The legs are one of the most important attributes of female beauty – a symbol of attractiveness and desire. Many women are not completely happy with the colour and appearance of their legs and today women who are unhappy with their legs have many options which include Varicose Vein Removal.

For many women the enlarged veins that can be flesh coloured, dark purple or blue that look like cords and appear twisted and bulging, swollen above the surface of the skin, often found on the backs of the calves or on the inside of the leg may make them feel less attractive or look older than they feel, Varicose veins affect 1 out of 2 people aged 50 or older.

A varicose vein is a superficial (close to the surface) vein lying under the skin. The heart pumps blood filled with oxygen nutrients to the whole body. Arteries carry blood from the heart towards the body parts. Veins carry oxygen – poor blood from the body back to the heart. The ssqueezing of leg muscles pumps blood back to the heart from the lower body. Veins have valves that act as one-way flaps. These valves prevent the blood from flowing backwards as it moves up the legs. If the one-way valves become weak, blood can leak back into the vein and collect here. The problem is called varicous insufficiency. Pooled bood enlarges the vein and it becomes varicose which in time enlarges and worsens.

• Increasing age – wear and tear may cause valves to malfunction
• Hormonal changes. These occur during puberty, pregnancy and menopause
• Pregnancy. During pregnancy there is an increase in the amount of blood in the ody. This can cause veins to enlarge. Usually they will improve within 3 months of deşivery.
• Obesity, leg injury, prolonged standing and other activities that weaken vein valves.
• Sex – women have a higher chance than men to develop varicose veins due to hormonal changes
• Genetics – heredity plays a big role in the existence of varicose veins.
• Standing for a long time – blood doesn’t flow as easily if you are in the same position for a long time as the muscles are not contrcting to push the blood back to the heart.

The best candidates for varicose vein removal are those who are in good physical health, are mentally and psychologically stable, preferably do not smoke, those who want to improve their appearance and those who have realistic expectations about the procedure and the results. Extra reasons may include those who suffer from:

• Aching pain and discomfort in the legs
• Easily tired legs
• Feeling of heaviness in the legs
• Swelling in the legs
• Darkening of the skin (in severe cases)
• Numbness in the legs
• Itching or irritated rash in the legs

Reasons to have Varicose Veins Removed:

• To increase self confidence and enhance self image
• Having family members with vein problems or being born with weak vein valves
• Hormonal changes. These occur during puberty, pregnancy, and menopause. Taking birth control pills and other medicines containing estrogen and progesterone also increase the risk of varicose or spider veins
• Pregnancy. During pregnancy there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. The expanding uterus also puts pressure on the veins. Varicose veins usually improve within 3 months after delivery. A growing number of abnormal veins usually appear with each additional pregnancy
• Obesity, leg injury, prolonged standing and other things that weaken vein valves
• Sun exposure, which can cause spider veins on the cheeks or nose of a fair-skinned person

Varicose veins may cause health problems that include:

• Severe venous insufficiency. This severe pooling of blood in the veins slows the return of blood to the heart. This condition can cause blood clots and severe infections. Blood clots can be very dangerous because they can move from leg veins and travel to the lungs. Blood clots in the lungs are life-threatening because they can block the heart and lungs from functioning.
• Sores or skin ulcers can occur on skin tissue around varicose veins.
• Ongoing irritation, swelling and painful rashes of the legs

Pregnant women sometimes complain of varicose veins. Pregnancy increases the volume of blood in a womans body, however, it decreases the flow of blood from the legs to the pelvis. This change in circulation is designed to support the growing baby, but it can produce an unfortunate side effect such as enlarged veins in the legs. Varicose veins may appear for the first time during pregnancy.

Some are very surprised to learn that hemorrhoids are actually varicose veins located in and around the anus.

Not all varicose veins can be prevented but some things can be done to greatly reduce the chances of getting varicose veins which include:

• Wear Sunscreen to protect your skin from the sun and to limit spider veins on the face.
• Exercise regularly to improve your leg strength, circulation, and vein strength. Focus on exercises that work your legs, such as walking or running.
• Control your weight to avoid placing too much pressure on your legs.
• Do not cross your legs when sitting.
• Elevate your legs when resting as much as possible.
• Do not stand or sit for long periods of time. If you must stand for a long time, shift your weight from one leg to the other every few minutes. If you must sit for long periods of time, stand up and move around or take a short walk every 30 minutes.
• Wear elastic support stockings and avoid tight clothing that constricts your waist, groin, or legs.
• Eat a low-salt diet rich in high-fibre foods. Eating fibre reduces the chances of constipation which can contribute to varicose veins. High fiber foods include fresh fruits and vegetables and whole grains, like bran. Eating too much salt can cause you to retain water or swell.
 

Planning

Pre-visit and during consultations the surgeon will try to evaluate your physical-mental health and any medical conditions. In order to obtain the best results it is important that you are honest with the surgeon, that you advise any previous surgeries, if you are taking any medications, herbal supplements, vitamins or other drugs and if you smoke. Be sure to discuss your expectations and goals. the surgeon is here to guide, advise and explain to you how the surgery will be performed, possible alternatives that may offer better results, the risks and limitations of each as well as details of follow up and after care.

The Procedure

Treatment and procedures for the removal of Varicose Veins:

There are a number of techniques used for the removal of varicose veins and the surgeon will discuss these with you and decide which is the most suitable option for you depending on the cause and the severity of the proble.

