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Objectives: Hands rejuvenation using subcutaneous nanofat injections : an innovative technique.

Introduction: We aimed to access wether our novel nanofat grafting procedure improves skin quality, while yielding a regenerative effect.

Materials / method: Patients who requested hands rejuvenetion were enrolled between january 2018 and June 2018. Fat was aspirated from inner face of the knee, or medial thigh, or lower abdomen regions. Following aspiration and flushing, microfat was obtained after washing with saline. This microfat was emulsified to obtain nanofat suspension, after adding 20% of PRP the emulsion was injected using a 25 G cannula into the subcutaneous layer at all parts of the hands. Images were obtained before and at 1,3, and 6 months. Patients were also administered a survey concerning hands appearance.

Results: Fifty patients were included. The clinical results were apparent between 2 and 4 weeks after injection, and improvements were continuously observed until 9 months postoperatively. All patients confirmed an improvement in texture, elasticity, firmness, fine wrinkles, and skin hydration, along with a regenarative effect. Only minor complications were noted, including redness and edema between 2 and 4 days, and some bruises and pain in donor site.

Conclusion: Hands rejuvenation with subcutaneous nanofat injections at all parts of the hands appears to be an effectice method, although additional studies are necessary.

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Objectives: 1/ Learn to adapt the lipofilling technique to indications in hand surgery.

2/ Familiarize with lipofilling as an adjunctive treatment to classical surgical management of Dupuytren's contracture.

3/ Keep in mind that microlipofilling to the reconstructed pulp may be of great help.

Introduction: Lipofilling applied to the hand has not been described until recently. And different applications have become possible thanks to the development of micro-lipofilling.
The authors present the results observed in 2 indications:
- lipofilling as an adjunctive treatment to open surgical aponeurectomy of Dupuytren's fibrosis.
-lipofilling to the atrophic post traumatic digital pulp.

Materials / method: Patients presenting primary contracture of stages I-IV were included and programmed for surge and lipofilling. Fat was harvested by means of the S’trim kit, centrifuged and reinjected in the palm. Follow up assessed the presence of mild and major complications at 1 week and 1 month.
The results of micro-lipofilling in a prospective study of patients with a history of pulp injury and presenting residual allodynia and cold intolerance were assessed based on the the QuickDASH score, the Simms-Weber sensitivity test, patient-reported cold intolerance and physician evaluated pulpe volume.

Results: 65 patients with stages I to IV were included over a 2 years and operated on by the same surgeon. The mean volume of fat harvested was 10 ml and the mean reinjection was 3 ml per radius. We observed 1 case of malunion, 2 cases of lipolysis, and no cases of infection. 2 patients presented hematoma at the donor site.
As for the lipofilling ot the pulp, the preliminary results of this study appear to be encouraging. The 5 patients included showed a fast amelioration of quality of life scores. Allodynia in the scars and cold intolerance were significantly improved.

Conclusion: This study suggests that combining lipofilling and OEA adds no complications. The brachial hypodermic fat seems to be a reliable and safe donor site. Further work would have to assess the reduction of long term recurrence, a major flaw in surgical treatment of DC.
As for lipofilling to the pulp, preliminary results are very encouraging. Further studies with Rigotomies and perhaps nano-fat injection would provide more reliable information as to the effectiveness of this regenerative technique.

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请注明名称（个人，公司，学会等等）: Unpaid Consultant (Unrestricted Research Grant/Disposables) for Harvest-Terumo BCT, BioTime, Medical Tech., Eclipse Aesthetics and Unpaid Investigator (Unrestricted Research Grant/Disposables) LipoGems

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请注明名称（个人，公司，学会等等）: Paid Consultant for, BioTime, Follica, Inc, Eclipse Aesthetics, and Bergen Medical

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这项工作的完成感谢以下机构的支持： Medical Advisory Board member for the following Boards; Board of Regents Aesthetic Stem Cell Society, Lightstim, Inc., Follica, Inc., Eclipse Scientific Advisory Board, and Aesthetic Guide Advisory Board.