What would be the best way to rejuvenate my hands? Should I address the veins or add fat? (Photo)

Your own fat is the most natural looking product available for hand rejuvenation. Fat transfer can be performed under local anesthesia, and help hide the veins and arteries you see with aging. Plus, the stem cells improve the skin.

Volume restoration with a robust HA volumizing filler has become routine practice in any active cosmetic dermatology practice. The fact that the tendons stand out so prominently suggests significant volume loss and is a very good indication that addressing this will rejuvenate the appearance of the hands. Sclerosing the blood vessels would likely do little for restoring a more youthful appearance to the hands, but will also disable vessels that one day may be critically needed for IV infusions for various medical treatments. Autologous fat transfer, as opposed to the nonsurgical use of robust HA fillers (which is nonsurgical and engenders little to no significant post-treatment downtime), has certain very important drawbacks. For one, it is a relatively expensive, two-step minimally invasive procedure that requires large bore cannulas to withdraw fat from the donor areas (usually buttocks, hips, belly) and then to transfer the fat into the recipient area. Borh areas engender a real period of post-treatment downtime. What's more, injected fat retains the characteristics of the area from which it is taken, meaning that when belly fat develops a midriff bulge, the fat taken from that region is likely to develop it, as well, in the recipient site. You would be wise to consult with an experienced, board certified cosmetic dermatologist. Best of luck.