techniques for volume restoration. The complication rate is low, and patient/surgeon satisfaction with outcomes is high.
authors: Department of Plastic Surgery, Pontifical Catholic University of Rio de Janeiro, and the Carlos Chagas Postgraduate Medical Institute, Ivo Pitanguy Institute, Rio de Janeiro, Brazil. office@markushandle.at
authors: Markus
authors: M
authors: Handle
authors: Luiz M
authors: LM
authors: Bonfatti-Ribeiro
authors: Bárbara H
authors: BH
authors: Barcaro-Machado
authors: Ivo
authors: I
authors: Pitanguy
mesh_terms: D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods; D002921:Cicatrix / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D017060:Patient Satisfaction; D010865:Pilot Projects; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012060:Rejuvenation; D015595:Skin Aging; D013524:Surgical Flaps; D013536:Suture Techniques; D013997:Time Factors