- Who is candidate for sclerotherapy ?
- The first consultation
- Review about the sclerotherapy
- Sclerotherapy risks and complications
The sclerotherapy is a common used not surgical but cosmetic procedure. The very small capillaries, which are normally superficially in the skin, become dilated and noticeable. In these cases spider veins, teleangiectasias, little red spots and simple or smaller-bigger complex formations of dilated veins will appear. With aging the veins, which already exist, will strech, more and more dilated veins will develop. With the increasing number of dilated veins, they will fuse and slowly bulk from the skin around. When they reach this growing phase they also cause problems and pain. This process is presented in different ages in the humans and progresses with different speed. There are women and men where this process appears in a young age. Sclerotherapy can be performed in all adults who has already these capillaries, but they are not yet able to the traditional vein surgery.
With the sclerotisation the treated part of the vein will be totally closed. The circulation will disappear and by the time the vein will absorb. In the case of big, extended varicosity the procedure will be performed more times, because the medication, which we insert into the veins, has a limited dosage. This has to be kept in the favour of the patient. Whatever sclerosing solution we use, it is important to know that the treatment is just symptomatic. We do not cease the root factor, but treat the dilated vein and the pain what it caused. By the time other varicose veins will appear in other places, but we can treat them also by sclerotherapy. The individual sensitivity of the patients are very different to the slight and moderate pain which occurs in the time of injecting the medication. In the treatment procedure we insert a sterile solution, which causes inflammation, into the veins. To the effect of this the veins become closed and by the time they absorb. At the end of the treatment the veins - which are totally empty – will disappear without any mark. Those veins which contain a little blood because of the regurgitation and have enough sclerosing solution, will be clotted. These clotted veins can be painful at the beginning, but by the time they will cease and disappear. In the case of complex capillaries the sclerosing solution can be more watery and a reprocedure can be necessary to perform.
After the injection of the sclerosing solution a 30-minute walking is recommended, and after that the patient can go back to the every day activity with wearing a flexible bandage on her/his lower limb. The treatment procedure can be repeated safely in the case of newly presented veins or other varicose veins in the periphery which remained from the previous treatment. The result of the cosmetic treatment can be visible directly after the procedure and the total result will be noticeable after the absorbtion of the clotted veins. It is a natural expectation that the women and men want to have a flat and tight skin in the lower limbs without any varicose vein. The vein treatments give back the smoothness of the lower limbs and excelerate the youthful appearance.
WHO IS CANDIDATE FOR SCLEROTHERAPY ?
- Simple or complex clusters of veins in the lower limbs.
- Slight or moderate feeling of stretching around the dilated veins.
- Your leg looks older because of the problematic veins.
The sclerotherapy can help in all of these. The injection treatment can not correct all the expectations -sometimes unreal- in the lower extremities, which were dreamt by the patients. We can not resolve everything with the procedure. On the one hand it has limits by the technics of the method, on the other hand just only those corrections can be performed which are able to the injection treatment. The medium-size or more bigger veins are not candidate for sclerotherapy. In these cases laser vein therapy can be performed. The sclerotherapy by itself can not solve the problems which are caused by the seriously dilated veins. These malformations can be treated but only by traditional or laser varicectomy.
THE FIRST CONSULTATION
At the consultation we will discuss Your problems, expectations and desired outcome. We will talk about everything which is in connection with the injection treatment and important in the aspect of the cosmetic procedure of the lower limbs. We will examine the superficial and the deep veins and the circulation in the deep veins as well. We will draw attention to the individual genetic factors which influence the plastic procedure. We will check the quality and the color of the skin in the lower extremities. There are malformations and discolorations which can not be corrected even by the best-performed procedure. We recommend other procedures if it is necessary. These can also correct the appearance of the lower limbs. These procedures are usually performed separately from the injection treatment: traditional or laser vein therapy, skin removal.
We will take some photographs –from different directions- about the present condition. The photographs allow the patients to examine and evaluate the lower limbs from different directions. If there are other important malformations in the lower extremities, the sclerotherapy by itself is not enough, other procedures can be necessary to be performed. We will decide the necessity of this together with You.
You will be asked about Your medical conditions, medical treatment, drug allergies, use of current medications and previous surgeries, procedures. It is very important to get accurate information about every medical conditions to plan the procedure with the best thoughtfulness. After the proper information the well-planned cosmetic procedure will ensure You the biggest satisfaction.
REVIEW ABOUT THE SCLEROTHERAPY
If You smoke, take aspirin or other blood thinner medications, or any anti-inflammatory drugs or other medications, please let us know! These drugs can increase bleeding or can cause other interactions during the general anaesthesia.
Sclerotherapy requires no anaesthesia. It causes a slight, sometimes moderate pain. If You have varicose veins as well, we have to treat them first and only after those the spider veins. The traditional or laser vein therapy decrease the number of the injected veins.
The aim of the method is to destroy totally the most inner part of the wall of the veins with minimal formation of sclerothrombus which leads to the fibrosis (cessation) of the veins. In ideal cases the treated part of the vein will be totally closed, and absorbed. The sclerosing solution is injected by a little needle into the veins and the vessel-trunk. A cotton ball and compression tape is applied to each injection site as it is finished.
