What surgery can make my hands appear more feminine? And what can improve the rough skin on my hands? (Photos)

Hands can be rejuvenated with a combination of fillers like Radiesse and Belotero, fat grafting with platelet-rich plasma (PRP) and lasers like Fraxel in addition to a physician-prescribed skin care protocol. I recommend getting a formal evaluation with a cosmetic dermatologist to develop a personalized treatment plan that works for you. Best, Dr. Emer

I would suggest a combination of physician directed moisturizing products, consider things like PRP with microneedling and go from there. I would suggest a visit with your PCP to rule out disease processes that can affect the hands and can be addressed from a system standpoint as well. Hope this helps!

The first thing I notice about your hands is the texture.  There are actually some very simple dermatologic tricks of the trade that can help before you even consider procedures.  First moisturize at least daily using a product containing glycerin to pull in moisture and dimethicone or cyclomethicone to seal it and make it feel silky.  It will help your skin quickly look better and stay better even if you are washing/using disinfectant liquids or wipes like 'purell'  (so common especially during cold season).  For additional improvement, start using a lotion or cream that contains an alpha hydroxy acid (lactic acid, glycolic acid) or retinoid (can be an over the counter retinol) at night under your heavier moisturizer.  Adding cotton gloves overnight will increase the penetration.  Over several months, the texture and color will become more even. From the photos, it does not appear that you have a volume loss or visible vessels and tendons.  If you did, then your dermatologist could inject a filler like Radiesse or Restylane Lyft to improve the surface contour and camouflage the visible structures.  If you had sundamage then fraxel laser resurfacing could help.  Simply for tightening you could consider a tightening procedure like Thermage however, I think the right topicals used regularly should be the first step.After using appropriate topical creams/lotions, if you are still having concerns, please see your dermatologist for evaluation.I hope this answer is helpful.  Best of luck.