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Vein Treatments
Enlarged veins appearing on the legs affect a large proportion of the population. Spider veins, reticular veins and varicose veins are the three most common types of ‘abnormal’ veins and are usually seen in combination. Varicose veins are the largest of the three and can be flesh colored, dark purple or blue, often appearing above the skins surface on the backs of the calves or on the inside of the leg. Spider veins are similar to varicose veins, but are smaller and red or blue in color. Reticular veins are larger and deeper than spider veins and often feed spider veins. Thread veins are also common, and these can be caused by external factors such as sun damage, hormonal changes, pregnancy and physical trauma. Although many sufferers are concerned with the aesthetic appearance of these veins, in some cases vein disease can result in health problems such as blood clots, eczema, skin breakdown and ulceration.
Sclerotherapy is the treatment that involves injecting a solution into unwanted veins and is one of the most common treatments for both spider veins and thread veins. Varicose veins can be treated with sclerotherapy, but they may require a specific vein operation if severe. The injected solution causes the vein walls to swell, stick together and seal shut, preventing blood flow. The vein subsequently becomes scar tissue, is eventually absorbed and fades away. A similar result can be accomplished using special laser heat to weld the vessels shut below the skin surface.
Raúl P. Rodriguez, M.D. has been an innovator in minimally invasive cosmetic procedures and operations for many years. Dr. Rodriguez has been performing sclerotherapy since 1982 and introduced the modern Tumescence Enhanced Sclerotherapy (TES) to North Texas in 2004. Dr. Rodriguez has over 20 years of experience with lasers and has been performing laser vein removal since 1996. Dr. Rodriguez introduced the TriVex vein removal operation to North Texas at Medical City Dallas Hospital in 2000.
A full consultation will take place with Dr. Rodriguez prior to any procedure, with expectations and results discussed along with a detailed, customized treatment plan. At the time of your consultation, he will help you decide on the best treatment options to achieve the results you seek.
Tumescence Enhanced Sclerotherapy (TES) for Spider Veins and Reticular Veins
Sclerotherapy is considered a simple procedure with minimal discomfort and no requirement for a hospital stay. The sclerosing agent used in the treatment contains local anesthetic properties to minimize uncomfortable sensation. Extensive veins may require more than one treatment.
The sclerotherapy treatment uses a superficial injection technique with solutions that vary in strength dependent upon the size of the vein that is to be injected. The sclerosing solution is injected into the affected veins using an ultra-fine needle. Typical sclerotherapy sessions last between 15 and 20 minutes. As the procedure continues some patients may feel small needle sticks, but the discomfort is minimal and acceptable to most people. If the reticular and varicose veins are treated primarily, the associated spider veins will often disappear by themselves without being injected due to the spider veins receiving their blood supply from the larger veins.
More than one treatment may be required depending upon the severity, area and amount of veins to be removed. The treated veins rapidly improve over a few weeks, with slower continued improvement for around three months.
Tumescent Enhanced Sclerotherapy (TES) is a newly developed and clinically tested office procedure that takes traditional sclerotherapy a step further by applying tumescent (meaning making the tissue “tight”) anesthetic solution with a small pump designed for the procedure.
A standard sclerosing solution is placed in veins with very tiny needles. This sclerosing solution (not saline) causes the veins to scar up and disappear. All patients tolerate this injection very well because the needles used are the size of a human hair. Special magnifying lenses and polarized light are sometimes used so the doctor can better see the veins in question.
In order to make the solution that is injected in the veins work better, another solution made up of saline, lidocaine and adrenalin is infused around the veins being treated. This causes effective compression that has the effect of isolating the sclerosing solution in the abnormal veins and preventing blood flow through them, which can lead to better results. Usually, fewer injections and fewer treatments are needed, saving you time and money. Less concentrated solutions are required as compared to conventional sclerotherapy, leading to improved patient comfort. Multiple sessions may be necessary, and occasional future treatments may be required to achieve and maintain optimal results.
Laser Spider Vein Treatment & Varicose Vein Removal
With this technique, a powerful laser light passes through the skin and is selectively absorbed by the blood within the spider veins. This damages the vessel with heat causing it to collapse, “welding” the vessel shut below the surface, and results in spider vein removal. Older lasers were most effective for small red veins such as nose and face spider veins. Laser models such as these were ineffective on the larger blue or purple veins commonly seen in the legs. However, Rejuvenex’ Lyra laser is different. This laser is effective with the blue/purple leg veins and does not have the complications of the older lasers, such as lightening the skin. This new laser can be fine tuned for all sizes of spider and thread veins, reticular veins and all skin types.
Depending on the severity of your condition, a more suitable solution may be TriVex TIPP surgery, rather than varicose veins laser treatments. Dr. Rodriguez will counsel you on the treatment options that will offer you the best results.
