Varicose Veins
Varicose veins are enlarged, dilated and twisted superficial veins typically in the legs.
Varicose veins areenlarged, dilated and twisted superficial veins typically in the legs, just under the skin which appear like serpingenous (like a snake) blue thick lines of veins which can be pressed upon by fingers. They decrease significantly after elevating the legs. Varicose veins usually cause few symptoms. However, few people may experience fatigue or pain in the calf region of the leg. Complications can include bleeding or superficial thrombophlebitis or development of ulcers. Due to the various physical, social, and psychological effects of varicose veins, they can negatively affect one's quality of life. Varicose veins are damaged veins found when tiny, one-way valves inside the veins weaken or are damaged. In healthy veins, these valves push blood in one direction only- back to our heart. When these valves weaken and don’t close correctly, some amount of blood flows backward towards gravity and gets accumulated in the vein. This extra blood in the vein puts pressure on the walls of the vein. With continual pressure of this backflow, the vein walls weaken and bulge over a period of time resulting in spider veins and progressively varicose veins. This causes the serpingenous appearance of veins.
Some people have a higher risk of developing these veins.
- If your blood relatives have spider veins or varicose veins.
- Activities or occupations that require prolonged sitting or standing like teachers, policemen
- Obesity
- Chances increase with age and during pregnancy.
A thorough physical examination and few targeted investigations (Doppler) are necessary before planning a treatment for varicose veins. Preventive measures are practised which help prevent new varicose and spider veins but cannot get rid of existing ones. There are surgical methods available for treating varicose veins which are effective and safe.
Varicose veins condition is pretty common, affects about 30% of population and becomes more common with age and in women.
Symptoms
- Aching, heavy legs which gets better after lying down
- Burning sensation in the legs
- Telangiectasia (veins arrange in a pattern of spider veins)
- Swelling of legs.
- Darkening of skin of legs and shin.
- Redness, dryness, and itchiness of skin of ankle region.
- Sudden muscle cramps.
- Excessive bleeding from any injury from the veins or leg.
- Lipodermatosclerosis (thick and discolored) of skin of ankle region.
Treatment may involve lifestyle changes or procedures with the goal of improving symptoms and appearance.
Lifestyle changes can control the progression of the disease, include:
- Wearing compression stockings
- Exercising
- Elevating the legs
- Weight loss
Mild and initial cases- Treatment is done conservatively. It includes:
- Above lifestyle changes along with
- Compression garments
- Anti-inflammatory medications
- Topical creams for skin problems
Moderate to severe cases- Conservative approach is not very beneficial and some medical orsurgical intervention is required.Possible medical procedures include the procedures which block the veins so that no blood is collected and all blood is bypassed to deep group and neighboring veins.
Discussions during a Varicose Vein Treatment consultation should include
- About your job profile, need for standing for long hours?
- Your medical conditions, history of surgery in recent past or any fractures and drug allergies (if any).
- Current medications and supplements
- Any previous treatment taken for the spider veins or varicose veins
A candidate opting for varicose Vein Treatment should fill up these criteria for better results:
- You should be physically healthy and motivated enough.
- You should be confident and positive about how to achieve the improvement.
- You should be ready to follow the instructions as told.
- You should have realistic expectations
Dr Amit Agarwal focus during consultation
- A thorough history and physical examination
- See any coexisting spider veins?
- Discuss the options for your treatment.
- Take photographs
- Any pre-existing health conditions and evaluation of your general health.
- Discuss about future remedial measures
Questions to be asked with your surgeon about your surgery
- Am I a good candidate for the procedure?
- What is the procedure?
- When can I return to work and daily routines?
- What is expected of me to change in my lifestyle to get better results?
Preparations to be done for the treatment
- You should be physically healthy.
- You should stop smoking if you are a smoker before the procedure.
- You should stop taking any supplements or drugs.
- Get the routine and few specific investigations done prescribed by Dr Amit Agarwal.
- Avoid taking anti-inflammatory drugs and herbal supplements as they aggravate bleeding.