Some available treatments include:

Sclerotherapy
This is the most common, most effective, treatment for both spider veins and varicose veins and it does not require anaesthetic. The doctor injects a solution into the vein that causes the vein walls to swell, stick together, and seal shut. This stops the flow of blood and the vein turns into scar tissue. In a few weeks, the vein should fade. The same vein may need to be treated more than once but most patients can expect a 50% - 90% improvement..
This treatment is very effective if done the right way. Most patients can expect a 50% to 90% improvement. Microsclerotherapy uses special solutions and injection techniques that increase the success rate for removal of spider veins. Sclerotherapy does not require anaesthesia, and can be done in the doctor's office.
Possible side effects include:
• Temporary stinging or painful cramps where the injection was made
• Temporary red raised patches of skin where the injection was made
• Temporary small skin sores where the injection was made
• Temporary bruises where the injection was made
• Spots around the treated vein that usually disappear
• Brown lines around the treated vein that usually disappear
• Groups of fine red blood vessels around the treated vein that usually disappear

The treated vein can also become inflamed or develop lumps of clotted blood. This is not dangerous. Applying heat and taking aspirin or antibiotics can relieve inflammation. Lumps of coagulated blood can be drained.
 

Laser Surgery
New technology in laser treatments can effectively treat spider veins in the legs. Laser surgery sends very strong bursts of light onto the vein. This can makes the vein slowly fade and disappear. Lasers are very direct and accurate. So the proper laser controlled by a skilled doctor will usually only damage the area being treated. Most skin types and colours can be safely treated with lasers.
Laser surgery is more appealing to some patients because it does not use needles or incisions. Still, when the laser hits the skin, the patient feels a heat sensation that can be quite painful. Cooling helps reduce the pain. Laser treatments last for 15 to 20 minutes. Depending on the severity of the veins, two to five treatments are generally needed to remove spider veins in the legs. Patients can return to normal activity right after treatment, just as with sclerotherapy. For spider veins larger than 3 mm, laser therapy is not very practical.

Possible side effects of laser surgery include:
• Redness or swelling of the skin right after the treatment that disappears within a few days.
• Discoloured skin that will disappear within one to two months.
• Rarely burns and scars result from poorly performed laser surgery.
Endovenous Techniques (radiofrequency and laser) – These methods for treating the deeper varicose veins of the legs (the saphenous veins) have been a huge breakthrough. They have replaced surgery for the vast majority of patients with severe varicose veins. This technique is not very invasive and can be done in a doctor’s office.

The doctor puts a very small tube called a catheter into the vein. Once inside, the catheter sends out radiofrequency or laser energy that shrinks and seals the vein wall. Healthy veins around the closed vein restore the normal flow of blood. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink after treatment. When needed, these connected varicose veins can be treated with sclerotherapy or other techniques.
Possible side effect is slight bruising.
Endovenous Techniques (radiofrequency and laser)
These methods for treating the deeper varicose veins of the legs (the saphenous veins) have been a huge breakthrough. They have replaced surgery for the vast majority of patients with severe varicose veins. This technique is not very invasive and can be done in a doctor’s office.
The doctor puts a very small tube called a catheter into the vein. Once inside, the catheter sends out radiofrequency or laser energy that shrinks and seals the vein wall. Healthy veins around the closed vein restore the normal f low of blood. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink after treatment. When needed, these connected varicose veins can be treated with sclerotherapy or other techniques.
Possible side effect is slight bruising
 

Surgery
Surgery is used mostly to treat very large varicose veins. Types of surgery for varicose veins include:
Surgical Ligation and Stripping - With this treatment, problematic veins are tied shut and completely removed from the leg. Removing the veins does not affect the circulation of blood in the leg. Veins deeper in the leg take care of the larger volumes of blood. Most varicose veins removed by surgery are surface veins and collect blood only from the skin. This surgery requires either local or general anaesthesia and must be done in an operating room on an outpatient basis.
Possible side effects: Serious side effects or problems from this surgery are uncommon.

• With general anaesthesia, a risk of heart and breathing problems.
• Bleeding and congestion of blood can be a problem. But the collected blood usually settles on its own and does not require any further treatment.
• Wound infection, inflammation, swelling and redness.
• Permanent scars.
• Damage of nerve tissue around the treated vein. It is hard to avoid harming small nerve branches when veins are removed. This damage can cause numbness, burning, or a change in sensation around the surgical scar
• A deep vein blood clot. These clots can travel to the lungs and heart. Injections of heparin, a medicine that reduces blood clotting reduce the chance of these dangerous blood clots. But, heparin also can increase the normal amount of bleeding and bruising after surgery.
• Significant pain in the leg and recovery time of one to four weeks depending on the extent of surgery is typical after surgery.
• Patients should be able to return to a light job after about 2 weeks and any heavy job within 4 weeks

Ambulatory Phlebectomy
With this surgery, a special light source marks the location of the vein. Tiny cuts are made in the skin, and surgical hooks pull the vein out of the leg. This surgery requires local or regional anaesthesia. The vein usually is removed in one treatment. Very large varicose veins can be removed with this treatment while leaving only very small scars. Patients can return to normal activity the day after treatment.
Possible side effects:
• Slight bruising
• Temporary numbness

Endoscopic vein surgery
With this surgery, a small video camera is used to see inside the veins. Then varicose veins are removed through small cuts. People who have this surgery must have some kind of anaesthesia including epidural, spinal, or general anaesthesia. Patients can return to normal activity within a few weeks.
Current treatments for varicose veins and spider veins have very high success rates compared to traditional surgical treatments. Over a period of years, however, more abnormal veins can develop. The major reason for this is that there is no cure for weak vein valves. So with time, pressure gradually builds up in the leg veins. Ultrasound can be used to keep track of how badly the valves are leaking (venous insufficiency). Ongoing treatment can help keep this problem under control. The single most important thing a person can do to slow down the development of new varicose veins is to wear graduated compression support stockings as much as possible during the day.

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