title: Hand aging: patients' opinions.
abstract: BACKGROUND
  The purpose of this article is to identify factors that make hands look youthful or old and to assess whether altering any of these factors could influence the perceived age of the patient.
  
  
  METHODS
  A questionnaire showing digital images of female hands of different ages was administered. Some images were altered digitally to remove veins, blemishes, or wrinkles. Makeup and jewelry were added to others. A total of 93 questionnaires were completed. Statistical analysis of results with chi-square test was performed.
  
  
  RESULTS
  Wrinkles, veins, prominent joints, thin skin, deformity, and spots characterized old hands. Fullness, lack of veins, and lack of wrinkles characterized young hands. Images with veins removed looked younger than the originals, and this was statistically significant in all cases. Images with added makeup and jewelry were also felt to look younger, but this was not statistically significant. Alterations to images of very elderly hands did not make them look younger.
  
  
  CONCLUSIONS
  The authors have established factors that characterize the age of hands and established that hands with less visible veins, in general, look younger. Previous articles have claimed that fat grafting reduces the visibility of veins.
authors.affiliation: Department of Plastic and Reconstructive Surgery and Burns Unit, Pinderfields Hospital, Wakefield, United Kingdom.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Bains
authors.forename: Helen
authors.initials: H
authors.lastname: Thorpe
authors.forename: Stephen
authors.initials: S
authors.lastname: Southern
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003357:Cosmetic Techniques; D005260:Female; D006225:Hand / Q000098:blood supply; D050823:Hand Joints; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010781:Photography; D012060:Rejuvenation; D012867:Skin; D040521:Subcutaneous Tissue; D011795:Surveys and Questionnaires; D014680:Veins; D014796:Visual Perception