Frequently Asked Questions

It's very important to understand our treatments and the effects they will have on you. We will of course outline everything and are happy to discuss concerns on out consultation calls. Please find below some of the common questions regarding all of our procedures and treatments.

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Varicose Veins - Laser and RFA

Post procedure:

 

After two or three hours on the ward you should feel fit enough to go home. Before you leave the ward staff will check your leg. They will give you a note for your general practitioner, and some painkillers to take with you. You will also be provided with an advice sheet. Your bandages will be removed the next day and a special support stocking is worn.

 

What about my wounds? 

Sometimes a little blood will ooze from the wounds during the first 12-24 hours after the operation. The amount is likely to be very small and bleeding usually stops on its own. If necessary, press on the wound for ten minutes with a dressing or a pad of paper tissues. If bleeding continues after doing this twice, phone the ward or your general practitioner.

Areas of tender lumpiness may be felt on the legs. This is caused by some bruising under the skin in the places where varicose veins were removed. It is not harmful and will gradually go away, but this may take several weeks. 

 

Will my legs be bruised?

Some bruising always occurs after varicose vein operations. This is sometimes quite extensive and may take some weeks to settle.

 

Will I have dressings or stitches?

The cuts down the leg are so small, they do not require stitches or adhesive strips. 

 

What about bandages and support stockings?

If you are advised to wear stockings during the days after the operation, these may be worn all the time, but if you find them uncomfortable at night, they can be taken off before you go to bed and then put on again in the morning. They are mainly intended to support the leg while you are up and about during the day. You should get clear advice about when to discard stockings – usually about ten days after the operation. 

 

Recovery - The Early Days:

 

How far should I walk?

Walking helps to disperse bruising and stops the leg becoming stiff. You can start to walk about as soon after the operation as you are able. The whole leg may be stiff, and tender to the touch in places. You will not damage any of the wounds by walking. Take painkillers and anti-inflammatories if you need them. Topical anti-inflammatory creams or gels can ease tender lumpy areas. Arnica can help with sensitive bruising.

You should aim to take walks every day for the first week or two. For many people this simply means getting back to their active daily routine as rapidly as possible. There is no special advantage in going for a single long walk during the day, although you may walk as far as you wish. Frequent walking is more important than walking a long distance. 

When you are not walking about try to put your foot up - either on a couch or on your bed. Avoid standing, or sitting with the foot on the floor as much as you can for about two weeks after the operation.

 

When will I be fully back to normal? 

This varies a lot between different people, and depends on how large and extensive your varicose veins were, which dictates the size of operation you will have had. In particular your recovery will depend on whether you have had an operation on one leg or both legs. 

 

If you have had surgery to one leg only: 

You are likely to feel tired for the first two or three days after the operation, and your leg will be stiff after walking long distances for about a week. By two weeks after the operation you are likely to be walking good distances with little discomfort, even though the leg may still be bruised and a little tender. 

 

If you have had surgery to both legs: 

You may need to rest two or three times a day for the first few days. It may be two or three weeks after operation before you are walking really comfortably. Your legs may be a little tender and bruised for a month or more. 

 

When can I drive a car? 

You can drive as soon as you feel confident that you can make an emergency stop without pain. This is often about a week after surgery. If you have an automatic car and surgery to the left leg then driving may pose little problem! If you are concerned, check with your insurance company. 

 

When can I fly? 

It is probably best not to fly for approximately one month after the operation. This is particularly important for long haul flights. 

 

When can I return to work and play sports? 

 

You can return to work and sporting activity as soon after the operation as you feel sufficiently well and comfortable. One week off of all work and a clear social diary is essential. If your job involves prolonged standing or driving, then you should not consider going back for at least two weeks. It is unusual to need more than about three weeks off work after surgery. 

 

Avoid violent sports while you are still in support stockings or bandages, and thereafter start with some gradual training, rather than in immediate competition. Do not go swimming until you are out of support stockings and all the wounds are dry. 

 

What are possible side effects or complications?

 

Serious complications are uncommon after operations for varicose veins. Some bruising is usual, and occasionally the leg becomes very bruised. This bruising may appear during the first few days after the operation: it will all go away over a period of weeks.

 

Aches, twinges, and areas of tenderness may all be felt in the legs for the first few weeks after the operation. These will all settle down, and should not discourage you from becoming fully active as soon as you are able. 

