San Francisco Sclerotherapy doctors

	Robert Swanson, MD Bay Area General Surgeon 350 Bon Air Road suite 300, Greenbrae		4 answers
	Charles K. Lee, MD San Francisco Plastic Surgeon 2250 Hayes St. Ste 508, San Francisco		1 answer
	Usha Rajagopal, MD San Francisco Plastic Surgeon 490 Post Street Suite 430 , San Francisco		1 answer
	Steven H. Williams, MD San Francisco Plastic Surgeon 4000 Dublin Blvd Suite 300, Dublin		1 answer
	Sonia Badreshia-Bansal, MD San Francisco Dermatologic Surgeon 360 Rose Ave, Danville

Recent Answers

Normal To Treat The "Main Veins" During Procedure for Sclerotherapy Rather Than The Spider Veins? I am scheduled to have sclerotherapy on the spider veins in my legs. A nurse practitioner for a plastic surgeon is doing the procedure. She said she would need to treat the "main" veins feeding the spider veins. I have seen nothing in the literature noting the need for this. Is this accurate? I don't want unneccesary or dangerous work done. I thought just the spider veins would be treated (?). Can you advise? Thanks!

A: It depends on what is meant by "Main Veins".

She is right that you should have the reticular veins that drive the spider veins treated. Without doing that, the spider veins are likely to recur. The spider veins are in the skin, the reticular veins are under the skin. The reticular veins are not, however the "main veins". These have names like greater, lesser saphenous or perforating veins. When the treatment involves these veins, things can start to get dangerous. The danger comes from blocking off major outflow veins or from producing thrombosis in the deep venous system (DVT or Deep Venous Thrombosis).

A sclerotheraputic agent that will not cause these larger veins to thrombose is a real advantage. Polidochanol is such an agent.

So it really does depend on what "main veins" means.I hope this helps.

Robert Swanson, MD

Bay Area General Surgeon

How to Repair Bulging Varicose Veins After Sclerotherapy? I am devastated. I am wondering how I can repair damage I believe to be caused by Sclerotherapy. I had nice legs except for a small amount of spider veins seven months ago. I am thin and very active. After injections into reticular thigh veins I have developed bulging varicose veins and severe cellulite where I got the thigh injections. It took years to develop the few spiders and they came on very gradual now my legs are covered and this is just seven months later. Is there any help for this?

A: Repairing bulging varicose veins requires finding the root cause

Bulging varicose veins are on the skin surface, but the deeper vein feeding the varicosities is usually much deeper and cannot be seen with the naked eye. A duplex ultrasound will identify the deeper branch, typically the greater or lesser saphenous vein, and show "reflux"-- where the veins allow blood to flow backwards instead of forward, causing blood to flow down into the legs, causing swelling, aching, and more varicose and spider veins.

If you had sclerotherapy for reticular veins, it is quite possible that you have venous reflux which should be diagnosed appropriately, and hopefully the root cause treated with endovenous ablation (EVLT) of your saphenous veins and phlebectomies--the actually removal of the varicose veins. This will lead to long term treatment and much improved symptoms and appearance to your legs!

Charles K. Lee, MD

San Francisco Plastic Surgeon

Does Sclarotherapy Work? I'm 30 years old and plan to get sclarotherapy. do it work and what are the side effects? How much does it cost?

A: Yes, sclerotherapy works

Spider veins and verticular varicose veins can be eliminated permanently through sclerotherapy.

I attached a video of sclerotherapy. This is only a portion of the procedure. You can actually watch the veins disappear as the solution is injected.

A laser is used as a second line of treatment or as a clean-up procedure after sclerotherapy when the remaining veins are too small to inject.

Usha Rajagopal, MD

San Francisco Plastic Surgeon