Varicose Vein Treatment (Thousand Oaks)
Varicose veins are raised, tortuous bluish-purplish veins that can be found in any parts of the leg or thigh. Their cause is not entirely clear, but can be seen after pregnancy, weight gain, prolonged standing, and other causes of incompetent valves. Varicose veins can range from very fine capillaries in the skin, termed spider veins, to large bulging ones. At the Kryger Institute of Plastic Surgery, we offer treatment for all types of varicose veins. Spider and small veins are treated with injection sclerotherapy. Medium to large varicose veins are treated with a simple procedure using a laser to destroy the vein (see below).
What is Injection Sclerotherapy?
At the Kryger Institute we use the most advanced techniques of injection sclerotherapy to treat varicose veins. Sclerotherapy involves injecting small amounts of a chemical directly into the varicose veins. This causes the vein to collapse and scar.
Injection sclerotherapy is a simple, in-office procedure. Topical numbing medicine is applied to the skin overlying the veins. The injections are done using a tiny needle and there is minimal discomfort involved. The procedure takes about 20-30 minutes. You can drive immediately following the procedure. Only a limited number of areas can be treated per injection session, and occasionally more than one session is required.
What is Endovenous Laser Therapy?
This procedure is done in the office or in the operating under local anesthesia or light sedation. It is a minimally invasive method of eliminating varicose veins. First, an ultrasound is used to map the location of the veins. A local anesthetic is injected into the skin at one spot. Using a small needle, a tiny catheter is threaded into the vein requiring treatment. A laser located within the catheter is used to destroy the vein from the inside. The mechanism of vein elimination is due to the steam generated by the heating of small amounts of blood within the vein. This minimizes any damage to other structures.
The procedure takes about an hour to complete. The ultrasound mapping of the veins is usually done a day or two before the actual procedure. If local anesthesia alone is used, you may drive home. If sedation anesthesia is used, the patient cannot drive themselves home.
What is the Recovery from Varicose Vein Treatment?
The recovery from injection sclerotherapy is minimal. Some mild bruising and swelling usually resolves within a few days. The pain doesn’t last for more than a day. Patients are advised to avoid strenuous exercise for several days. Occasionally, leg elevation or compression is required.
Endovenous varicose vein ablation has a slightly longer recovery. Swelling and bruising can last up to a week. Compression and elevation should be done for a week, and the patient should minimize standing for long periods of time. Exercise and strenuous activity is avoided for a week.
Walking is encouraged immediately following the procedure, and for at least 1-2 hours a day.
What are the Potential Risks?
Sclerotherapy is quite safe. The potential complications are not common and occur only at the site of the injection. They include severe bruising, skin discoloration, and rarely development of skin breakdown.
Endovenous vein ablation is also very safe. Bruising frequently occurs and normally lasts for 7-14 days. About one week after the procedure, the treated vein may develop a feeling of tightness similar to that after a strained muscle. This temporary discomfort, likely related to inflammation in the treated vein segment, is self-limited and may be treated with Advil, walking, stretching, and graduated compression stockings. Inflammation of the surrounding veins (superficial phlebitis) occurs in about 5% of cases and it is managed with Advil, compression, and ambulation. Significant complications following laser ablation are very rare and include numbness or tingling, discoloration, skin burns, and blood clots.
Who is a Good Candidate?
Men and woman with small, medium and large sized varicose veins should consider undergoing treatment. Especially if there is pain, swelling or a heavy feeling in the legs. Patients should otherwise be in good health.
Some patients are NOT good candidates. These include:
- woman who are pregnant or breastfeeding
- patients with blood clots (DVT), or those with a previous blood clot
- patients on blood thinners
- patients who will be unable to walk after the procedure
Does Insurance Cover the Procedure?
Varicose vein ablation is usually covered by insurance if you are having true symptoms (e.g. pain, swelling, aching, etc.). Our pre-determination process will identify whether insurance coverage is possible. Most PPO plans and Medicare will cover the procedure. In all cases, a preoperative ultrasound exam is needed to determine whether there is a true problem with the vein (reflux of blood due to incompetence of the valves). Most insurances will require failure of conservative measures (e.g. compression stockings) before authorizing the procedure.
If insurance will not cover the procedure, or you do not have insurance, our cosmetic coordinator will discuss the costs with you at your consultation.
Injection sclerotherapy is not covered by insurance. The cost is based on the number of areas being treated.
How Long Will I Be Off Work?
After injection sclerotherapy, you will be able to return to work after one or two days. After underling laser vein ablation, prolonged standing should be avoided. Jobs that involve prolonged standing will require up to a week off of work. Desk or office jobs require only a few days off work.
What if I have a problem? When should I call the office?
The Kryger Institute welcomes calls from patients. If you have any concerns at any time, please feel free to call our office. If it is an emergency, the doctors are available 24 hours a day, including weekends and holidays. There is always a plastic surgeon on call. Your surgeon will discuss all the risks and potential complications with you before surgery. You will receive detailed instructions about situations that warrant a call to the office.