Spider and Varicose Vein Treatment Options in Our Practice in Los Angeles
Nu Vela Esthetica, a modern Laser and Vein Center located in Porter Ranch, San Fernando Valley, offers the most advanced varicose vein treatments that are currently available in the Los Angeles area. Veins that can be treated at the Vein Clinic include Saphenous and perforator veins, bulging leg varicose veins, reticular veins (blue veins), spider veins (or thread veins), facial veins, and nose veins.
Whether you have pesky visible veins or leg pain associated with varicose veins, Dr. Raffi Dishakjian, M.D., a highly skilled vein surgeon, will be delighted to assist you and offer his advice and suggestions. Dr. Dishakjian will work with you to create the best personalized vein treatment plan that fits both your condition and your budget.
Until a decade ago, compression therapy involving bandaging or wearing of compression stockings was the only option available to vein patients preferring a non-surgical solution to their vein problems. Although compression stockings offer some relief to patients with aching and heavy legs and are beneficial to those with existing blood clots in the deep and superficial veins, or in healing ulcers; these stockings can't eliminate varicose and spider veins, and do not cure chronic venous insufficiency, the underlying cause of vein disease, also known as venous reflux.
Tailored to the needs of each patient, treatments offered by our vein center include:
Lasting and definitive treatment of chronic venous insufficiency and the resultant varicose and spider veins should always start with either surgery or one of the many minimally invasive procedures that are nowadays available in most advanced vein centers. In many cases, patients may require more than one kind of vein treatment to get the optimal results. A carefully planned treatment program will often be necessary to restore vein health, proper circulation and the desired aesthetic results. Dr. Dishakjian, the phlebologist at the Center, is qualified to offer an extensive variety of vein treatments to meet the individual needs of the patient. Dr. Dishakjian will review in detail the various vein treatment options for your individual condition and the expected results of the procedures.
Sclerotherapy for Spider and Small Vein Removal
Sclerotherapy is the standard treatment for spider veins and superficial small varicose veins that usually appear on the leg veins, but may also appear on other parts of the body.
Sclerotherapy entails injection of a sclerosing solution into a targeted spider vein or a reticular vein through a very fine needle. The chemical takes effect right away, collapsing the blood vessel within a few seconds. The body's natural healing process then re-routes the blood flow through healthy veins and the bothersome vein fades from view over a period of several weeks. The procedure is performed using the thinnest possible needles to minimize the pain of injection. In fact, most patients are pleasantly surprised about how painless this experience is when applied to spider vein removal. Typically 2-3 treatment sessions are needed for gradual fading of the treated veins. Compression stockings are recommended for most patients after treatment for about a week.
Besides noticeable cosmetic benefits, sclerotherapy may also remedy the bothersome symptoms associated with spider veins, including aching, burning and night cramps. More about sclerotherapy and spider vein removal.
SCLEROTHERAPY INJECTIONS FOR SPIDER AND SMALL BLUE VEINS
Foam Sclerotherapy to Treat Bulging Leg Varicose Veins
Ultrasound-guided foam Sclerotherapy is the latest innovative treatment for large, bulging, superficial leg varicose veins. These large veins cannot be treated with traditional liquid sclerotherapy; they contain too much blood which immediately dilutes the injected liquid sclerotherapy medication, thus rendering it ineffective. Foam sclerotherapy overcomes this problem by combining traditional sclerotherapy with a natural, soluble gas, to produce a shaving cream-like foam. The foamed agent does not readily mix with blood, keeping its full potency throughout the treated section of the varicose vein. Foaming also gives the sclerosing agent a very large surface area of contact with the vein wall while using a relatively small amount of the liquid agent, similar to the foamed liquid hand washing soap in common use.
