When performed correctly , both VNUS Closure and EVLT yield comparable results. Early on there were some differences, but in current day practice, they are the same
EVLT is not indicated for the treatment of hand veins. Sclerotherapy (inections of polidocanol or other sclerosant with or without foam) is the usual treatment of choice and is associated with a high rate of success.
If the refluxing segment is at the saphenofemoral junction (at the groin) then ablating the above knee greater saphenous vein may yield a good result. As a matter of fact, there is an ongoing debate amongst vein specialist as to whether the below knee saphenous vein needs to be treated in every patient. A thorough evaluation of the points of reflux and reentry on ultrasound allows a case by case decision. Having said this , there are ways around the inability to cross the vein segment. A guide wire may help or another access above the difficult segment. Sometimes a combination of thermal ablation and sclerotherapy may be used .
Botox can last up to 3 months . The effect of your current injections will most likely eventually wear off by 12 weeks . Typically vertical perioral lines are better addressed with fillers than with Botox
