New Body Cosmetic Surgery Center, Pasadena, CA

Vein Treatments Available At Dr. Yoho's Cosmetic Surgery Office

The Problem

There are three types of leg veins, varicose veins like big ropes, little tiny spider veins, and the "reticular" or blue veins that connect together like a map with roads on it. These reticular veins are often normal but can be treated if the patient desires.

Before 3 months
after		 Before 4 months
after

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Symptoms

Those with leg vein problems of any kind often have heaviness of the legs, swelling, achy pain, and sometimes discoloration and even ulceration.

How The Vein System Works

There are two main surface veins that drain into the deeper system: the greater and lesser saphenous veins. The greater saphenous vein is on the inside of the leg and extends down to the foot. The lesser saphenous is on the back of the calf. Note carefully: most vein problems are related to these two big veins and unless they are treated properly, recurrence is very likely. Big varicose veins and spider veins and all the ones in between are usually due to abnormally high pressure in these main vein(s).

Treatments Available

  • Sclerotherapy or injection therapy is effective for large and small vein treatment. The latest thing: injection of foam formulations that work better and are much less likely to produce problems than the old liquids injectables. Injections can be used for the smallest to the largest of veins.
  • Stripping or surgical removal of large veins is the time-honored way to treat them, but recurrence was frequent if there was no follow up with proper injection. And you have to have a real surgery, with cuts and stitches and a recovery. If there's anesthesia, there's the anesthesia risks and discomfort to consider.
  • Ultrasound-guided sclerotherapy made injections of the larger veins much more predictable and safe, and when foam is used becomes even more effective.
  • Endovenous laser ablation (EVLA) is a revolutionary new way to treat the large veins of the leg. Under local anesthesia, a tiny laser fiber is threaded into the vein and then the laser light is directed down the fiber and the vein is destroyed. This has the potential to completely cure the diseased vein with minimal down time and remarkably low chance of complications.
  • Other Lasers are sometimes used for the smallest veins, focused on the color of the vein.
  • The most modern effective treatment plan is: first, creating a map of the whole vein system using a color ultrasound machine. Then, if appropriate, the diseased parts are treated with either the new EVLA or the ultrasound-directed foam therapy. Weekly treatments are performed until the patient has no more significant disease visible on the ultrasound machine. We believe that this plan produces the best chance of long-term success.

You can read an article in Skin and Aging Magazine about these therapies if you click here.

Now that we have explained the variety of vein treatment procedures available to you, we invite you to schedule a consultation with Dr. Yoho today. If you are considering treatment for your spider veins or varicose veins, Pasadena cosmetic surgeon Dr. Yoho would like to meet face to face with you and answer all your sclerotherapy questions. And when you register online, your sclerotherapy consultation is free.

Complications and Risks

  • Every patient develops some degree of brown pigment change of their legs. This is from the bruising, and happens when the red blood cells go into the tissue around the vein after the vein has been destroyed. This can last months and in some cases can be permanent.
  • The areas treated may get red and swollen, which is called "phlebitis". We treat this with more injections to attempt to completely destroy the diseased vein, and give antibiotics.
  • Blood clots in the deeper vein system (deep vein clots of the leg) are rare, and will be discovered at your follow-up and treated after we look at the vein with the special ultrasound machine.
  • Blood clots of the legs that go to the lungs are theoretically possible but very, very rare.

Frequently Asked Questions

  1. Doesn't destroying all these veins leave me without enough veins to have my coronary artery bypass (heart) operation?
    Answer: the veins that are destroyed are diseased and couldn't be used by the surgeon anyway. They are too big.
  2. Don't I need some of these veins for my body to function?
    Answer: you have many thousands of veins in each leg and other normal veins will take over.
  3. How much discomfort will I have before and after the procedure?
    Answer: Dr. Yoho performs this procedure under local anesthesia. He offers sedation if you desire. But most people do well with just the local, as we are very gentle. After the procedure, if you have any pain that Tylenol® doesn't handle, we want to see you. This is very rare.
  4. How long does the procedure take?
    Answer: anywhere from 1/2 hour to an hour.
  5. Which veins can be treated?
    Answer: We mainly treat leg veins, but some of our patients request treatment for hand veins and this also works well.
  6. Are there any limitations on activity after the procedure?
    Answer: No, you should be as active as possible, but you must wear some compression sox as directed.
  7. What causes these veins?
    Answer: the natural maturation process, standing on your legs for occupational reasons, genetics, and pregnancy are some of the causes.

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