Varicose Vein Removal

Varicose veins are bulging leg veins. They commonly run in families and often appear during and following pregnancy. They are caused by an underlying problem in one of the two main surface veins of the leg. Broken one-way valves prevent blood from returning to the heart, thus, the blood flows downward instead of upward. The increased pressure backs up into veins just beneath the surface of the skin and the result is known as varicose veins. Varicose vein removal, also known as phlebectomy, helps relieve the symptoms of varicose veins and also improves the appearance of the area where the varicose veins are located. Varicose veins can be removed via surgery, wearing compression socks or undergoing lifestyle changes once the veins become overfilled with blood and enlarged.

Am I a Good Candidate for Varicose Vein Removal?

There are a number of factors that go into determining if a person is a GOOD CANDIDATE for removing varicose veins:

• If a person has one parent with varicose veins, the likelihood of developing varicose veins is increased by 20%-30%. If both parents have varicose veins, the chances increase to 80%.
• During pregnancy, the increase in female hormones weakens the vein walls. Leg veins enlarge and the valves do not work properly. This allows the blood to flow back down the leg (reflux) and collect in surface veins. Additional pregnancies worsen the problem. Fortunately, varicose veins do not appear with every pregnancy.
• People over the age of 50 have a good chance of developing the condition.
• Obesity plays a large part in developing varicose veins.
• Standing for long periods of time (at work for example) can cause the veins to become overfilled.

Patients that are less likely to develop varicose veins, or who are NOT GOOD CANDIDATES for their removal, include:

• Women who have not had a pregnancy
• Patients with skin infections or blood clotting issues
• People with poor leg circulation
• Patients that are in relatively good shape and maintain a healthy weight

How are Varicose Veins Removed?

The most important step in removing veins is to shut down the faulty main surface collecting vein (the saphenous vein) that is feeding the overlying bulging veins. In the past, this was performed by a method called vein stripping and this meant a trip to the hospital for large cuts and general anesthesia. Today, the underlying vein can be shut down with a laser, which seals the nonfunctioning vein and eliminates the backwards pressure so varicose veins cannot develop. Best of all, this procedure is done in the office under local anesthesia.

The next step is eliminating the bulging surface varicose veins.  They can be treated in one of two ways:

1. If the veins are small, the doctor can inject chemicals (known as sclerotherapy).
2. If the veins are larger they can be removed (microphlebectomy). Removal is usually done at the same time as the laser closure of the underlying vein.  The small scars heal quickly and they are almost invisible after a few weeks.

For patients who do not wish to undergo surgery, there are a number of other options available:

• Lifestyle changes such as not standing for long periods of time, maintaining a healthy weight and exercising to improve the circulation
• Wearing special compression stockings or socks to put pressure on the legs to help the flow of blood and decrease swelling
• Endovenous ablation therapy which uses heat and radiofrequency waves to block off a vein

What is the Cost of Varicose Vein Removal?

The cost of varicose vein removal might be covered by insurance since the condition is often a symptom of vein disease. Patients should check with their insurance provider to see if they can get some (or all) of the costs covered. The total cost depends on the type of varicose vein removal treatment performed by the doctor as well as the extent of the work. Overall, the price of varicose vein removal ranges from $1500-$5000.

Recovery and Downtime

During their RECOVERY period, patients need to wear support stockings for four or five days after the procedure during the daytime. The support stockings help reduce bruising and soreness.

There are several non-surgical steps patients can do to relieve the symptoms of varicose veins:

• Exercising
• Losing weight
• Elevating the legs
• Refraining from standing or sitting for long periods of time
• Avoiding tight clothing

Results

Immediately after the treatment, the leg will be fairly bruised. This takes about a month to go away. The small phlebectomy scars heal quickly. 

The cosmetic results of treatment for varicose veins are dramatic. Overall, the legs feel less heavy and swollen. The treated veins seldom return. But since the patient has an underlying tendency to get varicose veins, a problem elsewhere may pop-up that is remotely located from the original treatment site.

If a vein pokes out after surgery, and the underlying problem has been treated successfully, the vein can usually be treated with an injection.

Limitations and Risks of Varicose Vein Removal

In general, there is NO LIMITATION to the number of treatments a patient can have to remove varicose veins. There is also no limit on the number of varicose veins that can be removed during a single procedure.

There are some RISKS associated with having varicose vein surgery and they include:

• Infection
• Bruising
• Nerve damage
• Bleeding
• Changes in skin color in the treated area
• Vein inflammation
• Pain over the vein 

Consult With a Doctor

Before a patient undergoes varicose vein treatment, he (or she) should consult with a vein specialist to determine the severity of the condition as well as possible health risks. The doctor can also help the patient determine if the patient’s insurance policy will cover some, or all, of the treatment costs. An experienced doctor will examine the patient and determine the best course of action for treating the current problem as well as preventing future varicose veins.

Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Wayne Gradman, MD in Los Angeles, CA