If you want to guess someone's age, look at her hands.
Exercise and the right clothes can make our bodies look more youthful. Makeup and anti-wrinkle cream can keep our faces young. But for the most part, our hands have had little to protect them from the ravages of time.
Until recently. Cosmetic surgeons now offer a number of treatments to give aging hands a youthful appearance. People are taking advantage of them, too, particularly those who have cosmetic work done on other parts of their bodies.
"A lot of folks realize that the hands give them away," says Dr. Janet Turkle, a plastic surgeon in Indianapolis. "If they have a face-lift and they get all prettied up, all of a sudden, they're looking at hands that don't match."
It's a dynamic that Indianapolis plastic surgeon Bruce Van Natta expects will only increase over time. He, too, has patients who invest in a face-lift, then suddenly notice their hands.
"I think it's something we're going to see more and more as the boomers age," he says. "They're a little more attuned to this."
For Eileen Bewley, 53, the wake-up call came in the treble voice of a child.
A few years ago, Bewley was sitting on an airplane, chatting and laughing with the little girl next to her, when the girl looked down and asked, "Why do you have old-lady hands?"
The question did not completely take Bewley by surprise. Fit, with blond hair and a self-described tendency to "act goofy," Bewley frequently found herself mistaken for someone younger. Then her hands, which she described as being "skinny and wrinkled and veiny" would give her away.
Prompted by this little girl's tell-it-like-I-see-it question, Bewley decided to do something about her hands. She had Turkle inject Juvederm, a filler, to plump out her hands and give them a more youthful appearance.
Interest in so-called "hand lifts" has increased in the past five years, says Dr. Michael Fiorillo, a plastic surgeon in New York City
, with people staying in the work force longer. They may take pains to keep their faces youthful, but their hands stand out.
"You see men in a business suit and the only thing showing in a business suit is your face and the back of your hands," he says.
Turkle sees mostly women seeking treatment on their hands, presenting problems that range from thin skin such as Bewley's to dark, telltale age spots.
All of the same unseemly things that happen elsewhere as we age also transpire in our hands. They can wrinkle, develop age spots and lose fat. Mix in sun damage -- after all how many of us remember to spread that sunscreen down to our digits? -- and you have a recipe for granny hands.
That's where plastic surgeons enter the picture. If your hands' thinned appearance bothers you, you can rejuvenate them in various ways. A doctor can inject a filler such as Radiesse or Juvederm. This makes the veins less prominent, not unlike blowing up a balloon, Fiorillo says.
"You can kind of plump up the back of the hand. A lot of times you see the veins and tendons, and that makes the hand look a little older," Turkle says. "A youthful hand is a little fuller and plumper. If you look at an older hand, you see a lot more veins."
In the past five years, filler use has taken off, Turkle says. Fillers are used in many places, including earlobes that some people feel look too thin and wrinkly. Using filler on hands would probably cost about $900 for both hands, assuming each requires one filler. Typically, these fillers last six months to a year, and the more times you have this done, the longer each treatment seems to last, Turkle says.
For some, the filler effect can last even longer. Elaine Shaw had her hands done three years ago and has not returned. Shaw, 68, did only one hand for starters.
"I had the one done first, to see if I liked it," she says. "You could really tell the difference when you had them side by side."
Today, her hands still look younger, with the veins more concealed. Her face had always looked younger than her years, thanks to a sunscreen habit, and now her hands match, she says. She treats herself to manicures, and the combined effect draws comments.
"A lot of times I will be signing a credit card or at the bank and they will say, 'Oh you have pretty hands,' " she says. "For me that's a reaffirmation that they look nice."
Not everyone, however, is a fan of fillers.
Van Natta, a plastic surgeon with Meridian Plastic Surgeons in Indianapolis, prefers to use about an ounce of a person's own grafted fat as a filler. Not only does this method last indefinitely, it also produces a better appearance, he says. However, it takes longer -- about 2 1 / 2hours -- and costs $4,500 to $5,000.
For many people, it's not just a matter of thin skin but also sun-damaged skin with freckles and sunspots. Lasers and other techniques can help with that.
"Probably the ultimate treatment would be to do both -- one is providing volume and the other is treating the surface of the skin to make the texture better and to get rid of some of the pigmentation and uneven appearance to the skin," Van Natta says.
In fact, much of what you can do to improve your face, you can do to your hands, Turkle says. Microdermabrasion will stimulate the collagen, removing the top dead layer, and giving the skin a healthier appearance. Lasers will help erase brown sunspots and other discolorations.
Years ago, when Susan Norton tanned, she never thought about what all those rays might do to her hands. As she hit her 40s, though, her hands started to display dark age spots. She hated them. She would often cross her arms or hold them down to hide what she considered her unsightly hands.
"It really bothered me to the point where I would cover up my hands a lot," says Norton, 55. "I was so self-conscious of my hands. My mom's 86 and her hands look better than mine."
After three treatments with a light laser, however, Norton loves the way her hands look. When her treatments ended about two months ago, Norton decided she was so pleased with the result that she would have laser work done on her face.
After all, she figures, her face should look as good as her hands.