TIPP with TriVex for Varicose Veins
Trans-Illuminated Powered Phlebectomy (TIPP) uses the TriVex System. The TriVex system is a revolutionary new method for varicose vein removal. The procedure was developed by the founders of AmeriVein as a method for the accurate and quick treatment of varicose veins through a minimal number of incisions. In the year 2000, Dr. Rodriguez was the first surgeon to perform this procedure in North Texas.
The TriVex system uses two main components. The first instrument illuminates the varicose vein through the skin using advanced fiber optic technology. The vein resector is then guided next to the vein underneath the skin. Suction draws the vein into the tip of the vein resector where a rotating blade effectively removes the leg vein.
With this new varicose vein treatment, large clusters of varicose veins can be accurately removed through a minimal number of small incisions. It is far more precise and effective than other forms of varicose vein surgery, including endovenous laser coagulation. Patients recover quickly and enjoy excellent cosmetic results. Although there is no 100% perfect varicose vein cure, with this procedure Dr. Rodriguez minimizes unsightly scars and minimizes the chances of persistent veins, thus highly reducing the need for costly follow-up treatments.
TriVex System
Dr. Spitz developed the TriVex System in 1996. At that time, Dr. Spitz and Dr. Braxton were performing vein surgery using the ambulatory phlebectomy technique, which was then the state-of-the-art technique for vein surgery. It was, and remains, a very tedious operation with inconsistent results, but many surgeons still perform it.
In trying to devise a better way to remove varicose veins, the TriVex System was born. Dr. Rodriguez and surgeons around the world are now using TriVex for the accurate removal of varicose veins with excellent cosmetic results.
The TriVex System got its name from Tri- or three-way method (transillumination, tumescence and vein resection) of -Vex vein extraction. The TriVex System is the name for the instruments used in TIPP (Trans-Illuminated Powered Phlebectomy) vein surgery. These instruments include the two hand pieces (illuminating tumescent cannula and a vein extraction device) plus the generator and light source. Smith and Nephew Endoscopy (NYSE: SNN, Andover Mass.) is manufacturing and selling the system all over the world.
Drs. Spitz and Braxton have trained Dr. Rodriguez and other select surgeons from all over the globe in use of the TriVex System at the AmeriVein Training Institute. Patients have traveled from all over the world to have their procedures done by AmeriVein surgeons. Dr. Rodriguez learned the TriVex procedure at the AmeriVein Training Institute in 2000 and introduced the technique to North Texas that year.
Vein Treatment Recovery
There is minimal downtime with the sclerotherapy treatment, and patients are able to walk the same day without any major discomfort. Small swabs, which can be removed after half an hour, may be taped over the injection sites to stop any superficial bleeding. Following each treatment, patients are usually required to wear a compression stocking to assist with the closure of the veins and protect against deep vein thrombosis. If tumescent technique was used with sclerotherapy or laser vein removal, you may not have to wear compression stockings, which can be uncomfortable, especially in warm weather. Veins may look prominent following treatment before the body’s natural processes absorb them. A one-month healing interval must pass before a second procedure is performed, if required, with around two weeks required for any redness, slight bruising or swelling to disappear completely. Although the treatments will remove most spider veins and reticular veins and the varicose veins, the treatments will not always prevent new veins from appearing. Recurrences will need to be treated with a touch up treatment or a full surgical treatment in the future.
Vein Treatment Risks
Risks and complications of Tumescence Enhanced Sclerotherapy are minimal, with the procedure providing a safe and noninvasive way to remove unsightly veins. Small lumps may occasionally be felt which are absorbed over time. In rare cases a scab may take a few weeks to heal. Pigmentation changes may occur in areas where the veins have been removed, which are the color of freckles along with a pink matting of fine reddish blood vessels. These pigment changes may require further treatment.
Tumescence Enhanced Laser Vein Removal does not cause knots or pigmentation changes. The chance for heat injury to the skin is rare, and there is no increased risk of deep vein thrombosis, since the laser does not penetrate that far into the tissues.
Surgical vein removal, even with TriVex TIPP, always carries the remote chance of wound infection and scars. Deep vein thrombosis is always a risk with any vein treatment, and no matter how remote, the patient should wear the compression garments as advised by the surgeon if surgical removal was done.
TriVex TIPP may involve the use of sedation by an anesthetist, and total fees range from $4500 to $6500 per leg, depending on the severity of the varicose veins. You will require a painless ultrasound test prior to surgery to evaluate the deep veins that would not be treated by this procedure.
As with any other cosmetic procedure, geographical area, the clinic safety amenities, and level of surgeon expertise may also have an impact on the overall cost of the treatment. As these procedures are considered elective surgery, insurance companies generally will not cover them.
With Dr. Rodriguez’ advanced, nonsurgical and surgical treatment options, it appears unwanted veins can be a thing of the past. His techniques have been used and improved worldwide for many years and are commonly associated with low side effects and a high success rate for vein removal, offering excellent results. Although vein treatments are more common in women, more and more men are realizing the complications that can occur from problem veins and are seeking treatment for them, especially now that modern treatment options are available.
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