EVLA-The endovenous laser ablation procedure involves thermal ablation of incompetent, refluxing, varicose veins. Unlike vein stripping, EVLA permanently shrinks and collapses the abnormal vein, thereby leaving it in place without surgically removing the vein. Laser energy is delivered through a tiny laser fiber inserted into the targeted varicose vein.  The EVLA procedure is performed through a tiny nick in the skin to avoid scarring. No stitches are needed to close the small nick. The laser fiber is positioned using ultrasound guidance. We administer local anesthesia to completely numb the vein before treatment so the treatment is virtually painless. EVLA is an FDA-cleared minimally-invasive technique to treat symptomatic varicose veins with excellent clinical and aesthetic results. Complications are minimal in the hands of an experienced Vein Specialist. Most patients will be free of the symptoms that they had formerly suffered beginning the next day.  

Sclerotherapy is the "gold standard" and is preferred over laser for eliminating large spider veins (telangiectasiae) and smaller varicose leg veins. Unlike a laser, the sclerosing solution additionally
closes the "feeder veins" under the skin that are causing the spider veins to form, thereby making a recurrence of the spider veins in the treated area less likely. Multiple injections of dilute sclerosant are injected into the abnormal surface veins of the involved leg. The patient's leg is then compressed with either stockings or bandages that they wear usually for two weeks after treatment. Patients are also encouraged to walk regularly during that time. It is common practice for the patient to require at least two treatment sessions separated by several weeks to significantly improve the appearance of their leg veins.

Sclerotherapy can also be performed using microfoam sclerosants under ultrasound guidance to treat larger varicose veins, including the great and small saphenous veins. After a map of the patient's varicose veins is created using ultrasound, these veins are injected while real-time monitoring of the injections is undertaken, also using ultrasound. The sclerosant can be observed entering the vein, and further injections performed so that all the abnormal veins are treated. Follow-up ultrasound scans are used to confirm closure of the treated veins, and any residual varicose veins can be identified and treated.

Microphlebectomy is an in-office procedure used to remove varicose veins that are very close to the surface of the skin. This minimally invasive procedure is done in-office using local anesthesia. Veins are removed through tiny incisions, about 1mm in size. Stitches are not necessary since the incisions are very small and patients are able to walk after the procedure. Strenuous activity should be avoided for 1-2 days after the procedure. Compression bandages or stockings are worn post treatment. Your physician will let you know how long to wear these.

Spider veins are tiny visible vessels just under the skin’s surface. Spider veins are commonly found on the face and legs. During the treatment, the laser is placed on the skin over the spider veins. The laser energy passes through the top layer of skin to the targeted blood vessel, causing it to slowly heat up and seal itself. Some mild discomfort is normal, similar to the feeling of a rubber band snapping against the skin. Treatments can last for a few minutes to a half an hour. Multiple treatments may be necessary depending on the size and depth of the veins, but in some cases only one treatment is necessary. Post treatment there may be some redness that can last up to an hour, and clients are advised to wear compression hose for several days post treatment.