Nashville Vein Treatment doctors

Brian Biesman, MD Brian Biesman, MD
Nashville Oculoplastic Surgeon
345 23rd Ave N Ste 416, Nashville
1 answer
T. Wayne Day, MD T. Wayne Day, MD
Nashville Dermatologic Surgeon
24 White Bridge Rd, Nashville
1 answer
Steven Roth, MD Steven Roth, MD
Nashville General Surgeon
2400 Patterson Street, Nashville
1 answer
Michael Gold, MD Michael Gold, MD
Nashville Dermatologist
2000 Richard Jones Rd Suite 220, Nashville
Kevin F. Hagan, MD Kevin F. Hagan, MD
Nashville Plastic Surgeon
6050 Medical Center East, Nashville

Recent Answers

Am I at Higher Risk for Forming Blood Clots After Surgery to Remove Vericose Vein 5 Years Ago?

I had a vericose vein removed using the stripping method over 5 years ago. I had 5 ultrasounds following and never had a problem with blood clots before during or after surgery. I am planning on having a mommy makeover in February 2012. Am I at a higher risk for forming blood clots because of the previous surgery?

A: Blood Clots and Varicose Veins

Blood clots, the ones you have to worry about, those that can break free and go to your lungs, are formed in the deep veins. We call them Deep Vein Thrombosis.

That is different than most varicose veins. The ones that are most often removed are superficial, right under the skin. So removal of a varicose vein five years ago should have nothing to do with the current risk of a blood clot.

Blood clots and them breaking loose and going to the lungs, pulmonary embolism is most associated with general anesthesia. So any procedure that can be done under local, i.e., not being put to sleep, is much safer.

T. Wayne Day, MD
Nashville Dermatologic Surgeon
Blisters, Scabs and Now Brown Spots After Laser Vein Removal on Face. Help!

Had a Cutera CoolGlide laser vein removal treatment on my face around nose and on cheeks a month ago. A day after the treatment I got several round blisters and then scabs. On advice of the technician I treated with an Avene Cicalfate cream and aquaphor. I used SPF religiously? The lesions have now flaked off and are no longer raised but I am now left with round brown spots where th laser was fired. Will this go away? It looks like the brown spots are under the skin where the blisters were

A: problems after vascular laser treatment

I use this device on a regular basis to treat unwanted blood vessels around the nose and on the face.  There is indeed a risk of complications but this is low if the treatment is performed appropriately.  The brown spots may represent temporary or permanent discoloration.  I would have to see the areas to recommend specific treatment.  In some cases bleaching agents such as hydroquinone are of benefit.  Topical steroids can play a role in some situations as well.

Brian Biesman, MD
Nashville Oculoplastic Surgeon
A: Best varicose vein remedy

In general, for those large, ropey veins there will usually be an identifiable cause. The causes are usually from the superficial venous system and the perforator system. The only minimally invasive endovenous ablation technique that can directly take care of both systems successfully is VNUS Closure (RF or radiofrequency abltion). It takes 30 minutes or less, no incisions, local anesthetic with iv sedation, and when you leave the office no restrictions and no down time. The VNUS Closure FAST catheter has a less than 1% failure rate. The RFS catheter in experienced hands has a less than 10% failure rate. There are no well designed studies in the literature for the RFS catheter and the results are physician dependent (experience with the technique). Approximately 60-70 % of the time the ropey, bulging veins will shrink on ther own once the venous pressure is reduced.

The endovenous laser technique soon will undoubtedly prove in the literature to have a higher complication rate than RF (bruising, pain, numbness, etc...) as we often see at our own vein clinics in patients who refuse to complete there varicose vein treatment with endovenous laser (even in experienced hands). The endovenous laser technique uses too high a temperature to be safe for direct perforator vein ablation. For these reasons, we do not offer endovenous laser ablation. Too many patients don't like it. Very few patients complain about VNUS Closure.

For those residual bulging varicose veins there are other percutaneous, no incision techniques that can be used to shrink the varicose veins. If these tecniques are unsuccessful, ultrasound guided sclerotherapy or sclerotherapy can be used. As a last resort, more invasive phlebectomy techniques are available and may be necessary in up to 10% of patients.

Steven Roth, MD
Nashville General Surgeon
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