FAQ Veins

Veins

What are the main causes of varicose veins?
Varicose veins are genetic and run in families. There is a change in the ratio of collagen to elastin in a vein wall which weakens the wall and it dilates. Veins carry blood out of the leg and back to the heart against gravity. They therefore have valves within in them to prevent backflow of blood. When a vein dilates, these valves become incompetent and blood refluxes or ‘backflows’ into the leg. Less commonly, deep vein thrombosis may damage valves rendering them incompetent. Rarely veins are from congenital problems; where a patient is born without valves in the veins, or born with a vein malformation.
To what extent does one’s lifestyle play a role in the occurrence of varicose veins?
Varicose veins and symptoms may be aggravated by being overweight, smoking, standing professions and being sedentary.
Will varicose veins come back?
Varicose veins are not preventable or curable, however, they are maintainable. Veins can recur in some patients, although the rate of this varies. We counsel patients extensively on venous disease. Thus, if a patient has a procedure and starts to get any new symptoms or new veins, they come in early and we can usually treat them by a simple method, rather than waiting for the process to get to an advanced stage needing repeat surgery. Additionally, prior to any surgery proper vein mapping must be undertaken and all problem veins treated initially – this will reduce recurrence. With the above methods, veins are manageable.
What are the reasons for treating varicose veins?
There are 3 reasons we treat varicose veins: 1. To treat symptoms. Thus, anyone experiencing any leg symptoms from varicose veins as described above (heavy, throbbing legs etc) would benefit from treatment. 2. To prevent progression of disease. In some people the only concern is unsightly veins, however, even in this group up to a third of patients will progress during their lifetime to more advanced disease - meaning swelling, skin pigmentation, skin damage and wound formation. All patients with advanced disease and symptoms should have treatment. Skin pigmentation and damage is already irreversible and one needs to prevent this getting worse or a wound forming as this will take a long time to heal. Excessively larger varicose veins may result in a bigger procedure requiring an anaesthetic and a longer recovery. For asymptomatic veins, progression is slow and one will notice changes and the procedure is still an elective one. 3. Cosmesis. In some patients, cosmesis is the only concern and it is important to treat this concern. Veins can have a very negative psychological impact on a patient resulting in them avoiding situations where they would need to expose their legs - such as going to the beach, or prevents them wearing certain clothing. Treating the veins can improve this negative psychological aspect and improve quality of life of many people. The impact of unsightly veins is often not recognized. Overall the treatment of chronic venous insufficiency is improving Quality of Life.
What is the biggest misconception about varicose veins?
The biggest misconception is that varicose veins are a cosmetic issue only. Varicose veins can cause many symptoms that affect quality of life, and the same process that causes unsightly veins in some, causes swelling, skin pigmentation, skin damage and ulceration (wounds) in others. It is all part of the same process and can be severe. Once skin pigmentation and damage have occurred, it is largely irreversible.
Should Varicose Veins be treated?
Another misconception is that varicose veins should be not be treated. However, studies have shown that people with symptoms have decreased quality of life and treating venous disease properly is definitely worthwhile. Patients with vein problems are generally young and healthy and have long life expectancies. Thus treating them is certainly valuable. Compression stockings may help with leg symptoms but will not prevent progression of disease and compliance is a problem amongst patients.
How are endovenous procedures (RadioFrequency Ablation, Laser, Veneseal, MOCCA/Clarivein) to treat varicose veins done?
The procedure is usually performed on an outpatient basis. Using ultrasound, we will position the catheter into the diseased vein through a small opening in the skin. The tiny catheter of the laser or radiofrequency delivers heat to the vein wall. The vein wall subsequently shrinks and the vein is sealed closed. The non-thermal catheters use methods other than heat to close the vein. Essentially the diseased vein is closed and blood is re-routed to other health veins. With time more veins are opened up. If one has extensive veins or is anxious an anaesthetic may be given.
What happens after the Procedure?
Compression stockings and bandages are placed after a procedure. We will encourage you to walk and to refrain from extended standing and strenuous actives for a short period of time.
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Is the Procedure painful?
Patients generally report minimal pain during and after the procedure.
How quickly can I resume normal activity?
Patients are encouraged to walk immediately following the procedure, and most patients resume normal activities within 1 to 2 days. Intense sport may need to be delayed.
Is there any scarring, bruising, or swelling after the procedure?
Most patients report minimal to no scarring, bruising, or swelling following the RFA procedure. If phlebectomies are performed, these areas take longer to heal and there may be some bruising or small haematomas under the skin.
How are endovenous procedures different from vein stripping?
During vein stripping, incisions are made in the groin and calf, and a stripper tool is threaded through the diseased vein, to pull the vein out of the leg. With the RFA procedure, only one small incision is made at the insertion site and the vein is then closed and left in place. This minimally invasive approach virtually eliminates pain and bruising associated with vein stripping surgery.
Are the endovenous procedures covered by Medical Aid?
They are covered by most Medical Aids for patients diagnosed with venous reflux on a duplex doppler ultrasound.
Should all patients with wounds (ulceration) be investigated for varicose veins?
Yes!! Another lack of understanding in the medical field, is 70% of leg wounds are actually from an underlying vein problem, however, patients are often not fully assessed and treated and only managed with dressings. Treating a venous cause surgically, accelerates the rate of wound healing and reduces the rate of recurrence of wounds. All patients with leg wounds should have their vascular system properly evaluated.
Can Pelvic Pain be caused by pelvic varicose veins?
A third of patients with chronic pelvic pain, have pelvic congestion syndrome (pelvic varicose veins) as the cause.
Can veins cause leg swelling?
Yes, this is an important symptom of both superficial vein disease and deep vein thrombosis.
Are spider veins and varicose veins the same?
Spider veins are smaller and more superficial than varicose veins. In appearance, varicose veins are also more raised beneath the skin and linked to a deeper vein system. Symptoms such as swelling, cramping, and throbbing can also be experienced sometimes with varicose veins. Spider veins are generally more of cosmetic than health concern. Some people may experience some discomfort with them.
What is involved in sclerotherapy aftercare?
You will be advised to wear class 2 compression stockings after sclerotherapy for a minimum of 2 weeks during the day. We suggest that you not engage in vigorous activity or sunbathe for 2 weeks.
How long will it be until I see the effects of sclerotherapy?
Veins will thrombose first so they will initially appear darker before the body absorbs them. Most people will start to see veins disappearing in about 4-6 weeks. Everyone is different though and remember that not all the veins will initially close in one treatment session.
 

