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Defining the beautiful hand: how age and gender impact patient perceptions
Alannah Phelan1, Jing Xu1, Garrick Gu1, Jing Bai Qin2, Douglas M Rothkopf1
1 UMass Chan Medical School, Division of Plastic Surgery2NYU Grossman School of Medicine, Department of Plastic Surgery

Background: The hand, like the face, is highly visible and contributes significantly to an individualís overall aesthetic image and perceived age. Hand rejuvenation is becoming an increasingly popular cosmetic procedure. Current perspectives on hand aesthetics are primarily based on expert opinion rather than on lay population perspectives, which are less understood. Hand aesthetic grading scales group multiple hand characteristics into a single evaluation, limiting the ability to assess the relative importance of individual factors. The purpose of this study is to explore general population perceptions of the features that contribute most to an aesthetically pleasing hand, and to compare the relative importance of wrinkles, sun damage, prominent veins, volume loss and pigmentation in overall appearance.
Methods: Subjects over 18 years of age with no history of prior hand surgery were recruited from the general population. A survey containing photos of 20 standardized Caucasian hands (50:50 female-to-male ratio) were administered, and subjects were asked to rate the appearance of the following characteristics on a 10-point Likert scale: freckles, hair, skin tone, wrinkles, veins, and volume. Subjects are also asked to rate the overall attractiveness of these hands, and to guess the gender and age. Demographic information on participants gender, race/ethnicity, marital status, education, and household income was collected. The relative importance of each hand characteristic was compared with overall attractiveness scores through Pearsonís correlation analysis. Further partial correlation analysis was conducting using the MANOVA test while adjusting for repeated variables.
Results: One-hundred-and-seven participants completed the survey resulting in 2000 hand assessments. Participants were 63% female, and the mean age was 43.6?17.0. Pearsonís analysis demonstrated hand volume to be the most important characteristics in relationship to overall attractiveness (r=0.75) [Figure 1A]. MANOVA analysis also demonstrated, hand volume (r=0.74), followed by hand wrinkles (r=0.73) and skin tone (r=0.70) were most correlated with hand attractiveness (all p<0.0001) [Figure 1B]. For female hands, volume (r=0.80), wrinkles (r=0.82), and skin tone (r=0.79) were positively correlated to overall attractiveness (all p<0.0001). For male hands, volume (r=0.67), veins (r=0.62), and wrinkles (r=0.60) were most positively correlated to overall attractiveness (all p<0.0001). For both hand genders, the attractiveness of wrinkles correlated most closely with younger hand age (r=-0.59).
Conclusions: Hand volume, followed by wrinkles and skin tone, had the greatest impact in overall hand attractiveness. The hands with the most attractive wrinkles were perceived as younger for both hand genders.


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