- Admission on the day of the surgery& meeting the anaesthetist for Pre-Anaesthetic Check up (PAC)
- Written consent form to be signed
Varicose vein Treatment procedure includes
- Injection Sclerotherapy (for small veins)- Injection of a sclerosant solution into each affected vein causes the vein to collapse, and fade. This improves circulation in the treated leg and reduces swelling. This treatment is completed in single sitting.
If sclerotherpy is chosen by you, then it is an outpatient office procedure which requires your stay at the centre for about 2 to 3 hours. The affected veins are injected with a sclerosing solution. This solution irritates inside of the vein, and with time this vein collapses and fades away. After sclerotherapy, the treated area is dressed with creppe bandage. The affected veins initially look bruised but in a course of few weeks, the colour slowly fades away. You will need to go for a walk daily and wear the compression stockings for 3 weeks to prevent possible side effects. You can return to work the very next day - Vein ligation and stripping- Surgical procedure by which the collected blood in veins is emptied and the culprit valves are exposed and ligated by surgical knots. The abnormal veins are stripped out. This is the definitive procedure and chances of recurrence are minimal as compared to sclerotherapy and laser therapy.
Recovery after sclerotherapy/Vein ligation and stripping
In the recovery period of Varicose Vein Treatment, Dr Amit Agarwal will instruct you to wear compression garment for your legs to heal properly. There will be some bruising after the treatment but this usually subsides within a day or two.
You will be discharged next day after the surgery. Sutures will be removed after 14 days of surgery.
You can resume your normal activities quickly within a week or two with some specific instruction prescribed by Dr Amit Agarwal. Follow up schedules will be provided to you at the time of discharge.
- Wear compression garment for three to six months.
- You should not sit or stand in one place for more than an hour or two.
- Avoid running, squatting or heavy lifting
- Go for a walk daily.
Within a month, the bruises will diminish and you will start feeling comfortable in wearing leg-baring fashion. You also can resume your exercise routine after a month.
Preventive measures help prevent new varicose and spider veins but cannot get rid of existing ones.
- Do exercises regularly
- Elevate your legs while lying on bed
- Do not stand for long periods
- Avoid bathing in hot water for long periods of time
- Compression stockings of appropriate size and right amount of pressure- to help move the blood back to your heart. The steady pressure also lessens swelling in your lower legs and reduces the risk of getting a blood clot.
Risk and complications post-surgery
Varicose Vein Treatment also involves some risks and complications which include
- Hyperpigmentation- This discoloration also fades away, but it may take some months.
- Swelling and bruising.
- Rarest chances of Ulceration if overlying skin is unhealthy.
- Recurrence is common after surgery if few precautions are not followed as advised.
Do s and don'ts
- You should always discuss any previous surgery or medical conditions without hesitation.
- You should always wear support stockings as it reduces swelling and gives proper shape.
- You should immediately consult your doctor if you have any complication.
- You should always maintain a healthy lifestyle for best and prolonged results.
Frequently Asked Questions
If you have blue enlarged, dilated and twisted superficial veins typically in the legs, just under the skin and have dull aching pain or recurrent ulcers in leg, then you are a suitable candidate for the surgery.
You will be sent home immediately after the injection and next day after the surgery.
There will be scars at the incision sites but subsides with time.
Quitting smoking is a perfect solution even without surgery as it involves many health risks, but it's totally up to you wish that you want to quit or not. But you should surely stop smoking before the procedure and 2 weeks after the injection.
You can resume work a week or two after the procedure.
Varicose Veins Images
Indivisual results may vary from person to person.
These pictures are shown for the purpose of education only.
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Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.
MS, DNB (General Surgery) MCh, DNB (Plastic Surgery),
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If you have flat or small breast and you want to improve your breast and hip contour ratio then you are a good candidate for it. The answer will be best provided after the first consultation with Dr Amit Agarwal.
Acute pain will be there for almost a week which gradually reduces and there will be soreness and swelling which may take up to 3 weeks to subside.
You can join your work and daily routines after a week of the procedure and can start exercising after 3 weeks of it.
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This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
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