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Dr Redman is connected to world experts on an academic, clinical and personal level via the International Vein Network.
  • Super well and super happy thanks! Not a moment of trouble or pain. In fact, I have referred a lady from Bodytec to Laura. She was asking where I had it done and where I went. I couldn’t have had more good stuff to say!
    Jacqui Goodwin
  • Very satisfied patient - five-star treatment I find Dr Laura Redman's Clinic to be one of the most professional surgery's I have been to. She came highly recommended by another vascular surgeon. The reception was very welcoming. I had two procedures done on two different occasions and must say never was I treated with such compassion. The procedures went off well and I’m recovering at a speedy pace. Not forgetting on the second procedure my transport home could not make it to pick me up and Dr Redman's assistant transported me home. I would recommend anyone to Dr Redman because in what era last has a doctor transported a patient home.
    Shahiema Hendricks
  • I should have done it sooner! The centre staff were very professional and thorough in their approach which meant I was kept well informed and assured every step of the way. Doctor Redman uses the latest technology in her diagnosis coupled with her skills and experience.  The results of my procedure changed my well-being, and I should have done it sooner! Regards, Mogamat Sedick Samuels 
    M S Samuels
  • The most wonderful experience... I can testify that I underwent a procedure at the Centre and had the most wonderful experience during that and follow up procedures. I am still in the process of further treatments and can recommend the Centre to anyone that consider veins treatments
    Mrs CM Oosthuizen
  • Thank you, thank you! Just a quick, sincere note for Dr Redman, if you don’t mind passing on the message: All the ulcers have healed!!!!!!!  Yippppppeeeeeeeee! I just want to thank you for everything you have done for me, I cannot describe to you in words how grateful I am!  That a simple thing such as taking a bath/shower without having to worry about dressings or a plastic packet on my foot!  -  it just makes me extremely happy and it’s all because of your tenacity in dealing with my stubborn a$$! J and healing me in many more ways than you could imagine.  Thank you, thank you! Truly wonderful to walk into a practice that puts patients first.  Thank you.
    Liesel Shelley
  • Good morning to all at the Centre, I would like to thank each one for their wonderful care and kindness that I experienced . The best I have ever experienced in the medical field.
    Mrs Rosalie Burger

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FAQ Veins