I do not see a role for filler or fat transfer in your case. You are bothered by the the texture and discoloration. Microneedling, light peels, photorejuvenation, are some of the procedures which will reduce the laxity the discoloration. The use of hand creams containing hydroquinone and good moisturizer can further improve the results . You should also use sunblock regularly.
Hi seen your pic of your hands regarding your concern of volume loss which can be improved by long lasting fillers,.for more longevity results soft tissue augmentation with autologous fat grafting will be a better option,to begin with to use topical creams and sunscreen to protect from extrinsic ageing.
What option is best to rejuvenate my hands?
Radio frequency is the best current gold standard laser treatment for tightening of the skin. It is useful all over the body, fave and hands.
The hands, just like the face, need care and attention. Since we often neglect to put sunblock on our hands they tend to age more rapidly. My recommendations for hand rejuvenation include: Radiesse injection for volume restoration. This filler is injected under the skin of the hands to help them look more volumized and youthful. It will help mask visible veins in the hands which become more prominent as we age. For the skin of the hand I would start with topical skincare products. You need to be vigilant with sunblock and reapply it throughout the day. Maintaining the moisture barrier of the hands is also important so make sure you moisturize them regularly. You might consider a heavy moisturizer at night and sleeping with cotton gloves on. Remember to treat your hands like your face. You can use your facial skincare products on your hands (or products designed exclusively for hands). The important things are to minimize environmental exposure and improve the quality of the skin on the hands at your age.
The response to cold raises the question whether you have a condition called Raynaud's disease which makes you more sensitive to cold. This may occur alone or be associated with collagen vascular disease. For Raynaud's cold avoidance is best. For simple measures for improving the appearance of your hands essential fatty acids such as flaxseed oil will add to the overall health of your skin and excipal hand cream from cvs will help.