They have conquered the effects of ageing on most parts of the body, but plastic surgeons have had little success with wrinkly hands.

Those in pursuit of the perfect body can have their stomachs tucked, their faces lifted, their breasts enlarged and their necks pinned up. However, they give away their age at the first glimpse of withered, shrivelled hands.

But now a growing number of doctors believe they have reached the final frontier in plastic surgery. Ironically, they have found that the answer to firm hands is the thing most of us despise: fat. Surgeons take the blubber from the stomach and inject it into hands in a process called lipostructure.

The Wellness Kliniek in Belgium sees two people a week from the UK and offers all types of hand surgery. Surgeon Jeff Hoeyberghs, its clinical director, says: 'As you age, the quality of your skin starts to deteriorate. You get spots, veins become more visible and the fat over it thins. We gently put fat back in.'

Inevitably, the new trend has been pioneered in America, where news of its popularity in the clinics of Manhattan has reached the pages of the Wall Street Journal.

'If I moved my hand back toward my wrist, then of course the skin tends to wrinkle,' Sandy Jarmuth, a 61-year-old New Yorker who has had the operation told the paper. 'But if I just hold my hands straight in a normal position, they look great.'

Bonnie James, 50, shelled out $2,000 (£1,300) to have it done, with liposuction and a facelift. Now, she says, 'I don't hide my hands as much.'

Fat is used because of the complications of alternative fillers. Botox may provide the perfect forehead but would be too restrictive to motion in fingers, and collagen, used to pump up lips, would not provide the bulk needed to fill the sagginess of ageing hands.

Patients can have their skin peeled and veins removed. But the main problem is the number of veins and tendons, and this has made many doctors reluctant to operate for cosmetic reasons. 'It is difficult because there are so many structures in the hand,' says Babu Peravalia, an orthopaedic surgeon from Manchester. 'The front of the hand alone has 10 tendons and two nerves.' In Europe a hand-peeling procedure is available for €350 (£240) per hand and veins can be removed for between €600 and €700. Lipostructure on the hands costs around €600 per hand per session and it takes on average two sessions.

It can be painful, with bruising lasting for a fortnight and scabs for longer; patients may have to wear an arm sling for a few days, so it makes more sense to have one hand done at a time. Don't expect miracles. 'We don't make hands perfect,' says Hoeyberghs.