Varicose vein treatment with this procedure is associated with minimal to no pain, and involves the insertion of a catheter or a needle into the main affected superficial vein through which the foam is injected. The Duplex ultrasound imaging is then used to guide and monitor the spread of the foam. More about varicose vein treatment with foam sclerotherapy
Venefit™ Targeted Endovenous Therapy and Endovenous Laser Treatment (EVLT)
At last, two minimally invasive and gentle alternative procedures to painful vein stripping surgery for superficial venous reflux disease. Endovenous Laser Treatment (EVLT) and Venefit™ Targeted Endovenous Therapy (formerly known as VNUS Closure™) are office based varicose vein treatmenty procedures. They involve the ablation of the major superficial diseased veins that are in direct communication with the deep venous system. These varicose vein treatments are performed under local anesthesia, whereby a needle hole opening in the skin is used to thread a catheter (Venefit or VNUS) or a laser fiber (EVLT) into the vein near the knee. The catheter or the laser fiber is then guided up the thigh and positioned using duplex ultrasound imaging. At this stage, radiofrequency or laser energy is precisely delivered to the identified diseased vein. The generated heat energy causes the vein wall to collapse permanently. Dr. Dishakjian will later treat the remaining side branches with sclerotherapy, foam sclerotherapy, or topical laser surgery, depending on their size and nature. More about Venefit™ Targeted Endovenous Therapy (VNUS Closure) and EVLT or other surgical and non-surgical options for varicose vein treatment.
Currently the Venefit™ Targeted Endovenous Therapy is the only FDA approved technology to treat the shorter perforator veins of the legs. Perforator veins, which are short connecting veins located along the entire length of the legs, allow blood drainage from the superficial venous system and deep venous system. When diseased, the valves of these veins malfunction allowing reverse flow and channelling blood directly from the deep veins into the superficial ones. The abnormal blood flow results in the formation of bulging superficial varicosities, thread veins, brown stains, and leg ulcers. Until recently, a surgical endoscopic procedure, SEPS (Subfascial Endoscopic Perforator Surgery) was the main method of eliminating the abnormal flow in these veins.
VNUS CLOSURE FOR VARICOSE VEIN TREATMENT
Laser Removal of Small Leg Veins
Laser Vein Removal may be an alternative or complimentary to sclerotherapy for the elimination of small spider veins and thread veins. During the procedure, a topical local anesthetic cream is applied to the area to be treated, and a brief laser beam is pulsed onto the skin. The beam heats the veins, degrades them, and seals them off. The treated veins may become temporarily inflamed, but will be absorbed by the body and disappear within a few weeks.
Even though facial veins are being treated with sclerotherapy, lasers and light based treatments are the best solution for facial reticular and spider veins. The problem with sclerotherapy around the eye is that the medicine that is being injected could travel backwards into vital structures of the head and can cause vision loss or blindness. Depending on the size of the vessel and the color, Dr. Dishakjian, M.D., a phlebologist and cosmetic surgeon, will either choose an IPL or one of the lasers intended for this purpose. Both laser and intense pulsed light are generally safe, provided they are handled by an expert physician. Occasionally, some degree of scarring and/or hyperpigmentation (darkening of the skin) can occur in dark-skinned patients. Fortunately, however, the range of patients who can benefit from this treatment is very wide.
All laser and IPL procedures for facial veins basically work behind the same principle. The laser's energy is selectively absorbed by red blood cells, and the generated heat destroys the vessels. Over time the remains are absorbed by the body and the targeted veins disappear.
Laser or IPL facial vein treatment procedures do not require any anesthetic, the skin cooling device attached to the hand pieces minimize the pain caused by the light beams. After the vein treatment, your skin will be red for a few days and depending on the laser and the type of vein that was treated, you may have some bruising and darkening of the veins. This normally resolves within 2-5 days, but in some cases it may take a number of weeks to do so. More about Facial reticular and spider vein laser treatment.
FACIAL RETICULAR VEIN - LASER TREATMENT
NOSE SPIDER VEINS - LASER REMOVAL
Also known as Ambulatory phlebectomy, is a method of removing medium-to-large surface varicose veins through very small punctures that do not require stiches. The vein removal procedure, originally developed in Europe, is ideal for getting rid of veins that are too large to treat with sclerotherapy and too close to the skin to safely and successfully treat with endovenous procedures.
Vein removal using microphlebectomy is normally done in a doctor's office using a local anesthetic. Skin incisions or needle punctures as small as 1 mm are used to extract a vein with a phlebectomy hook. The hook is inserted into the tiny puncture in the leg, a section of the vein is hooked and then removed through the incision. By removing certain sections of the vein, the areas of the vein which are not removed will "clot off," eliminating the bulging veins for good. There is very little discomfort with the procedure and very little "down time" during your recovery. Most individuals are allowed to return to work and resume their normal activities immediately after the procedure. Compression during the following two weeks minimizes the swelling and discomfort and allows for proper healing.
