Yes, you can remove varicose veins without surgery and without scars. I will explain how.
So, first of all, what exactly do we mean by surgery?
Well, most people think of surgery as a treatment that requires admission to hospital and which is carried out in an operating theatre under a general anaesthetic. When thinking about surgery we imagine that the treatment will involve surgical incisions or cuts, stitches and surgical scars.
Until about 10 years ago, that’s exactly what varicose vein treatment involved. Most treatments for varicose veins were carried out by surgeons who only performed surgical operations.
Fortunately, things have changed. Now, you can have your varicose veins treated under local anaesthetic in a clinic rather than in a hospital and you can walk in and walk out of the clinic in just a few hours.
This is not what most people regard as surgery. You are not treated in a hospital operating theatre, you do not have a general anaesthetic and you will not have surgical cuts and stitches.
The old surgical operation for varicose veins was called “Surgical Stripping”. A surgical cut was made in the groin, the varicose veins were tied off and the unhealthy vein was pulled out. This painful operation had to be carried out under a general anaesthetic.
What's new in non-surgical vein removal?
In my clinic,”surgical stripping” has now been replaced by Endovenous Laser Ablation under local anaesthetic as a walk in walk out procedure.
This avoids the need for a general anaesthetic, avoids admission to hospital and the treatment can be carried out through small pin pricks in the skin. There are no stitches and no surgical scars.
How is non-surgical vein removed done?
This is how I perform Endovenous Laser Ablation. My patient lies on a treatment couch. First of all I scan the leg with ultrasound to identify the unhealthy vein in the thigh. This vein has a condition called superficial venous reflux. The valves are unhealthy and allow blood to flow down the leg in the wrong direction. This reflux causes varicose veins lower down the leg to bulge.
Once I Identify the unhealthy vein with ultrasound, I numb the skin with local anaesthetic and I introduce a very small needle into the vein under ultrasound guidance. The needle is about the same size as that used to withdraw blood for a blood test. Through the needle I introduce a very fine laser fibre. Once the laser fibre is accurately positioned at the top of the thigh, I numb the vein with local anaesthetic and activate the laser equipment.
The laser heats the vein from the inside to a temperature at which the vein is instantly closed and sterilised. All the living cells that make up the vein are devitalised, meaning that they cannot regrow or rejoin.
I have never seen a vein successfully treated by Laser ever recover and regrow.
But what about the varicose veins further down the leg?
I numb the skin directly over these veins and I make a small puncture in the skin. I use a 1 mm instrument and through the small puncture in the skin I gently extract the varicose veins.
Now, I know what you’re thinking. “You said the veins could be removed without surgery”.
These veins are very gently extracted with micro-instruments and the small puncture heals over with no scar. We regularly ask our patients during our procedures to give the procedure a “pain score”.
Nearly every patient says that they feel very little and that the procedure is not painful.
Because the vein extraction is performed under local anaesthetic, because it is not painful, because it does not leave a scar and because it can be performed on a walk in walk out basis, this is not surgery in the generally accepted meaning of the term. This micro-extraction procedure is called “Phlebectomy”.
Why can't you remove the varicose veins by Laser?
Well there are two reasons. Firstly, the varicose veins are very twisty and tortuous. It is simply impossible to negotiate a straight laser fibre inside a tortuous twisty varicose vein. The second reason is that the varicose veins lie very close to the surface of the skin. The heat energy from a laser fibre within a varicose vein could injure the skin and cause a burn. For these two reasons, it is better to gently extract the varicose veins from cells by Phlebectomy.
So in summary, yes I can treat and remove varicose veins without surgery and without scars. These before and after clinical photographs prove the point.
- Non-surgical treatments avoid general anaesthesia. Although modern general anesthetics are very safe, procedures carried out under local anesthetics are even safer.
- The cosmetic outcome is much better with a non-surgical approach. There are virtually no scars and patients treated with non-surgical methods are much happier with the cosmetic outcome.
- The recovery after non-surgical treatment is much quicker. It’s a walk in walk out procedure and people can get back to normal activities very quickly. People can drive and get back to work within a day or two. Please note however that if your job involves heavy lifting, standing for long periods in a hot environment or if there is a possibility your legs may get knocked at work (i.e. you have a very physical job), you may need a little longer off work, perhaps a week or two.
- Because there are no surgical incisions or cuts, the risks of infection are almost eliminated completely. Indeed, because the procedure is under local anaesthetic on a walk in walk out basis and guided by ultrasound at every step, nearly every single complication is much lower (including DVT and nerve injury).
- The risk of vein recurrence is much lower with these modern non-surgical treatments. Endovenous Laser Ablation sterilisers the vein as it closes it. Unlike surgical stripping, there are no raw, living ends of aim that can regrow and rejoin. After surgical stripping, this process of regrowth (which is called neovascularization) is one of the commonest reasons for veins coming back. Neovascularization simply doesn’t occur after Endovenous Laser Ablation.