 

Lumps under the skin are common and are sometimes tender. They are not dangerous and will gradually be digested by the body, but this can take several weeks. Occasionally they can be quite painful during the first two weeks or more. Topical anti-inflammatory creams and gels are helpful.

 

Infection is an uncommon problem, but can occur. It usually settles with antibiotic treatment. 

 

Rarely, a leak of clear lymphatic fluid can occur from a wound, and this may take up to a few weeks to dry up. 

 

The risk of a complication such as infection or thrombosis is in the order of 0.5%.  The surgery is very safe.

 

Is there any scarring?

 

The scars on your legs are easily noticeable to start with, but will continue to fade for many months after the operation. Very occasionally, some people develop a little brown staining where the veins were removed, or areas of tiny veins appearing in the skin nearby: this is unpredictable and uncommon. 

 

Small nerves under the skin can be bruised when removing varicose veins close to them. This is uncommon, but will give an area of numbness on the leg, which settles or gets smaller over some weeks. If varicose veins on the foot are removed, damage to small nerves is a special danger. If a main vein behind the knee needs to be dealt with, then there is a small risk to the nerve which conducts feeling from the skin on the outer part of the lower leg and foot. The risk of nerve damage is increased when surgery is done after previous operations in the area.

Deep vein thrombosis causes swelling of the leg and can result in a blood clot passing to the lungs. It is an uncommon complication after varicose vein surgery, but is particularly unlikely if you start moving your legs and walking frequently soon after the operation. Heparin injections are given just before surgery to make the blood clot less than normal: these reduce the risk of thrombosis but increase bruising. If you are taking the contraceptive pill, your risk of thrombosis is increased, and the surgeon will discuss with you the pros and cons of stopping the pill or continuing it and taking special action to reduce your risk of a thrombosis. If you start taking the contraceptive pill while waiting for your operation, please let us know. 

What are the risks?

Any general anaesthetic carries risks, but considerable precautions are taken to keep these risks as low as possible. 

 

Will my varicose veins come back? 

 

Some people develop new varicose veins during the years after a varicose vein operation, but this is uncommon after thorough surgery guided by accurate duplex scanning. Rarely, varicose veins simply re-grow in the areas which have been dealt with, or else they develop in a different system of veins which was normal at the time of the original operation. If veins develop again they can be dealt with should they be troublesome or unsightly.

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Veinwave

What are Facial Thread Veins?

 

Facial thread or broken veins are also referred to as red veins. These veins are usually red in colour and form a reticular or net-like pattern on the cheeks, nose or chin. They may follow acne as a teenager or exposure to the elements such as horse riding or other outdoor pursuits.

 

How are they Treated?

 

The most effective treatment for facial veins is Veinwave. This is a delicate thermocoagulation technique which destroys these fine veins instantly with excellent cosmetic results. The treatment is an office based procedure. It is important not to wear foundation, artificial tan or other cover up on the day of treatment. One needs to avoid sunburn for a few days afterwards, use a sunblock if necessary.

 

Sharp scratches are experienced during the treatment session but this is not too unpleasant. Afterwards, small red dots may be visible at 10 -14 days. These little marks resemble tiny cat scratches and are called micro-crusts. They appear and then resolve completely. No cover up is necessary as they are usually not as noticeable as the original thread veins.

 

A top up session is usually required after the initial treatment. Rarely a third treatment is needed. As the veins are destroyed, they cannot return. However, more red veins can form over months or years, they are usually treatable.

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Micro-injection Sclerotherapy

What you need to know:

 

Spider or thread veins are similar to varicose veins but are a lot smaller and closer to the surface of the skin. Spider veins are usually red or blue in colour and resemble a spider web pattern. They occur most often in women and usually appear on the face and the legs.

 

The most common causes of spider veins include: Prolonged standing or sitting. Defective valves in the underlying veins. Other factors that may play a role in the development of spider veins include: Heredity, hormonal changes, pregnancy and sun exposure.

 

Spider veins may be mildly uncomfortable but they are not medically a serious condition. To prevent spider veins and reduce discomfort from existing spider veins it is advisable to protect your skin from the sun, exercise regularly, control your weight, avoid prolonged sitting and standing, wear elastic support stockings. Veinwave therapy is a cosmetic treatment for red spider or thread veins. This involves thermal-coagulation of these fine veins. The procedure is relatively painless and can be used for red veins on the legs. It is the only effective treatment for red veins on the face and nose.

