Best Filler for Thin, Wrinkled Hands? (photo)

You are quite correct. Thin-skinned, sinewy hands with prominent, protruding veins is a dead give away of a person's age, even when the face and neck appear younger. Whereas even up to not that long ago there was little to be done for this problem, today, we can use volumizing fillers to reinflate the dorsum (backs) of the hands to smooth and reinflate the hands and camouflage the protruding tendons and veins.I have been performing nonsurgical hand rejuvenation for twenty years. Most recently, my favorite combination of volumizers for this purpose is Radiesse combined with Juvederm Ultra Plus XC in my Upper East Side Manhattan practice and Radiesse combined with Princess Volume in my Israel satellite facility where a far greater number of regulatory agency approved products are available.The procedure is nearly painless and takes about ten minutes per hand to perform. One or more entry sites on each hand are numbed with local anesthetic and the material is placed in the sunken areas between the tendons on the backs of the hands via a blunt-tipped cannula and then massaged into place to re-inflate (i.e. restore lost volume) and to smooth the area. The results are immediate and typically engender a "Wow!" response. Bruising and swelling are common for a couple of days afterward, but generally pose no significant downtime problems. Seeking consultation and treatment by a physician injector with experience and expertise in  nonsurgical rejuvenation of the hands is essential. Make sure to check his/her befores and afters photos. 

There are several options that help rejuvenate the hands.  First, fillers that are hydrating or volumizing work well to improve the appearance of the hands.  Restylane Silk is a volumizing and hydrating filler that works well to provide support as well as hydration to the back of the hands.  Radiesse is also popular in this area and works well.  Fat is an option but can be more expensive, more unpredictable because of resorption, and can be asymmetric once the swelling subsides.  

The face and the hands loose fat with age.  As a result the tendons and veins appear more prominent.  Restoring the lost volume with either fat transfer or a filler such as Radiesse can be a very rewarding way to treat this problem.  Fat transfer is essentially permanent, however,  fillers need to be repeated.