You are suggesting that this would be done for cosmetic reasons since you currently are not experiencing any pain or symptoms. If done properly and you are otherwise healthy, it would depend upon your preferences. Long-term results tend to be very good.

Published on Jul 11, 2012

It is your call; it depends on you. Given that you report no apparent symptoms, you have the luxury of either treating them now or later. However, you should keep in mind that your vein issues will only continue to get worse with time and given the amount of vein issues that it sounds like you already have, the progression of your vein issues can be relatively quick. You should also be aware that the more vein issues you have and the longer you have them, the more likely that you can get permanent skin changes that come along with chronic vein disease. Treating your vein issues early can help to prevent this.

Published on Jul 11, 2012

Once you have faulty valves in the greater saphenous vein (GSV), they almost never return to normal. The damage in terms of varicose veins and skin damage will only worsen over time. Treatment is easier when damage is less severe. If you are planning for a pregnancy soon, you run the risk of the ablated vein opening up when pregnant due to the added pressures on your veins from the pregnancy and hormones. If pregnancy is expected years away, opening up is probably less likely.

Published on Jul 11, 2012

The incompetency of your great saphenous veins and unsightly varicose veins, they will only get worse over time. Treatment is the only thing that will help remedy these issues.

Published on Jul 11, 2012

It is usually better and recommended to have treatment as soon as possible to avert further complications in other veins, including the possibility of having deep vein complications. The only reason to not have treatment would be if you are pregnant.

Published on Jul 11, 2012

Before you seek treatment there are a couple points to consider. First, I would suggest getting the veins fixed in a timely manner since they typically get worse over time. But, in order for insurance to pay for the procedure, you have to meet certain criteria. Often you have to make changes to your lifestyle, use analgesics (ibuprofen or other over-the-counter pain relievers), and experience pain or other symptoms such as heaviness, burning, itching and cramping. You may not meet these criteria right now. Varicose veins are typically progressive, which means they get worse over time. You may need to wait until these symptoms are present to have insurance approve the procedure. On the other hand, if you do not have insurance and want to pay in cash, you may seek treatment any time. Secondly, you should consider the possibility of future pregnancy. If you intend to become pregnant, you may want to wait to fix the veins until after your childbearing years. If you fix them now you should keep in mind that the risk of re-occurrence is higher with pregnancy. Finally, a venous consultation with a physician could address your concerns and help give you further counsel.

Published on Jul 11, 2012

Many times, you may not notice the symptoms because your legs have become accustomed over time to the effects of venous disease. You should seek medical advice and consider treatment if you have visibly large varicose veins.

Published on Jul 11, 2012

There are a number of issues you need to consider when making the decision to move ahead with venous ablation. As you say, you are young: Are you planning to have any children? This is a big consideration, especially since you are not, at present, experiencing any discomfort. To wait until you are done having children would definitely be advisable. Also, you mention you have unsightly varicose veins. I assume you would want to address them at the same time you have your venous ablation. If so, there is the modality to consider. For varicose veins, we use the microstab phlebectomy procedure, which we feel provides the patient with the best therapeutic and cosmetic results. There are other approaches, and you might be wise to educate yourself about them. Finally, you mention EVLT or EVLA, which is the laser ablation technique. We use the VNUS closure procedure, which utilizes radiofrequency heat in place of laser heat. While both techniques ablate or "close" the vein, there are differences. We feel that the VNUS procedure is less traumatic to the tissue surrounding the vein being ablated and too, there is less post-procedure discomfort. You may want to investigate these two techniques before making your final decision.

Published on Jul 11, 2012

If you are asymptomatic you can wait. However, the varicose veins may worsen with time.

Published on Jul 11, 2012

Venous insufficiency tends to be a progressive problem that will only worsen with time. During the advanced phase of the disease, permanent skin changes, scarring, and ulcers can occur. While it is not an urgent treatment now, it is better to treat early even though your legs remain asymptomatic.

Published on Jul 11, 2012

You should have the laser ablation done sooner rather than later. If you wait, your varicose veins will only worsen, as will your symptoms.

Published on Jul 11, 2012

Generally, the endovenous laser ablation procedure is done for either pain or cosmetic reasons. Either way, both are reasonable indications. Over time, the veins will just enlarge further. It is your choice to wait or proceed now. It should be noted, however, that insurance companies typically only cover a procedure if pain is involved.

Published on Jul 11, 2012

The standard of care for approval of these procedures by insurance companies is pain or other quality of life issue besides appearance. If you have no symptoms, why do you want it fixed? Are you prepared to pay for it as a cosmetic procedure? Are you comfortable wearing support stockings? The question is not waiting until you get older, but waiting until you get symptomatic.

Published on Jul 11, 2012

If you have no symptoms from your varicose veins, it is OK to wait. The complications or side effects from venous insufficiency take years to develop.

Published on Jul 11, 2012

Treatment at this time depends on how embarrassing the veins look to you and how worried you are about blood clots. People with varicose veins are six times more likely to have clots than people without varicose veins. If you have a personal or family history of clotting tendency, treatment would be advisable sooner than later. Otherwise, in the absence of complications, you may postpone treatment until symptoms occur.

Published on Jul 11, 2012