Without a Trace – Vanishing Varicose Veins

People will go to great lengths to look their best, improving anything from minor, physical flaws to major deformities. However, correcting one problem may, in fact, cause another. For people who suffer from large, painful varicose veins, conventional methods of stripping and ligation (using incisions to get rid of varicose veins) often leave horrible, disfiguring scars. The patient was forced to grapple with a seemingly no-win situation.

Recently, a revolutionary technique, which originated in Europe, known as ambulatory phlebectomy, was introduced in America, to treat patients with large varicose veins. The technique leaves virtually no scars, because no incisions are needed. Instead, the physician uses a needle to make small punctures and, with the use of specially designed hooks, removes the veins.

Dr. William Wolkstein, a board-certified plastic surgeon at the New Jersey Vein and Cosmetic Center, has been practicing ambulatory phlebectomy for the past three years, and with greater frequency than virtually any physician in the New York metropolitan area. Because there is no need to seek treatment at a hospital, Dr. Wolkstein is able to perform the procedure in his office. Ambulatory phlebectomy is appropriate for men and women with large varicose veins that are unable to be treated with Sclerotherapy, a technique that removes smaller veins.

Patients first visit Dr. Wolkstein or his partner Dr. Joseph Fretta, an internist/phlebologist, to determine if they are candidates for ambulatory phlebectomy. While Sclerotherapy is appropriate for smaller veins, if performed on veins that are too large, patients run the risk of hyper-pigmentation or dark spots and patches. Sclerotherapy causes the vein to close down and stick together, as a result of a schlerosing agent. If a vein is too large, there is difficulty sclerosing it and closing it down. Hyper pigmentation may result with inadequate closure of the vein. Ambulatory phlebectomy alleviates hyper pigmentation associated with inadequate closure of the vein by Sclerotherapy. This technique totally removes the vein without a scar. Using the ambulatory phlebectomy technique, no staining of the skin occurs, because the vein is removed entirely in segments by the specially designed hook.

Once a patient qualifies as a candidate for ambulatory phlebectomy, Dr. Wolkstein uses a local anesthetic and sedation, allowing his patient to be awake, but comfortable, during the entire procedure. The chosen area of the leg is injected with a numbing mediation, and small needle punctures are made along the length of the vein. The length can run from the ankle to the thigh, depending on the area that requires treatment. Through these needle punctures, Dr. Wolkstein inserts the specially designed hook into the vein tissue and phlebectomizes the vein, or removes it. In some cases, the veins are as wide as one to one and a half centimeters. Because no incision is made, sutures are not necessary, and the patient’s leg is then placed in a pressure bandage, ready to leave the office. Some bruising will develop, but it disappears within a week to ten days. Patients are required to return 24 to 48 hours later to have the dressing removed and must wear special support hose for one week. After the bandage is removed, patients can resume exercise immediately. After then entire process is complete, the treated veins are gone permanently.

Thanks to ambulatory phlebectomy, patients with large varicose veins now have a favorable option that features permanent, excellent results, without embarrassing, disfiguring scarring.