Can very large veins in arms be removed? I'm a very healthy 70 year old woman. (Photos)

Question

I've had large veins (legs and arms) all my adult life. It seems the older I get, the larger the veins appear and more uncomfortable they become. Leg veins were removed years ago, and I asked the doctor about removing the arm veins, but he said I wouldn't like the result. Perhaps this is a rare request, so I would like feedback from another doctor, preferably in the Tampa Bay area.

Raffy Karamanoukian, MD, FACS · Answer

It’s important to distinguish between varicose veins and spider veins when choosing between laser therapy, sclerotherapy, and vein surgery. With two board certified vein specialists, our center uses a combination of visual examination, functional flow measurements, ultrasound, transillumination, and infrared light to map out vein networks prior to therapy. Lasers can be used to treat deep varicose vein insufficiency, vein perforators, and varicose veins. Sclerotherapy is ideal for spider veins and reticular veins. Whereas surgery is reserved for severely incompetent varicose vein segments.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian
Realself100 Surgeon

Michael Nguyen, MD · Answer

Venous insufficiency of the lower extremities approach depends on many factors. First of all, signs and symptoms of leg vein disease include varicose veins, leg or ankle swelling, leg heaviness and fatigue, leg pain, aching or cramping, burning or itching of the skin, restless legs, skin changes or rashes, ulcers, open wounds, or sores. Factors that contribute to the presence of venous insufficiency include age, gender, family history, heavy lifting, multiple pregnancies, obesity, and prolonged standing. The way healthy leg veins work is that they contain valves that open and close to help the blood return back to the heart. Venous reflux disease develops when the valves that keep blood flowing out of the legs and back to the heart no longer function, causing to pool in the legs and leading to signs and symptoms above. Without treatment of venous insufficiency, those with the disease may experience progressive symptoms like leg swelling, skin damage and/or ulcers that can debilitate and impact a great deal the quality of life; however, that outcome is preventable with proper treatment. This is the reason of treating venous disease in the legs. However, approach is different for upper extremity because vein are closer to the heart, and they do not present the same problems as the legs many times do because of venous insufficiency. I recommend you visit a board certified vein specialist first for an evaluation including ultrasound to check for patency of the upper extremity deep and superficial system to make sure there is not a complication. Discuss all pros and cons of cosmetic treatments and options for vein appearance of the upper extremities. 
All the best,

John Landi, MD · Answer

A large part of my practice is the treatment of hand and arm veins which I have been doing of almost 20 years.  Certainly this is a cosmetic procedure but it carries excellent cosmetic results.  I use a combination on endovenous laser and sclerotherapy and the procedure is done in the offie under local anesthesia with almost no downtime.  I am located in Naples, Fl.

Can very large veins in arms be removed? I'm a very healthy 70 year old woman. (Photos)

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