- Traditional varicose veins surgery
- Who is candidate for traditional varicose veins surgery ?
- The first consultation
- Review about the traditional varicose veins surgery
- Traditional varicose veins surgery risks and complications
The varicectomy is a common used surgical procedure. 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. It is more common in those women who takes anticonceptive pills or the vein problems are already presented in their family. The traditional varicectomy can be performed in all adults, who does not have contra-indications.
With the traditional varicectomy we remove the treated part of the vein or cut off its continuity. The removed vein will disappear or in the cutted vein the circulation will cease and by the time it absorbs. In the case of bilateral vein problems the procedure will be performed in two different ocassions, because first we operate one of the limbs to have the other limb for loading. This has to be kept for the favour of the patient. By the time new varicose veins can appear in other places, which is caused by the broken valvules of the veins which were previously closed in those persons who are liable for that
This can be also treated successfully with another operation. The sensitivity to the slight or moderate pain which appears after the procedure is very different in the patients. The cutted and clotted vein can be painful at the beginning, but by the time it absorbs and the problems disappear without any signs. The result of the operation will be visible directly after the procedure, but the final result can be seen only the total absorbtion of the bruises and the clotted veins.
It is a natural expectation that the women and men want to have a smooth and tight skin in the lower limbs without any varicose veins. The traditional vein surgery gives back the smoothness of the lower limbs and excelerates the youthful appearance. The correction makes the women and men legs attractive again, increasing their self-confident.
WHO IS CANDIDATE FOR TRADITIONAL VARICOSE VEINS SURGERY ?
- Simple or complex clusters of veins in the lower limbs.
- Slight or moderate feeling of stretching around the dilated veins.
- Dilated, crooked veins in the legs.
- Your leg looks older because of the problematic veins.
The traditional varicectomy can help in all of these. The varicectomy 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 operation. On the one hand it has limits by the technics of the operation, on the other hand just only those corrections can be performed which are able to the varicectomy. The medium-size or more bigger veins are candidate for the traditional surgery. The varicectomy can not solve the problems which are caused by spider veins or very small veins. These malformations can be treated by sclerotherapy 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 varicectomy 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 varicectomy: sclerotherapy 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 varicectomy 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 TRADITIONAL VARICOSE VEINS SURGERY
THINGS TO DO BEFORE THE OPERATION
You will need to have some examinations before the operation: blood test, ECG and chest X-ray. To have all of these results the operation can be performed in the biggest safety.
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.
Even if You also have superficial spider veins, we have to treat first the bigger varicose veins and only after that the capillaries. The varicectomy decreases the number of the injected veins. The traditional varicectomy is almost always performed with general anaesthesia ( in assorted cases in intravenous sedation or local anaesthesia ) with hospital background. The last two methods is only possible in little procedures. For Your security during the surgical procedure which is performed with general anaesthesia we check Your heart rate, heart beat, blood pressure and blood oxygen level with monitors.
In the traditional vein surgery we make an incision in the femoral area at the junction of the saphenous magna vein. We block all the side veins which are connected to the femoral vein to avoid the possibility of recurrence. The saphenous magna vein will be strangulated in front of the junction not to narrow the femoral vein. After this we make an incision in front and above the inner ankle, where we search for the vein. A special catheter is threaded into it to grasp the vein and remove it through the incision. Those little veins which are not in the line of the removal we cut off and pull out through small incisions. Previous scars or injuries can hinder the thread of the probe. In this cases some extra incisions can be necessary to be performed according to the situation of the vein. We aim to minimize visible scarring and to achieve the best result. As bigger and crooked the varicose veins are, as bigger the bruises will be, but as bigger the relieve will be as well after the operation. Considering the longer and varicose veins, there is always a little amount of leaking blood and oedema which can cause haematomas but they will absorb by the time.
At the end of the traditional varicectomy we cover the incisons by dressings and help the patient to take on the chosed flexible bandage.
THINGS TO DO AFTER THE OPERATION
In the case of the operation, which was performed with general anaesthesia, it is practical to spend one night in the hospital. If the operation was performed in intravenous sedation or local anaesthesia, after the surgical procedure it is allowed to go home.
After the procedure it is recommended to have rest and spare Your legs with due foresight. Between the first and the third days after the operation You can feel more discomfort, but this is just temporary, which are caused by the bruises along the removed vein. 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 next day You have to get out of the bed and make short walks in the room to ameliorate the circulation. It is forbidden to sit or stand for long time. It is recommended to put a pillow under the knees during sleeping.
The initial discoloration and oedema is just temporary and will disappear fast. These can be natural complications of the operation. To reduce bruising and local reactions it is recommended to use ointments and creams. The stitches will be removed after 2 weeks. It is recommended to wear the special flexible bandage in the first 4-6 weeks. Two weeks after the vein surgery do not drive car and for six weeks avoid any stiff sports and physical activity! During this period You have to avoid sunbathing and going to the solarium! After the sparing period You have to cover the scar with sun protection cream for a long time!
After every plastic surgical procedures You have to return for follow-up care regularly, thus after the varicectomy 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!
TRADITIONAL VARICOSE VEINS SURGERY 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 traditional varicectomy 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 vein surgery: superficial vein inflammation ( thrombophlebitis ) or bruises through the removed vein. These can be reduced by the appropriate compression techniques. To prevent the significant bruises 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 that in the deeper layer of the skin haemosiderin will be deposited and this will paint the skin.
With the most modern devices, materials and stitches which were inserted by the most friendliest techniques it can happen that the colour of the scar will be brisk and red, thick in touch and a little bit widened. This depends on mostly personal liability, thus it can have significant differences. This malformation decreases by the time, thus the scar will be thinner and its colour will fade. If this does not occur, we remove the scar and treat the new scar with other special scar-treating methods.
The complications can be vanquished or revised with the appropriate treatments and procedures. The bruises will disappear by themselves. They do not cause permanent malformations.
With an appropriately performed traditional varicectomy the dilated, crooked varicose veins disappear and the heavy leg feeling stops.
The traditional varicectomy makes the tired lower limbs smooth, tighter and more youthful again. In reasonable cases we can ameliorate the result with other methods ( sclerotherapy or skin removal ). 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 the case of recidive, varicose veins can appear again after the -otherwise successful- operation. In this case the vein problem deteriorates. The little side veins, which were closed before, will open because of the degenerative processes and the disorder of the valvules, and will dilate. In a progressed case new veins will appear as well.
If new veins appear, the new varicose veins can be treated by local laser varicectomy or sclerotherapy.
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 perform.