Varicose veins are an ongoing source of frustration and discomfort for millions of people who suffer with them. At the very least, these twisted, oversized veins in the legs are often a source of cosmetic embarrassment. For other people, they cause daily pain and can lead to more serious medical problems. The experts at Commonwealth Vein Center in Colonial Heights, VA can address your varicose veins non-surgically using a technique known as a phlebectomy.
What Is a Phlebectomy?
Phlebectomy is a treatment for varicose veins that goes by several names, including micro-phlebectomy and ambulatory phlebectomy. All are designed to address the same problem of removing varicose veins. During the procedure, several tiny incisions are made in the skin, through which the doctor will remove the varicose vein. Because the incisions are so small, stitches are not required.
The treatment is known as ambulatory because it typically doesn’t require a stay in the hospital. The work will be done in your doctor’s office under light sedation using a local anesthetic. Phlebectomy treatment on its own is often effective in removing varicose veins, but for more extensive cases it can also be safely combined with additional treatments to produce greater results. These optional procedures are also done on an ambulatory basis. Our experts will advise you on the best course of action to deal with your varicose veins.
Why Do I Have Varicose Veins?
Weak or damaged valves in your legs are what lead to varicose veins. Your body’s arteries carry blood from your heart to the rest of your tissues, and your veins send the blood back to your heart for circulation. To perform the job of returning blood to your heart, the veins in your legs are forced to work against gravity while you stand.
Muscle contractions in your lower legs act as blood pumps while standing and walking, while stretchy elastic vein walls help your blood return to your heart. Tiny valves in your veins open to let blood flow toward your heart and then close again to stop blood from flowing backward. When these valves become weak or damaged, blood does flow backward and pool in the vein, which causes the veins to be unnaturally stretched or twisted. This engorgement is what causes unsightly and painful varicose veins.
What Are the Risk Factors for Varicose Veins?
Varicose veins often appear spontaneously on our legs as we get older. Aging causes wear and tear on the valves in your veins that regulate blood flow. Eventually, that wear causes the valves to allow some blood to flow back into your veins where it collects instead of flowing back to your heart.
Women are more likely than men to develop varicose veins. Hormonal changes during pregnancy, pre-menstruation or menopause may be a factor because female hormones tend to relax vein walls. Hormone treatments, such as birth control pills, can also increase the risk of varicose veins.
Pregnancy itself can also be a source of varicose veins. During pregnancy, the volume of blood in the body increases. This, of course, is designed to support the growing fetus. However, the additional blood volume can also produce the unfortunate side effect of enlarged veins in the mother’s legs.
Other potential factors come into play in developing this condition, such as your family history. If your other family members had varicose veins, there’s a greater chance you will too. Obesity is also a common cause because being overweight puts added pressure on your veins. Standing or sitting for long periods of time is a culprit too. Your blood doesn’t flow as well if you’re fixed in the same position for long periods of time.
How to Prepare; What to Expect
A phlebectomy session in your physician’s office requires little preparation. It’s a good idea to wear clothing that will fit loosely enough to pass over the leg wrappings that will be applied after treatment. Comfortable shoes are recommended too, as they’ll make walking easier immediately after the doctor completes the phlebectomy.
If your doctor has prescribed a compression stocking to wear after the procedure, you should be sure to bring it to the appointment. Avoid applying oils or lotions on the limbs that you’ll be treating prior to the procedure. Clean skin will make it easier to mark veins for treatment.
You’ll be asked to change into a gown, and then staff members will clean the area that’s been targeted for treatment. Sterile drapes, which are sections of sterilized, absorbent, cloth-like material, will be put in place. Once the doctor marks the veins to eliminate, you’ll receive a local anesthetic and the work will begin.
Once the area to be treated has been injected with the anesthetic, tiny incisions are made over the veins to be treated. This is done using a specialized tool that looks and works like a high-tech crochet hook. The clinician will then remove the vein or veins using this special tool. The additional incisions made will allow any excess fluid to drain from the area after the treatment.
When all the veins targeted on one leg have been removed, the sterile drape pads are placed next to the skin and your leg is wrapped tightly in a therapeutic compression bandage. Your compression stocking goes on top of these pads and/or bandaging, which applies even more helpful pressure to the area being treated. The stocking is usually used for at least 48 hours.
