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Vein Surgery – San Diego, La Jolla, Inland Empire, Temecula
Stuart B. Kincaid, MD, FACS

Spider and varicose veins can affect the appearance of legs for both men and women. Spider veins look like fine webs or starbursts of veins that appear in small areas close to the surface of the skin. Spider veins can appear on the face in addition to the legs. Varicose veins are swollen, purple or blue and raised from the surface of the leg. In some cases, they look like bulging cords.

No one knows the actual cause of varicose or spider veins, but contributing factors include family history of vein problems and hormones. Natural changes in hormones from puberty, pregnancy and menopause increase the likelihood of varicose and spider veins for women. Obesity and long periods of standing can also contribute to their appearance. Medically, neither varicose nor spider veins are generally harmful, but they can be unsightly.

A variety of procedures are available to treat spider and varicose veins. Consult with you surgeon to make the best choice for you. In all cases, once the damaged vein is deadened, healthy veins take over blood flow to the leg.

Sclerotherapy is the most widely used technique and is highly effective for treating spider veins. The procedure is performed in a doctor's office and requires no anesthesia. Tiny needles are inserted into the damaged veins and a solution is injected. The solution causes the veins to swell and shut, which stops the blood flow. Eventually, the veins turn to scar tissue and fade. In some cases, particularly for varicose veins, more than one injection treatment may be required for complete closure of the vein. Some short term side effects of the procedure include stinging, cramping, red patches, skin discoloration and bruising. Patients may take aspirin and apply heat to alleviate any discomfort. Risks from the procedure include an allergic reaction to the solution or blood clots.

Electrodessication, similar to sclerotherapy, uses an electric current instead of a solution to seal off the damaged vein. This procedure offers an alternative to those individuals who are allergic to the injected solution used in sclerotherapy, but it may leave scars.

Laser Surgery has traditionally been used to treat spider veins of the face. New technologies have made this a viable alternative for varicose veins as well. A laser light is directed in short bursts at the damaged vein, which makes it fade and disappear over time. There may be some redness or swelling immediately after the treatment, but these side effects subside. Any discoloration fades in 1 to 2 weeks. Generally it takes about 15 to 20 minutes per treatment and requires 2 to 5 treatments per leg.

Closure Technique. This is a relatively newer, office-based and non-invasive technique for treating varicose veins. A tiny catheter tube is placed in the vein. Radiofrequency energy is sent through the catheter into the vein, which causes the vein to shrink. Some slight bruising is a common side effect of this procedure.

Surgical Ligation or Stripping. For larger or more extensive problems, this technique is used to literally remove the veins from the leg. The procedure can be performed on an inpatient or outpatient basis using general or local anesthesia. A small incision is made in as inconspicuous an area as possible. The vein is tied shut and removed or stripped from the leg. The most common side effects from this surgery are inflammation, infection and tiredness. Many patients experience some nerve damage around the scar, which can lead to some numbness, burning or a change in sensation. Blood clotting is also a concern, although medication can be prescribed to help prevent any clotting.

Ambulatory Phlebectomy is similar to surgical ligation or stripping. The outpatient procedure can be performed using a local or general anesthetic. Again, small incisions are made in the leg. In this case, surgical hooks are used to grab and remove the veins. Scars from ambulatory phlebectomy tend to be smaller than those resulting from surgical ligation and stripping.

No vein treatment is 100 percent. New veins can grow where old veins were eliminated and, particularly in cases of family heredity, they may also become varicose or spider veins. However, vein treatments are generally quite successful.

For more information visit The American Society for Aesthetic Plastic Surgery (ASAPS) and The American Society of Plastic Surgeons (ASPS).