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

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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Is there a difference between PAD and varicose veins, and are there tests to confirm? Also can you have Venous closure surgery if you have PAD?

Peripheral arterial disease (PAD) usually refers to atherosclerosis in the walls of arteries, causing blockage which can manifest as pain in walking, fatigue in the calves with walking, poorly healing wounds, leg uclers, or severe pain in the feet.

Varicose veins and venous insufficiency are very different problems. A skilled physician usually can differentiate venous disease from arterial disease very quickly with a patient history and clinical exam. Some patients will have both arterial and venous disorders and some arterial testing may be in order.

Sometimes the arterial testing is measurement of blood pressures or flow at different levels in the legs. At other times, arterial ultrasound studies may be of value. VNUS Closure procedures and LASER procedures can be done on patients withe arterial occlusive disease as long as the blood flow is adequate for healing, but should be perfomed only after a careful evaluation of the patient for adequancy of arterial blood flow to the tissues.

- Dr. Wright

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I’ve read about injecting Botox to cause muscle atrophy around the jaw lines hence making your face to appear slimmer or less square. How effective and safe is the procedure?

I do not perform Botox in this region. Best person to check with would be a plastic surgeon.

- Dr. Wright

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I just got a facial, my last one was over 6 years ago. Should there be a regularity to how often I get a facial? Also, what kind of facial is best for overall skin health?

You can have facials as often as you like as long as they are not irritating your skin.

It would probably not be best to have them any closer together than 7 days as you may risk skin irritation. As all alternative to weekly facials, you may want to consider getting on a healthy exfoliating skin care product like a glycolic acid based wash or pad. Glycolic acid encourages exfoliation, which means that your skin cells reproduce more quickly and your skin generally feels softer and smoother.

- Dr. Wright

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I have very fair skin with freckles, and would like to get a chemical peel to lighten the freckles and even out my skin. What particulat peel or chemicals should I look for?

With fair skin, one has to be careful with peels. Lighterpeels will be OK in experienced hands. Sometimes, certain parts of the face (below the eyes for example) should not be peeled at all. get a consultation first to discuss your goals and skin type with an experienced provider before starting any chemical peels.

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What can I do to help with the side effects of this condition?

Any scar can be hard to treat. Some peels and bleaching agents can be helpful to lighten the scar.

- Dr. Wright

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How can I tell if spots on my face are Sun Spots or something else?

Most likely theses spots are sun spots. There are flat, darker than your normal skin color. They will vary in size. They won’t have any scaling. Borders are round. They are uniform in color.
Ones to be concerned about:
1. Irregular borders
2. Within the same spot there is an area that is much darker
3. Sudden change is color or size or shape

- Dr. Wright

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There are many variables that determine how many sessions one needs.

Here are some of them:
1. Type of laser
2. Patient tolerance to treatments – if one can’t tolerate a higher setting then it will take many more sessions.
3. Individual response to laser
4. Skin color – the darker the skin the more conservative you will have to be to avoid burns
5. Color of Hair – the darker the hair, the more the laser will affect the the hair follicle.
6. Skill of operator
7. Area of the body – facial hairs are usually less stubborn, pubic areas require more
8. Gender – males often will need more treatments
It is always best to get a consultation to have at least an estimate of the number of treatments. It is a must ask for the type of laser, the experience of the center and the person who will perform your treatments.

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The corners of my mouth look turned down, like I’m frowning or unhappy, when I am not showing any expression. Can lip injections help turn the corners of my mouth up?

Both dermal fillers and Botox can flatten the corners of your lips and get rid of the down-turned mouth.

- Dr. Wright

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The freckles on my face multiplied and have now formed what looks like a very large freckle, while I was pregnant, and it didn’t go away. What is this and is there anything I can do?

What you are describing sounds like melasma which is an unique pigment condition that is hormone driven. Melasma once activated is unfortunately not curable and can only be controlled. Lasers such as the Fraxel refine can be beneficial up to a certain point but they do run the risk of increasing the pigment. You can try Cosmalan which bleaches the pigment or other bleaching agents that contain Hydroquinone.

- Dr. Wright

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