Trying to decide if I should proceed with EVLT and microphlebectomy?

Question

I am in my early 40s and am scheduled for EVLT and microphlebectomy on one leg with a reputable surgeon. I am however having second thoughts as I am concerned about chronic pain and discoloration. I am not bothered by my veins symptomatically right now (other than the cosmetic appearance) so I don't want to cause problems unnecessarily but I am also concerned about worsening of my venous disease given my strong family history. Is prolonged pain (weeks to months after procedure) common?

Tif Siragusa, MD · Answer

If you experience any swelling in your legs as well as bulging veins, the first line of treatment is daily use of 20-30 mmHg compression stockings.  This usually will help slow down the progression of the problem but usually does not make it go away.  The risks for EVLT and phlebectomy should be extremely low.  A lot of patients become a little nervous when they read about the potential complications.  Remember, we are required to list every problem that has ever occurred on the consent form, even if an individual doctor has never had that complication.  I'd speak with your doctor about what he has noticed to be the chances of developing any complications and I think you'll feel much better once you do.

Andres Zavala, DO · Answer

Treating varicose veins and underlying venous insufficiency sooner rather than later can help lessen risk of complications of advanced disease including increased risk of blood clots, venous ulcers and chronic skin changes that are not reversible. At times I have had patients that say "I have no pain" or "my legs feel fine" and proceed with treatment for "cosmetic purposes", only to find out after treatment that their legs "feel much better, lighter, have more energy" etc...  The symptoms are insidious and rarely happen overnight, so there are many that simply get used to the way their legs feel and assume discomfort or pain later in the day is normal. There are of course some patients that truly don't have symptoms, but in many cases these will develop later if left untreated. While treatment is certainly optional, I believe that treatment is often the best course of action; especially in someone that already has bulging varicosities or leg swelling.
 Pain after the procedure is usually very manageable and rarely last more than 1 to 2 weeks and in many patients only a couple to a few days. Just make sure you are being treated by a vein specialist with experience and discuss your concerns.

Richard J. Grisoli, MD · Answer

If you are having symptoms and have significant venous insufficiency, then I highly recommend the EVLT procedure. This will likely prevent you from developing a venous stasis ulcer on your leg down the line. When performed by an experienced physician, it is very safe and almost always effective.

Megan Deacon-Casey, MD · Answer

Getting venous insufficiency treated via an EVLT will not cause any long-term side effects, the procedure is done under local anesthesia right in the physician's office and you are up and around immediately after. Many of our patients come before work or even during their lunch break. Also, patients tolerate the procedure so well with very minimal pain. 
Venous insufficiency is hereditary and it tends to progress if left untreated, you may be asymptomatic right now, however you mentioned the need for a phlebectomy which means you have varicose veins that are bulging and those tend to get larger and bulge ever more with time.

Albert Malvehy, MD · Answer

"Why didn't I do this sooner?" This is the question I hear from almost all my patients after their treatment. People are afraid of the unknown, of the potential pain, of the cost, or they think it's just cosmetic; so they suffer and things just get worse. Get your problem fixed by someone you trust. You will be much happier.

Trying to decide if I should proceed with EVLT and microphlebectomy?

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Answer: "Why didn't I do this sooner?"

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Trying to decide if I should proceed with EVLT and microphlebectomy?

Answers (10)

Answer: EVLT

Answer: EVLT

Answer: "Why didn't I do this sooner?"

Answer: "Why didn't I do this sooner?"

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Recommended reading

Everything you need to know about EVLT

Our mission is to create a world where every investment in modern beauty is Worth It.