To restore volume to "old-looking" hands, I prefer Radiesse or autologous fat (fat taken from one part of your body and injected into the backs of your hands). Both give excellent results. You have less down time with Radiesse than you would with autologous fat, but, even with the fat transfer procedure, post-operative pain/swelling/bruising is really minimal. I never use a hyaluronic acid filler (like Juvederm or Restylane) to restore volume to the hands. Using it in combination with Radiesse (in the backs of the hands) does not prolong the effects of the Radiesse. There is nothing harmful about using Juvederm to restore volume to the backs of the hands, it's just that you'd need quite a few syringes of the product (Juvederm or Restylane) to achieve comparable results as you'd get with one to one-and-a-half syringes of Radiesse (1.5cc in each syringe), and the effects would not last as long as they would with the Radiesse. To treat aging hands, I like to use a combination of volume restoration with IPL (intense pulsed light) or the Q-switched alexandrite/ruby/nd:yag laser to remove the sun spots. In addition, another laser, the fractionated carbon dioxide laser (Fraxel Re:pair or Lumenis Active/Deep FX) can be used on the backs of the hands to promote skin thickening (collagen regeneration and remodeling) and even out pigment irregularities. Finally, if the veins on the backs of your hands appear prominent and still bother you despite the restoration of volume to the area, they can be treated with sclerotherapy (injections into the veins which cause your body to ultimately break them down and subsequently resorb them). For each of these procedures, I'd recommend that you see a physician who has experience specifically in treating the hands (ie. cosmetic dermatologists/plastic surgeons), and with whom you feel comfortable. Asking your doctor for examples of "before" and "after" pictures from patients that she/he has treated is always a good idea.