[Duhan Plastic Surgery Clinic Varicose Veins] - [Varicose Vein Procedure Guide]

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Varicose Vein and Vascular Dilation Procedures

■ As living standards have improved, interest in beauty has expanded from the face to body shape and the lower extremities, and a variety of procedures are being performed to create beautiful legs.

■ Venous dilation is one of the signs of aging, and statistics show that 10–20% of the population has this condition.

For centuries, treatment for venous dilation has developed mainly in Europe, and at the center of that treatment are surgery and sclerotherapy.

■ Our clinic adopts the treatment methods of Europe, the birthplace of venous disease treatment, and performs procedures by combining simple sclerotherapy, compression sclerotherapy, ultrasound-guided sclerotherapy, ambulatory phlebectomy, great saphenous vein stripping, and high ligation.

■ Venous dilation requires choosing the appropriate treatment method according to the location, cause, size, and severity of the affected vessel, and in some cases, multiple combined procedures are necessary.

■ Venous dilation cannot always be completely treated with laser alone, sclerotherapy alone, or surgery alone, so after an accurate diagnosis in advance, the most appropriate method must be selected to achieve good results.

Guide to Varicose Vein Procedures

Information on the treatment of varicose veins and venous dilation

Do you see unsightly veins in your legs?

Do spider veins or blood vessels show through on your face?

Do they look unpleasantly raised on the backs of your hands and arms?

If blood vessels are visible beneath the skin or protruding, do not leave them alone.

Unsightly veins can now be easily addressed.

No matter how beautiful your face is, if blood vessels show through, you can feel self-conscious.

No matter how attractive your legs are, if blood vessels show through, you may not be able to wear a skirt.

You cannot go around wearing gloves just because thick veins are protruding on your pretty hands.

At Duhan Varicose Vein Clinic, we can simply solve all of these problems.^^

Various Methods of Varicose Vein and Vascular Dilation Procedures

Surgical treatment

For the treatment of thick blood vessels, surgery has been the mainstream approach in several European countries for the past several decades, and even in European countries that remain at the forefront of varicose vein treatment, the main treatment for varicose veins is still surgery.

Advantages of surgical treatment

1. Surgery has almost no recurrence.

2. The results after surgery are superior to methods using lasers.

3. Wound healing is faster than with other methods.

4. Scarring is almost nonexistent.

5. Unlike laser (EVLT), which comes with various procedural limitations, it is not restricted by the vessel’s diameter or shape.

6. Unlike phlebectomy using transillumination (Trivex), there are almost no postoperative sensory disturbances or sequelae caused by nerve damage.

7. Even severe varicose veins can usually be cured with a single surgery.

Disadvantages of surgical treatment

1. The procedure takes a long time.

2. It is difficult to operate on vessels with a small diameter.

Types of surgical methods

Great saphenous vein stripping

Great saphenous vein stripping means surgically and cleanly removing the thick main vein that is the cause.

The remaining scars from the surgery are at two points: where the pin is inserted and where the pin comes out, and the scars are kept to under 1 cm, so scarring is hardly an issue.

Also, because it does not cause nerve damage, there is no need to worry about sequelae.

Ambulatory phlebectomy

Ambulatory phlebectomy is named to mean that walking is possible after surgery.

Unlike the past, when areas with blood vessels were indiscriminately incised and operated on, this is a groundbreaking surgical method that creates only 2 mm small holes in each area under local anesthesia, resulting in almost no scarring.

It is also a method with almost no nerve damage because only the blood vessels are selectively removed.

High ligation

High ligation is a method of blocking the reflux area of the valve in the great saphenous vein. Unlike great saphenous vein stripping or ambulatory excision, which completely remove the enlarged diseased vein, this method preserves the vein while blocking only the reflux area.

In other words, it is similar to repair work done to seal a hole in a dam.

It is a surgical method used to block the reflux area in the early stage, before the blood vessels have become severely dilated.

The key to surgery is that recurrence can be prevented only when reflux is blocked in all the branches of the blood vessels as well.

These vascular branches cannot be resolved with laser treatment.

Sclerotherapy

Sclerotherapy is used to treat vessels with a diameter of 5 mm or less.

A sclerosing agent is placed in a syringe and injected into the diseased vessel.

The procedure is simple, using the same method as a regular injection into a blood vessel.

The downside is that if the treatment area is large, the procedure must be performed multiple times, and it takes about 1–2 months after the procedure for the blood vessels to disappear completely, which can be inconvenient.

For fine vessels, there is no treatment that can replace sclerotherapy, so it is the best treatment for vessels with a small diameter.

There is also a method using pigment laser, but the effect is weaker, it is only effective for red vessels with a diameter of 0.1–0.2 mm, and it requires multiple sessions.

Ultrasound-guided sclerotherapy

This refers to a method that can replace the area that would otherwise require surgical high ligation with sclerotherapy.

When there is a reflux area in a vessel with a small diameter, the vessel can be treated simply without surgery by confirming the ultrasound image and injecting the sclerosing agent into the reflux area of the vessel.

Transilluminated powered phlebectomy (Trivex)

This method makes two incision openings, shines light under the blood vessel through one area to identify the vessel’s location, and then removes and suctions out the vessel with a powered blade.

Advantages

It allows blood vessels to be removed easily.

Disadvantages

1. By indiscriminately removing blood vessels and nerves, sensory disturbances may occur after the procedure.

2. Small vessels such as capillaries or reticular veins cannot be treated.

3. It is difficult to use on large trunk vessels such as the great saphenous vein or small saphenous vein.

Endovenous laser treatment (EVLT)

Endovenous laser treatment refers to inserting a laser-emitting catheter into the vessel and using laser heat to damage the vessel and close it.

Advantages

It can be conveniently used for large vessels such as the saphenous vein.

Disadvantages

1. Even in the case of the saphenous vein, a laser catheter cannot be inserted into a tortuous vessel, so in practice the procedure is difficult.

2. It cannot be used in areas where small vessels are clustered.

3. If the laser power is high, there is a concern about nerve damage or skin damage.

4. If the laser power is low, the treatment effect may be insufficient or there may be a risk of recurrence.

5. It cannot block reflux in the vascular branches at the starting point of the saphenous vein, leaving room for recurrence.

Knowledge you should have correctly about varicose vein procedures

Procedures such as transilluminated powered phlebectomy (TRVEX) and endovenous laser treatment (EVLT) have limited indications, so there are not many vessels to which they can be applied, and many problems arise, including recurrence and side effects.

In advanced European countries that are at the forefront of varicose vein treatment, surgery and sclerotherapy, which have been verified over decades, are widely used, and lasers or transilluminated powered vein removal are rarely used.

The reason is that there are not many vessels suitable for these procedures, and problems such as side effects and recurrence occur frequently.

Many new procedures have not been verified, and they are often performed for show, so caution is needed.

Precautions regarding procedures

Varicose vein procedures must be performed under an accurate diagnosis.

The choice of procedure depends on the cause and the condition of the blood vessels.

A good procedure is one with no side effects and reliable effectiveness.

A method that minimizes swelling and pain after the procedure should be chosen.

For varicose vein procedures, scarless surgery and sclerotherapy are the most preferred methods.

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