What Type of Doctors Treat Varicose Veins?
Until a few years ago, varicose vein treatment was the domain of vascular surgeons, since treatment meant a surgical procedure known as ligation and stripping. This treatment involved multiple skin incisions, surgically cutting and tying veins, then physically pulling veins out of the surrounding soft tissues, often requiring general
aneshtesia and an overnight stay in a hospital for pain management. However, with the advent of portable office based duplex ultrasound technology, medical lasers, and endovenous ablation techniques (heating the vein from inside with a catheter), the surgical scalpel was replaced with a needle, and the associated skin incisions, scarring and hospitalization were eliminated, moving the procedure from the operating room to the office setting.
Whereas many vascular surgeons still practice the traditional vein stripping and ligation, the practice of phlebology (vein care) has undergone a revolutionary change fueld by these technological innovations. Currently, phlebologists come from a diverse mix of medical backgrounds, like radiology or anesthesiology, specialties involving expertise in needle based vascular access. According to the definition given by the American College of Phlebology, a phlebologist is a physician who specializes in the diagnosis and treatment of vein disorders. In the year 2005, the American Medical Association, AMA, recognized phlebology as a separate self-designated specialty, the same as dermatology, vascular surgery, or any other recognized specialty.
Dr. R. Dishakjian is a board certified anesthesiologist and a phlebologist with a long surgical operating room experience. Moreover, Dr. Dishakjian is a cosmetic surgeon and an expert in cosmetic lasers. Accordingly, besides being treated by an expert phlebologist, you can be assured of the best possible cosmetic outcome. Please don't hesitate to call us to schedule a consultation with Dr. Dishakjian. Consultation is free.
What to Expect from Your Vein Center?
Each patient requires an individualized treatment strategy based on his or her unique circumstances. A systematic approach to evaluation and assessment helps guide a vein doctor workup the eventual treatment plan.
At Nu Vela, evaluation and assessment begins with Dr. Dishakjian, who takes notes of your medical history and collects information related to your specifics of venous disease, including family history, predisposing factors (such as clotting disorders), symptom onset, and information about previous treatments. In conjunction with this history, Dr. Dishakjian may perform a physical examination of varicose veins and suggest an Ultrasound test to collect essential and detailed information regarding your venous anatomy and function. Based on the assessment, the doctor will then discuss vein treatment options, necessity, cost, insurance coverage, side effects, and carefully coordinate an appropriate and customized treatment program to meet your specific needs and restore proper circulation and optimal vein health and appearance. It should be mentioned that most insurance plans, including Medicare, cover varicose vein treatment, once the medical necessity is established. Note that the cost of Ultrasound test is not included in free consulation; however, three quarters of what you pay is reimbursable as payment towards varicose vein treatment.
THE DOCTOR ON ABC EYEWITNESS NEWS
Diagnostic Ultrasound for Evaluating Vein Disorders
Treatment failures for spider and reticular veins are often due to overlooking problems with deeper veins in the legs, such as refluxing saphenous and perforator veins. Only ultrasound can diagnose these problems. If the test is ordered and performed at a hospital or outpatient diagnostic center, it is often done by a technologist, who is not properly trained in evaluating the superficial veins. At Nu Vela, patients are not referred to an outside imaging center or hospital for ultrasound evaluation; Dr. R. Dishakjian, with extensive experience with the technology, personally performs all ultrasound evaluations.
VEIN TREATMENT AT NU VELA ESTHETICA
Questions About Cost of Vein Treatment or a Treatment?
Our vein clinic is located in the northwest San Fernando Valley, near Chatsworth, with easy connection from most local Los Angeles freeways. Click the "Contact us" button at the top of the page for directions, or call 818-832-4500. The receptionist at the Center will be delighted to assist you with any enquiries regarding cost, additional information on varicose vein removal options, or scheduling a consultation session with Dr. Dishakjian. Consultations with the vein doctor are free with the purchase of any service. We charge a nominal refundable consultation fee for the first office visit only. This fee is fully credited towards a subsequently purchased service.