The treatment itself is painless. Discomfort is usually limited to a minor pinching sensation when receiving the numbing medication. Some patients report being able to feel some pulling and pushing during the actual treatment, but reported discomforts are minor and rare. If all this sounds quick and easy, that’s because it is. The entire treatment takes about an hour.
After Your Treatment
Our medical staff encourages patients to get up and walk right away. It’s important to walk because contraction of the surrounding muscles helps to purge the treated areas of excess fluid. This reduces the risk of blood clots and contributes to the healing process.
Most patients can return to their regular activities the same day, although strenuous workouts right away are not recommended. You may return to light daily activities immediately following your procedure. Depending on the extent of the work, your physician may recommend 2-3 days of eased activity. Both rest and walking are recommended. Strenuous activity such as workouts can usually be resumed 5-7 days following the procedure.
A day or two after your procedure, your doctor will remove the bandage and check the incisions for normal healing progress. After the bandage is removed, you may be advised to continue to wear compression stockings or hosiery for one to three weeks. Each patient is different, so check with your doctor for these and other post-treatment tips. Actual recovery time depends on each patient and the specific amount of work they’ve had done.
Once you come home from your treatment, you should make it a point to elevate your legs at least 3 to 4 times for a few moments during your recovery period. When the recovery period is over, you can remove the compression stockings to shower, but you should wear them for the rest of the day for at least a week. Your doctor will advise you according to your specific circumstances.
The Recovery Period
During recovery, you should avoid soaking your treated legs in baths or hot tubs until you are done wearing the compression stockings. It is normal to have some minor bruising after the procedure. This commonly goes away completely by 3 to 4 weeks.
You may experience some swelling around the treated area, especially when you’ve been standing for a long time. Your doctor may recommend that you take a non-steroidal anti-inflammatory drug such as ibuprofen for any discomfort and to reduce inflammation.
How Long Will Recovery Take?
Following an ambulatory phlebectomy, the treated leg is likely to drain fluid for the first 48 hours. As a result, the dressing and perhaps even the compression stocking may feel slightly damp. Post-procedure symptoms and discomfort are highly variable from patient to patient. Your doctor will monitor your progress and can give you a clear picture of what to expect.
As previously mentioned, elevating your legs is strongly recommended following your treatment. As far as walking, your doctor may advise 30 minutes each day for the first 2 weeks after your procedure. Walking can be done in short increments throughout the day that add up to 30 minutes, or you can walk it all at once, whichever works best for your schedule.
Because every patient is different and every treatment area has its own specifics, recovery time from phlebectomy varies from person to person. Still, within the above guidelines, you can expect to be back to easy activity after 1-2 days, to be tending your pads and compression for 2 or 3 days, and wearing compression support for 1 to 3 weeks. In virtually all cases, any after-effects such as bruising and tenderness will be gone by this time, and you can resume your life, only without the unwanted varicose vein.
Are There Any Restrictions I Should Observe?
While ambulatory phlebectomy has a relatively low impact on the patient, there are some restrictions during the first five days following the treatment that are well worth observing. Taking care of yourself post-procedure ensures a smooth recovery.
Since your legs carry the brunt of your body’s weight, you should try to avoid heavy lifting during the days following your recovery. This can put undue strain on the treated area. The same precaution also includes strenuous physical exercise that you do while standing, so take it easy on any gym activity.
As previously discussed, you’ll also want to protect your incisions from potential sources of bacteria. One of the most notorious sources of these is a hot tub, no matter how well it’s been cleaned. Avoid these soakings until your incisions have healed and you’re back to normal. That said swimming in a chlorinated pool can be highly therapeutic for the post-procedure patient. Swimming lets you keep your feet at or above the level of your heart while you exercise, which is good for the post- phlebectomy recovery.
Come Find Out More
At the Commonwealth Vein Center, we take a scientifically proven approach to varicose veins that yields guaranteed results. Using one or more of our time-tested techniques, you will receive complete removal of your varicose veins. In addition, you will have the most pleasant medical experience possible. Contact the experts at Commonwealth Vein Center in Colonial Heights, VA. We look forward to meeting you and helping you achieve your cosmetic and wellness goals.