Defining Key Features in Patient Perspectives of Hand Aesthetics

Alex Joo, Alannah L. Phelan, Jing Xu, Garrick Gu, John Karpuk, Baijing Qin, Alexander Li, David Chiu, Douglas M. Rothkopf

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background The hand is highly visible and contributes to an individual's aesthetic image and perceived age. Current perspectives on hand aesthetics are primarily based on expert opinion rather than on lay population perspectives, which are less understood. Our study explores general population perceptions on the features that contribute most to an attractive hand. Methods Participants rated the attractiveness of 20 standardized hands as well as the appearance based on each characteristic: freckles, hair presence, skin tone, wrinkles, vein appearance, and soft tissue volume. The relative importance of each feature was assessed by comparison with overall attractiveness scores through multivariate analysis of variance. Results A total of 223 participants completed the survey. Soft tissue volume (r = 0.73) was most strongly correlated with overall attractiveness, followed by wrinkles (r = 0.71), skin tone consistency (r = 0.69), veins (r = 0.65), freckles (r = 0.61), and hair (r = 0.47). Female hands were perceived as more attractive, with a mean rating of 4.7 of 10, compared with 4.4 in males (P < 0.001). Participants correctly identified the gender of 90.4% of male hands and 65.0% of female hands. Age was strongly inversely correlated with attractiveness (r =-0.80). Conclusions Soft tissue volume is the most important factor in lay perception of hand aesthetics. Female and younger hands were perceived as more attractive. Hand rejuvenation may be optimized by prioritizing soft tissue volume with filler or fat grafting, with secondary priority on resurfacing to address skin tone and wrinkling. An understanding of the factors most important to patients in aesthetic appearance is critical to achieving a pleasing result.

Original languageEnglish (US)
Pages (from-to)S634-S638
JournalAnnals of plastic surgery
Issue number6
StatePublished - Jun 1 2023
Externally publishedYes


  • hand aesthetics
  • hand rejuvenation
  • patient perceptions

ASJC Scopus subject areas

  • Surgery


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