Legs Beautiful

Everyone loves the look of smooth legs: unblemished and without imperfections. Unfortunately for 20-25% of women and 10-15% of men, varicose veins — unsightly, sometimes painful and capable of causing medical afflictions if left untreated — are a reality. Luckily, there are several ways to battle this vascular dilemma. Your doctor may suggest non-surgical options first, but if the results are poor, more intrusive therapies, such as injections and surgery, are necessary. And according to Canadian doctors, another option, laser treatment known as endovenous laser ablation (EVLA) is quickly becoming the best method.

“Heredity is the biggest cause for varicose veins, or a standing occupation like a bartender, nurse, doctor or someone who does heavy lifting,” says Dr. Douglas Hill of The Vein Treatment Centre in Calgary. Other contributing factors include pregnancy and obesity.

Dr. Dion Davidson of Valley Medical Aesthetics in Kentville, Nova Scotia suggests that one of the underlying causes of varicose veins is Chronic Venous Insufficiency (CVI). “CVI affects gravity and causes pressure in the legs. Some weaker vein walls fail and the blood goes back down to the feet, instead of the heart.”

“At lunch time or coffee time, get your legs up above your heart — point and flex”

Regardless of the cause, it’s imperative to start therapy as soon as possible. Dr. Anthony Salvian of Pacific Vein Clinic in Vancouver suggests wearing compression stockings with 30-40 mmHg (millimetres of mercury). In addition, he says, “at lunch time or coffee time, get your legs up above your heart — point and flex. Also try and keep calves pumping. This should relieve the symptoms.” Dr. David Szalay of Oakville Laser Clinic & Spa in the GTA, recognizes that some causes are beyond our control, however, “the only risk factors we can change are weight and lifestyle. Keep moving and periodically rest and elevate legs when not active.”

Despite physical afflictions, it’s definitely veins’ unattractive appearance that pushes people — usually women — to seek help. “Men tend to have hairy legs so it doesn’t bother them. When they come in they say, ‘my wife sent me,’” says Dr. Salvian. He also suggests that varicose veins have “insidious symptoms” and people seeking cosmetic correction may not notice the ache and fatigue associated with them until they are treated.

Once the doctor has assessed the cause, he or she will recommend the proper procedure. Sclerotheraphy involves a chemical injection that hardens the vein so it is no longer active. If the vein is severe and caused by the saphenous vein (the large superficial vein beginning in the upper thigh), surgery, or the more effective alternative, EVLA, is used. In fact, Dr. Szalay suggests, “Thermal/laser ablation is the preferred technique in most parts of the world for varicose veins related to saphenous incompetence.”

People often choose surgery because it’s covered by health care, but it isn’t always the most successful. “Because of its advantages, laser is replacing surgery. There are few instances where surgery is still the best,” says Hill.

“EVLT is taking the vein world by storm... It’s really becoming the focus of doctors who are at the forefront of venous disease.”

Endovenous Laser Treatment (EVLT) or EVLA (its generic term) is far less invasive than surgery; it can be done within an hour at a regular doctor’s office and uses only a local anesthetic. “[EVLT] is treatment of large veins by destroying the vein with heat energy,” says Dr. Davidson. “There is no general anesthetic, no scarring and it’s as good or better than surgery.”

During laser treatment, the doctor inserts a fibre into the varicose vein using a catheter. The heat energy from the fibre kills that portion of the vein. The procedure is relatively painless, although one might feel local heat from the laser. However, “90% of patients say it’s not painful,” says Davidson.
“There is much less discomfort than surgery, and early recovery, as most people can return to work and day-to-day activities immediately,” says Szalay. Laser ablation seems to have a better long-term success rate as well — meaning there’s a smaller chance of new varicose veins in the same area.
“EVLT is taking the vein world by storm,” says Hill. “It’s really becoming the focus of doctors who are at the forefront of venous disease.” •

Dr. Dion Davidson, Valley Medical Aesthetics, Kentville, N.S., 902-678-2121, valleymedicalaesthetics.ca

Dr. Douglas Hill, The Vein Treatment Centre, Calgary, 403-220-9353, veintreatmentcentre.com

Dr. Anthony Salvian, Pacific Vein Clinic, Vancouver, 604-874-0532, cdnvein.ca/profile_pacificvein.html

Dr. David Szalay, Oakville Laser Clinic & Spa, Oakville, Ont., 905-842-8346, oakvillelaserclinic.com