Wrinkle reduction from the wrist, top of the hand, and knuckles by surgical skin excision is one of the best-kept secrets of cosmetic plastic hand surgery. Most plastic surgeons are not familiar or comfortable with the procedure — it requires both the precise anatomical understanding of a hand surgeon and the refined aesthetic technique of a cosmetic plastic surgeon, a combination that few practitioners possess. The result is that many patients who would benefit dramatically from this approach are never told it exists, and instead try a series of non-surgical treatments that produce limited and temporary improvement. The reality is that no non-invasive modality effectively and permanently removes wrinkles from the dorsum of the hand or tightens the skin to the degree skin excision can achieve. For patients seeking definitive correction of hand and wrist wrinkling — particularly when combined with other rejuvenation procedures — surgical skin excision is uniquely effective. At Los Angeles Plastic Surgery, Dr. John Anastasatos performs hand wrinkle reduction by skin excision as part of comprehensive aesthetic hand rejuvenation.

Dr. Anastasatos performs hand wrinkle reduction with the most directly relevant academic credential possible: he completed a fellowship in Hand and Upper Extremity Surgery and Microsurgery at the University of Alabama at Birmingham — formal subspecialty training in the deep anatomy of the hand that few cosmetic plastic surgeons possess. Dr. Anastasatos was profiled by the Beverly Hills Courier in a feature titled “Anastasatos turns Body Restoration into art form” — a profile reflecting his reputation specifically for refined aesthetic surgical results. He has been an invited lecturer at the Royal Society of Medicine in London with an invited 2026 return as featured speaker. With over two decades of facial and hand surgical expertise in Beverly Hills since 2007, he is board certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons (FACS), a member of the American Society of Plastic Surgeons (ASPS) and American Society for Aesthetic Plastic Surgery (ASAPS), and named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World.

Why Skin Excision Solves What Non-Surgical Treatments Cannot

Wrinkle reduction by skin excision solves one of the most difficult problems in cosmetic medicine: noticeable, stubborn wrinkles that persist on the dorsum of the hands, wrists, and knuckles despite the patient’s best efforts with topical products, injectable treatments, and other modalities. The fundamental reality is that:

• Excess wrinkly skin cannot be tightened by non-invasive means — once skin laxity has developed, the only way to remove it is to physically excise it
• Other rejuvenation methods address volume, pigmentation, or surface texture — but not the actual excess skin
• Skin excision produces permanent results — the removed skin does not come back, and the tightening is durable

The procedure addresses two simultaneous goals: removing the excess wrinkly skin from strategic locations, and tightening the rest of the skin of the hand, wrist, and digits.

How the Procedure Works

The technique is built around precise small incisions placed at strategic locations on the hand, wrist, and knuckles. These incisions are designed to remove wrinkly skin while producing the most refined possible scar — and to allow tightening of the surrounding skin as the excised tissue is closed.

The procedure can be performed in multiple settings:

• Operating room — for combination procedures or patients who prefer general anesthesia
• Office-based procedure — for patients with limited correction needs
• Local anesthesia only — when patient preference favors avoiding sedation or general anesthesia

Combining With Other Hand Rejuvenation

Hand wrinkle reduction is typically performed in combination with other rejuvenation procedures of the hand for comprehensive aesthetic correction. Common combinations include:

• Chemical peels of the hand — addressing pigmentation and surface texture alongside skin excision
• Radiesse injections to the hand — restoring volume to complement the skin tightening
• Fat transfer to the hand — adding deep volume that softens the underlying anatomical structures
• Dorsal vein removal — eliminating prominent veins as part of total hand rejuvenation

For patients pursuing complete hand transformation, combining skin excision with volume restoration produces results that no single procedure can match.

Recovery After Hand Wrinkle Reduction

Recovery is comfortable and brief:

• Minimal downtime — most patients return to routine activities quickly
• Comfortable recovery taking only a few days
• Sutures removed at approximately 7 days post-procedure
• Permanent results — the excised skin does not return, and the tightening is durable

Schedule a Hand Wrinkle Reduction Consultation in Beverly Hills

If you have wrinkly hand and wrist skin that has not responded to topical or non-invasive treatments, surgical skin excision may produce the result other approaches have not. Dr. Anastasatos welcomes patients to the Beverly Hills office at 436 North Bedford Drive, Suite 202, Beverly Hills, CA 90210, for a private consultation. Contact Los Angeles Plastic Surgery to schedule your appointment.