Varicose veins can cause a great deal of discomfort: pain, aching, swelling, itching, and tired legs are some of the symptoms we treat with varicose vein surgery. However, varicose veins can also cause self-consciousness and dissatisfaction with your appearance. That’s why many patients ask, “Will my varicose veins go away after surgery?”
What causes varicose veins?
In healthy veins, tiny, one-way valves keep blood flowing upwards, toward your heart. But with varicose veins, some of those valves have become weak or damaged by age or injury. This causes them to leak. Gravity pulls blood down your legs where it pools inside the veins.
And because your veins are like a river system, with smaller branches flowing into bigger ones, when a large vein malfunctions, blood backs up into the smaller tributary veins. These engorged smaller veins are what you can see under your skin, but the real problem is actually much deeper. That’s why when we treat varicose veins in the legs, we focus first on the large veins— usually either the greater or lesser saphenous vein.
How are varicose veins treated?
Varicose veins are treated with a procedure called venous closure. As the name implies, this procedure involves closing the damaged saphenous vein so that blood no longer flows through it. Your body then reabsorbs the tissue and naturally reroutes blood flow to nearby, healthy veins. The result is that blood no longer pools in your legs relieving your varicose vein symptoms and reducing the overflow of blood to the smaller tributary veins.
There are several different methods that can be used to close the vein, all of which achieve the same end result.
Laser and radiofrequency ablation. These procedures both use heat to scar the vein closed. Your doctor will numb your leg, then make a very small incision either in your lower calf (for the lesser saphenous vein) or your mid calf (for the greater saphenous vein). A catheter (thin tube) will be inserted through the incision and threaded either to the back of your knee (for the lesser saphenous vein) or your groin (for the greater saphenous vein). Then, either laser energy or radio waves are used to generate heat. As the catheter is slowly withdrawn, the heat damages the length of the vein causing it to permanently close.
Ultrasound guided sclerotherapy. This varicose vein treatment uses a medicine called a sclerosing agent to close the vein. Your doctor will numb your leg at the injection site then use ultrasound to see the vein. Using a thin needle, they’ll inject the medicine into the vein. Once injected, the sclerosing agent irritates the vein wall, causing the vein to collapse.
Vein glue. This newer procedure uses a medical grade adhesive to literally glue the vein shut. As with laser or radiofrequency ablation, your doctor will make a small incision and thread a catheter into the saphenous vein. They will then inject a small amount of adhesive and apply pressure to the outside of your leg to help it set. This process is repeated down the entire length of the damaged vein.
What to expect after surgery
After your venous closure surgery you should expect to feel quite a bit of relief from your varicose vein symptoms including aching, itching, and leg fatigue. You may experience some bruising and swelling, but generally the pain is minimal and can be treated with ibuprofen or Tylenol. Your doctor will ask you to wear compression stockings and walk at regular intervals to help with the healing process.
It may take 2-3 months for your body to fully heal after your surgery. During that time be sure to follow all of your doctor’s instructions. It’s also a good idea to take before and after photos to track your progress.
Will varicose veins go away after surgery?
Because your body needs time to heal, you shouldn’t expect to see any immediate changes to your varicose veins after surgery. However, you should begin to feel better right away. Most people will see their varicose veins get much smaller or even disappear within 2-3 months. Everyone is different, though, and sometimes varicose veins don’t go away on their own.
What can be done if my varicose veins don’t go away after surgery
If you are unhappy with the appearance of your varicose veins 2-3 months after your venous closure surgery, don’t despair, your doctor can help. There are two methods your doctor can use to eliminate persistent varicose veins.
Foam sclerotherapy. Similar to the procedure described above, your doctor can use a sclerosing agent to collapse the remaining varicose veins, flattening them out. The procedure is fast and causes little pain, but it still may take several months for your body to heal to the point where you will see final results.
Phlebectomy. If you want your varicose veins to go away immediately, you can opt to have your doctor remove them entirely. This procedure is called stab phlebectomy or microphlebectomy and involves making tiny incisions through which your doctor can surgically remove the problem veins. The incisions are so small that sutures usually aren’t needed and there shouldn’t be any scarring. However, if you are prone to keloids, then stab phlebectomy may not be right for you.
The primary purpose of venous closure surgery is to offer relief from the pain and aching caused by varicose veins. It is not a cosmetic procedure. However, your doctor wants you to feel comfortable and confident after surgery. They will, therefore, work with you to make your varicose veins go away as much as possible after surgery—it will just take a bit of time and patience.