Vein Treatment Varicose Veins Laser Lipo & Vein Care Center Ask the Doctor

Q: I had veinwave treated for spider veins on my face 2 months ago but my face is worse after the treatment. It looks scarred. Will this go away?

A: I wasn’t aware the Veinwave could cause scars. The company that sells the machine claims it doesn’t scar. I have not seen any scarring. My guess is that you have some hyperpigmentation, which usually fades over a year or so. Consult with your doctor about your results and their cause.

- Dr. Wright

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Q: My compression stockings really hurt the back of my knees I cannot gt my compression stocking to not have wrinkles. These wrinkles gather around the back of my knee and really hurt. How do I overcome that?

A: The keys with compression stockings are that they fit properly and that they are worn. It seems that they do not fit you properly. They could be too long. I would recommend a custom fit stocking or perphaps another brand. Please discuss your results with your doctor to ensure a proper fit.

- Dr. Wright

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Q: How long do sclerotherapy chemicals stay in the bloodstream? I would like to become pregnant, but would like to know what’s safe.

A: I am asked this question many times. You can safely get pregnant immediately after a treatment. But if you do get pregnant in the middle of a series of treatments, you should stop all treatments until 3 months after you deliver. This is a wide safety margin for the prevention of blood clots. The medications that are used by almost all experts, Sodium Tetradecyl Sulfate and Polidocanol, are very safe. They are fatty acid esters similar to lidocaine. They are cleared out of your system in 24 hours or less and present no difficulties.

- Dr. Wright

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Q: I have to wear a compression sock because I had a DVT and the valve in the vein that runs behind my knee is broken. I am still young and would like this fixed so I don’t have to wear the sock. Is there a procedure to fix this?

A: I strongly recommend that you continue to wear the compression stockings per your physicians recommendation since this has been shown to decrease the chance of “post thrombotic syndrome.”

Additionally, you really need to know which “valve is broken.” A complete ultrasound is needed. If you do not have any DVT anymore and you have superficial venous reflux, that could be treated and you could get improvement of your symptoms (assuming you have them).

- Dr. Wright

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Q: Is EVLT recommended for lipodermatosclerosis (LDS)?

A: Lipodermatosclerosis is a form of scarring due to venous insufficiency. It will not go away with the laser procedure but may improve if treamtent gets rid of the cause of your venous insufficiency.

- Dr. Wright

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Q: It is the tool used to pull veins through microincisions. What are these called?

A: Phlebectomy hooks would be the general name for the tool. There are many types including Varaday, Ramelet, and Mueller to name a few.

- Dr. Wright

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Q: Can you please detail some of the restrictions after an Endovenous Laser Ablation?

A: Normal activity should be ok, including walking, standing, and house chores. Activity can essentially be resumed right away. Rigorous exercise and heavy lifting (<20lbs) will need to be delayed by 1 week. Typically showering is ok immediately as well. I advise compression stocking use on the leg for 1 week after the procedure.

- Dr. Wright

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Q: Is it harmful to your leg circulation to sit with them crossed?

A: Leg crossing has by myth been accused of causing all varieties of circulatory problems.

Interestingly, there has not been a scientific article confirming this ingrained and still-propogated rumor. Even more fascinating, there is strong and growing evidence the leg crossing favors circulation, especially the vein system! Many studies well designed have demonstrated that sitting with legs crossed reduces stagnation and pooling of blood.

- Dr. Wright

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Q: Does it matter if I fly after a varicose vein surgery?

A: While there is no specific answer to this important question, the following guidelines should help: First, the question comes up because air travel is a known risk factor for the development of vein thrombosis and phlebitis. The concept is to minimize multiple risks for these complications. The risk of phlebitis is rather low after a vein operation, however the nature and extent of the procedure is the most important aspect to consider. Other pre-existing risks need also be taken into account. These include a previous history of phlebitis, a known hematologic hypercoaguable state, the general activity of the individual, and several co-morbid conditions.

While data suggests that the risk of flying increases over 2 1/2 hours, a planned shorter flight may be extended due to airline schedules, ect. I feel it is safe for a limited phlebectomy to fly after 2-3 days, where an extensive large vein sclerotherapy or endovenous vein ablation in my practice would lean towards 7-14 days.

- Dr. Wright

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Q: I just had Endovenous Laser Ablation and some of my bandages are blood soaked. Is this normal or is something wrong?

A: Some blood in the bandages is seen sometimes. It is not a serious or concerning complication for the great majority of patients. Compression for 5-10 min should take care of the problem. If it continues bleeding, you should notify your doctor immediately.

- Dr. Wright

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Q: If I have problems with just one leg, can I wear one compression stocking on the affected leg?

A: You can wear stockings on both as a matter of fashion.

- Dr. Wright

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Q: My doctor, during the screening, just said I had lots of veins and it would take at least 4 treatments. I specifically asked him about the ankle area and he just said “how afraid of needles are you?” I’ve read this area is difficult to treat?

A: Sclerotherapy can be very successful around the ankle. One must first be sure that all of the larger incompetent veins in the distal calf and ankle have been treated. I prrfer to treat ankles in several sessions since overaggressive sclerotherapy at the ankle can result in temporary swelling of the foot which can be very annoying to patients.

It is true however, that the foot and ankle are slightly more sensitive than the calf and thigh. These areas are basically skin and bone, with little subcutaneous tissure, or “meat” to help absorb inflammation. In addition, there are numerous tiny superficial nerves in these areas. Treatment is effective, but this area is sensitive.

- Dr. Wright

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Q: It’s been a year since my surgery and I still have brusing. Does that mean it is permanent?

A: Probably not. Most likely what you are seeing is not really bruising, but what we refer to as staining. This is a light brownish discoloration, which looks like a light bruise. This is caused from trapped blood in the areas of the treated veins.

Typically the body slowly reabsorbs this over time, and while the process is generally over a period of many months, it is not unusual for it to last longer. Although it may be difficult, the best thing to do is to be patient. You need to have a 1 year follow-up with your vein doctor to ensure there is no residual problem which may be slowing the reavsorption process, and which may be easly treated.

- Dr. Wright

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Q: Will Veinwave treat varicose veins?

A: No, the Veinwave can not treat the size of a varicose vein. Only the tiny red spider veins. Veinwave is very effective with these, but a larger vein calls for different treatment.

- Dr. Wright

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Q: I heard that ELVeS has recently updated or added a new type of procedure. What is it, and how is it different from ELVeS?

A: ELVeS is certainly the endovenous laser associated with the least discomfort by patient rating, on a scale of 1-10 (10 being the worst), the average rating was 3. Which is almost zero, but not quite. It is not completely painless but close. Discomfort is very low.

- Dr. Wright

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