 

How is the procedure done?

 

Micro-injection sclerotherapy is a consulting room procedure for small veins in the legs. A solution is injected into the tiny veins to irritate the lining and cause them to seal off. They are then naturally reabsorbed. This process does take some weeks before a difference is seen.

 

When can’t I get the procedure?

 

If you are pregnant or breastfeeding, you may be advised to postpone sclerotherapy or Veinwave treatment. It is not known how sclerosing solutions or other interventions may affect breast milk, nursing mothers are usually advised to wait until after they have stopped breastfeeding.

 

What is Micro-injection Sclerotherapy used to treat?

 

Sclerotherapy is ideal for the treatment of bluish coloured thread veins. It is used to supplement Veinwave treatment of red spider and thread veins.

 

Micro-injection sclerotherapy can enhance your appearance and your self confidence, but it is unrealistic to believe that every affected vein will disappear completely as a result of treatment. After each sclerotherapy session, more veins will begin to fade. Two or more sessions are usually required to achieve optimal results; these may be combined with Veinwave sessions. Before you decide to have thread veins treated, think carefully about your expectations and discuss them with us.

 

What are the Risks Related to Treatment?

 

Serious medical complications from sclerotherapy are extremely rare when the procedure is performed by a vascular surgeon. It does take some weeks for a noticeable difference to be seen. For the first two days after treatment the areas injected will look red and puffy. This inflammation is normal, does not feel uncomfortable and disappears completely. Veins may look more prominent after treatment before they are absorbed by the body's natural processes. Bruising on a very minor scale may be evident where the needle has been inserted. Occasionally small lumps may be felt. They are usually less than the size of half a pea. These will be absorbed over time. Rarely an area of injection may form a scab which can take weeks to resolve. A common cosmetic complication is pigmentation. Where veins have been absorbed marks can appear which are the colour of freckles. Most people feel that this is more acceptable than the original flares. Such staining does fade over some months. Another problem that can occur is pink matting in which fine reddish blood vessels appear around the treated area, requiring further injections or Veinwave therapy.

 

What does Planning Your Treatment look like?

 

During your initial consultation, your legs will be examined. We may photograph or draw a simple sketch of your legs. During the examination, you will be checked for signs of more serious vein problems, especially underlying varicose veins. A hand-held Doppler ultrasound device is sometimes used to detect any back flow within the venous system. If such problems are identified, your surgeon may require further information from a leg duplex ultrasound scan. Problems with the larger veins should be treated first, or treatment of the surface veins may be less successful.

 

We will ask you about any other problems you may have with your legs, such as pain, aching, itching or tenderness. You will also be asked about your medical history, medications you take, or conditions that would preclude you from having treatment.

 

Where is the Treatment Performed?

 

Sclerotherapy of spider veins is a relatively simple procedure that requires no anaesthesia, so it will be performed in one of our consulting rooms.

 

How long is the Procedure?

 

A typical sclerotherapy session is relatively quick, lasting only about 15 to 20 minutes. The consultant surgeon will inject a sclerosing solution into the affected veins using an ultra-fine needle. Bright, indirect light and magnification help ensure that the process is completed with maximum precision. As the procedure continues, you will feel small needle sticks but the experience is very acceptable to most people.

 

How long does it take to get back to Normal?

 

Although you probably won't want to wear any leg-baring fashions for about two weeks, your activity will not be significantly limited in any other way from sclerotherapy treatment. A one-month healing interval must pass before you may have your second series of injections in the same site. After each treatment, you will notice further improvement of your legs' appearance.

 

Over 90% of patients are pleased that they look better after sclerotherapy. If you've been wearing long skirts or trousers to hide your spider veins, you'll now be able to broaden your fashion horizons. Often, patients are surprised at the dramatic difference in appearance between a treated leg and an untreated one.

 

Although sclerotherapy will obliterate the noticeable veins for good, it is important to remember that treatment will not prevent new spider veins from emerging in the future. As time passes, you may find that you need "touch-ups" or full treatments for new veins that surface. But even if you choose not to have further sclerotherapy, your legs will look better than if you never had treatment at all.

 

This information is general in nature. It is for guidance only, We can advise you on specific information relating to your veins.

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