THINGS TO DO AFTER THE PROCEDURE
After the sclerotherapy – directly after the treatment – a 30-minute walk is recommended to increase the deep vein circulation! Two days after the procedure it is recommended to have rest and spare Your legs with due foresight by wearing the flexible bandage. The flexible bandage can be supplied by 2nd level compression stockings. It is recommended to cool the treated area in the day of the procedure, which can reduce the swelling and the permanent discoloration. It is forbidden to do massage on the treated areas! The injected solution destroys the wall of the veins, thus in the injection sites slight bruising and swelling can appear. To reduce the bruising and the local reactions it is recommended to use ointments and creams. Between the first and the second days after the operation You can feel more discomfort, but this is just temporary, which are caused by the already mentioned malformations. No scars will appear by the procedure.
One week after the procedure avoid any stiff sports and physical activity! During this period You have to avoid sunbathing and going to the solarium!
After every plastic surgical procedures You have to return for follow-up care regularly, thus after the sclerotherapy as well. The regularity of this depends on the type of the procedure and other personal feautures of the patient. At the previously discussed follow-up cares we will examine the operational area and discuss about the things to do in the future. Please remember that if You have any questions or problems, please do not hesitate to contact us independently the appointment!
SCLEROTHERAPY RISKS AND COMPLICATIONS
If the operation is performed by a qualified plastic surgeon, the operation and the post-surgical recovery period will be without any unexpected episodes. The sclerotherapy as all other surgical procedures can have complications, even ideally. Besides the generally presented complications (bleeding and infection) – which are very rare -, can occur some special complications because of the sclerotherapy. Superficial vein-inflammation (thrombophlebitis) will not appear by the empty vein technique (appropriate compression). If a little amount of blood regurgitates into the treated part of the vein, a clot will develop inside the vein and can cause inflammation. To prevent this it is recommended to use the compression bandage and ointment in the treated sites. Some people are liable to pigmentation some are not. In those people who are liable to pigmentation other disorders of iron-storage and –transfer can be presented in significant percentage. The frequency of pigmentation is around 10%. Usually it is not definitive, but can last 18 months. The permanent pigmentation – which lasts more than 12 months – occurs in 1-5% of the patients. This discoloration can follow the thrombophlebitis in the persons who are liable to it. It can develop in the treated area. Its reason is that in the deeper layer of the skin haemosiderin will be deposited and this will paint the skin. In those people who are sensitive some temporary reactions can appear: collapse, vertigo, nausea, visual disorders or metallic taste.
As in all medications, in all those persons who are liable, a sensitivity reaction can appear. In the case of allergy a slight local reaction can develop: redness of the skin around the site of injection. Temporary numbness and tingling, swelling, discoloration and burning sensation can occur in the site of the injection. In these cases we stop the procedure and start an antiallergic treatment. If the flexible bandage moves or is eliminated before the time and the sclerosing solution accumulates in the place of the injection, it can cause skin necrosis. This affects only a little part of the skin around the site of the injection, but its healing can be prolonged.
You do not have to be afraid of thrombosis or embolism, because in the case of appropriate injection and compression the wall of the vein will be totally compressed – the blood is depleted - , and blood cot can not appear. Only the fibrosis of the wall of the vein appears, which is considerably connected to the wall of the vein, thus it is enough stable. In that case if the sclerosing solution gets into the deep vein, nothing will happen, because the flow is more bigger in the deep vein than in the little ones and the solution can become more watery. The watery solution can not cause problem in the wall of the vein. It is very important to have a 30-minute walk directly after the injection to increase the circulation.
In a very small percentage it occured that the treatment was not effective.
The complications and bruises will disappear by themselves with the appropriate treatments. They do not cause permanent malformations.
An appropriately closed, shrinked vein can not open and become loose again. If new veins appear, the injection has to be performed again. The reappaerance of the veins has two reasons: recanalisation or recidive.
Recanalisation can appear shortly after the injection. With the not appropriate sclerosis the destruction was not completed totally in the wall of the treated vein. Because of the not damaged, unhurt cells the lumen can develop again. If a big thrombus appears inside the vein, the compression was not appropriate. The developed, big thrombus will shrink by the time. Channels and fissures will appear in that. This reasons can lead to recanalisation.
In the case of recidive, varicose veins can appear again after the -otherwise successful- operation and sclerotherapy. In this situation the vein problem will deteriorate. The little side veins, which were closed before, will open because of the degenerative processes and will dilate. In a progressed case new veins will appear as well.
If recanalisation or recidive appear, the procedure has to be performed again.
The sclerotherapy makes the tired lower limbs smooth, tighter and more youthful again. In reasonable cases we can ameliorate the result with other methods ( traditional or laser vein operation and skin removal ). The injection plastic procedure makes the women and men more confident. The result is long-lasting, but in those persons who are liable for the formation of varicose veins, new varicose veins can appear in other areas. In these cases the procedure can be performed again. Gravitation, changing in water-content and flexibility of the tissues, and other changes by the aging have effect on the skin and the quality and quantity of the underlying tissues of the lower limbs. If the aging leaves mark on the lower limbs, other procedures can be necessary to be perform.