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Varicose Leg Veins – Aesthetic Treatment

What are varicose veins?

Varicose leg veins are those veins that have lost their morphology, look and function. They are the dominant disease of the superficial vein system, and they usually appear on the inner part of the upper leg and lower leg, or behind the knee, solitary or in a group. In healthy veins there are valves – small “ valves “, that direct the blood flow in the leg veins opposite to gravitation, towards the heart.

vene-slika-1The changes of the vein valves that lead to varicose veins

There are two kinds, superficial and deep varicose veins. The first are fat curves and knots that are easily noticed, while the deep veins between bones and muscles can not be seen. Vein insufficiency leads to a number of symptoms, and the disease has the following stages. First capillaries appear in the skin looking like a net of veins, that, in time, grow into varicose and painful veins. As the disease progresses, the legs begin to swell, and eczema appears. Unless the disease is healed, the next stage occurs. Wounds appear, that can not heal easily ( ulcus cruris venosum ).

vene-slika-2Photo of varicose leg veins

Why operate varicose veins?

According to statistics, varicose veins are one of the most frequent diseases that people deal with. Diseases of the veins are very frequent: 10-30% of the entire population. i.e. 50-55% of adults have problems with veins. The most vulnerable group are those aged 30 to 40, because their health problems diminish their work capability and life quality. The number of those with this disease in Serbia is like in the rest of the world. In our country, about 20% of the population suffers from this disease. About 5000 people a year are diagnosed with this disease and are recommended for hospital treatment.

Patients with insufficiency of the veins can feel heavy legs, pain, cramps and other symptoms. Chronic vein insufficiency leads to skin disorders like swelling of the legs, painful cramps, eczema, hyperpigmentation, lipodermatosclerosis and ulcerations. The effect of vein insufficiency on the aggravation of life quality in patients is great, so we can freely state that varicose veins are a real social and medical problem that can absolutely be compared with other chronic diseases like diabetes and cardio-vascular diseases. So, we can say that only timely treatment can prevent the appearance of serious complications.

Methods of treating varicose veins

Endovein thermal vein ablation

  1. Radiofrequent vein ablation – RF closure procedure
  2. Laser vein surgery


Radiofrequence ablation of veins is often called “ vein surgery radiowaves” or sometimes “ VNUS Closure operation”. This is a method of treating varicose veins of the legs, based on the closing of the damaged main superficial veins from inside, by heat generated by the RF generator. RF closure fast catheter heats the wall of the vein from the inside, thus leading to the closing-tacking of the damaged veins. By   closing the damaged veins, we avoid classic extraction of the veins from the body and then re-direct the blood flow into a healthy vein, there by liberating the patient from symptoms, both visual and aesthetic, and subjective. The operation is performed in local ( TLA ) anesthesia, and the patient  is mobile the same day, and capable to work.

Vein surgery by RF method under the control of ultrasound and TLA anesthesia (local anesthesia )

2. Vein surgery with laser– EVLA

Endovein  laser treatment – EVLA  is applied the same way as radio frequency treatment, except that a laser light beam is activated the tip of the catheter, which transfers energy to the vein wall and leads to a closure, and the result is the same ,ie. ( coagulation ) of the vein.

In classical surgery vein surgery, the veins are surgically removed from the body, while in vein surgery with RF, laser and foam, the veins are closed, ie.obiliterated.

Removing the veins with foam – foam sclerotherapy

The removing ( sclerosation ) of veins with foam is called “ foam  vein surgery or ultra sound removal of veins with foam “ or shortly as “UGFS” or the “ UGS method., derived from “ ultrasound guided foam sclerotherapy “. This method is based on the closure of damaged veins and capillaries from inside by a chemical agent, foam, that leads to the damage of the inner wall of the vein., which in turn leads to the closure and gradually to the disintegration of the vein, and re-directs the blood to healthy veins. With this method, it is possible to treat veins without anesthesia, or with a very small amount of local anesthesia, without surgical cuts and with a very speedy recovery. The procedure is short, only about ten minutes. That is much more convinient than classic surgery of the veins, that are done in hospitals

prikaz-primene-pene-i-njeni-efekti-na-prosirenim-kapilarimaThe review of the application of foam and its effect on enlarged capillaries.

Classic vein surgery

Classic surgery of the veins ( so called stripping ), is a kind of operation of the veins, based on extracting the damaged veins, opposed to already mentioned methods based on closure of damaged veins. The extracting of veins means multiple cuts and sutures of the skin, usually total anesthesia, hospital conditions and longer recovery. That is the reason, that in the last ten years the classical vein surgery is replaced by above mentioned contemporary endovein ablations.

What method of vein surgery is the most successful?

The answer to this question are the results of the meta analysis of 119 studies published in the Journal of Vascular Surgery 2009 year:

Method Success after 5 years of following
Radio-frequent ablation (RFA) 95%
Laser vein surgery (EVLA) 95%
Sclerosation of the veins with foam (UGFS, UGS) 74%
Classic surgery (stripping) 76%

Table: The percentage of patients treated with different methods in the USA in 2002-2012:
( source J. Mauriello, Endovenous Laser Ablation of Varicose Veins: Where are we going? The table does not include patients treated by sclerosation with foam UGFS, but, according to the portal “ E-medicine “, it is used almost as frequently as laser treatment.

Year Classic surgery Endovenous thermal ablations
2002 93% 7%
2005 43% 57%
2008 5% 95%
2012 3% 97%

Cosmetics in the battle against varicose veins

Varicose veins are a health, and aesthetic problem. Besides medical appliances, in prevention and treatment you can use cosmetic preparations. The use of adequate cosmetics improves the circulation, stimulates the synthesis of collagen, and regenerates the skin cells. The adequate cosmetic preparations decrease swelling and pain of the legs varicose veins, they have a lifting effect, they improve skin texture, microcirculation and skin metabolism. It is recommended to use preparations from orange skin- Diosmine PHLEBODIA 600 1 x 1 a day.


Gels, crèmes and ointments that contain diosmine, are also recommended. They should be used regularly to be gently massaged into the skin, until it is completely absorbed by the skin. If you prefer natural medicine , you can use marigold ointment or preparations of wild chestnuts.

Prevention of varicose veins

The prevention of varicose veins is a lot of physical activity, regular resting of the legs and less weight. Wearing of elastic stockings is also recommended, and people who spend a lot of time standing on their feet, and have varicose veins, must especially be careful.


Photos before and after surgery

vene-pre-i-posleBefore surgery and the second day after surgery ( no cuts, no sutures, no scars )