They have to tone everything down for the anime especially since its at the golden time or whatever when most of Japan is watching tv, and i don't think Tsunade uses Henge or genjustsu to keep a young appearance because Jiraiya says she uses a "special jutsu" for that and only when she used the seal release when the dot on her head healed her did her hand become wrinkly. So i think its some kind of medical jutsu