At Elysium Skin Centre we can treat abnormal veins of any size from fine capillaries and spider veins through medium-sized reticular veins right up to large varicose veins and perforators. Our Excel V laser is ideal for fine vessels on the face, neck and chest, while Microsclerotherapy, Ultrasound Guided Foam Sclerotherapy and Endovenous Laser Ablation are used to treat veins of all sizes on the legs, hands, arms and other sites. Dr Csilla and Dr Hugo have been treating veins for longer than they can remember. Dr Csilla exclusively uses the Excel V laser, while Dr Hugo specialises in sclerotherapy and endovascular laser ablation for varicose veins.
The Cutera Excel V is a high-power precision laser system manufactured in the USA. It combines 532nm KTP and 1064nm Nd:YAG lasers to specifically target haemoglobin pigment in red blood cells. Heat produced by the laser light destroys the abnormal vessels.
Excel V is used to treat a wide range of vascular lesions, including dilated capillaries and fine spider veins anywhere on the body. It is particularly useful for treating “broken” capillaries on the face, neck and chest, and for fine matted vessels following sclerotherapy and endovenous laser therapy on the legs. It is also used to treat discrete vascular lesions such as cherry angiomas, venous lakes and vascular birthmarks.
You will have an initial consultation with Dr Csilla, Dr Hugo or Nurse Fay and then have Reveal ™ photography to highlight the underlying vascular changes in the area to be treated.
A clear, cool gel is applied to the skin over the area to be treated. Anaesthesia is rarely needed for vascular laser treatments. The skin is pre-cooled prior to each laser “shot” by a chilled sapphire on the laser device. This reduces discomfort. When the laser discharges it feels a little like a warm rubber band snapping on the skin. Each vessel takes one to five laser shots to be destroyed. Any discomfort is only very brief.
After treatment, ice packs and cool compresses may be applied to settle any residual heat in the skin. Before you leave, sunscreen is applied to the treated area and makeup can be used to cover any redness or dark spots. Most procedures only take 5 -10 minutes but extensive treatments may take 30 – 45 minutes.
Laser is quick, relatively painless, effective and non-invasive. The results are seen within a few days. In addition to treating abnormal blood vessels and redness, Excel V is also very effective at treating abnormal pigmentation.
Redness, mild swelling and some bruising are common after vascular laser treatment and are considered normal reactions. They can be covered with makeup and settle quickly. Cutera lasers are manufactured to the highest standards and are designed to treat a wide range of skin types. Complications such as blistering, ulceration, scarring and changes in pigmentation (either reduced or increased pigment) are rare in experienced hands.
The cost of Excel V laser depends on the number of vessels to be treated and the time it takes. The minimum cost is $220 for a few spots or vessels. Otherwise the procedure is charged in time intervals. Please call the clinic for more information regarding pricing.
For microsclerotherapy to be effective, it is important to determine if there is an underlying cause that needs to be treated beforehand. Often there will be slightly larger reticular veins feeding the thread veins, and these will require ultrasound guided foam sclerotherapy. Very occasionally there is a more extensive source of increased pressure which might require endovenous laser ablation. Our doctors will assess you and advise the best treatment plan.
Most patients require two to four treatment sessions depending on the extent of the veins. Spider veins are paradoxically more difficult to treat than larger varicose veins. It is normal to require more than one session of injections and resolution of the thread veins can take some time. If there are extensive spider veins, it may not be possible to inject all of these at the one time. Occasionally only one session is required, however, one patient with extensive spider veins covering almost the entire surface of her legs required thirty treatment sessions. She was delighted with the results.
While laser and IPL are very effective in treating spider veins on the face, they are often more painful and less effective with spider veins on the legs. At Elysium Skin Centre we have all methods of vein treatment and will advise you which will be most effective in your case.
The total cost of this treatment depends on the extent of your spider veins, the time it takes to inject them and your response to the treatment. Initial consultation and assessment by our Doctors is $200. The cost of each treatment is $330 (for 15 minutes), $440 (for 30 minutes) and $550 for 45 minutes.
While UGFS treatment is safe, there is a limit to how much foam solution can be injected in one session. We would love to continue injecting until we have treated all of your veins, however, if the number of abnormal veins is extensive this is simply not possible. We advise patients to point out which veins are bothering them the most and our specialists will inject those first in case it is not possible to inject all of the veins in one session. We want you to get the most out of each injection session, so we advise waiting a minimum of 4 weeks between treatments.
No! Although some doctors treat large veins by foam sclerotherapy the results are not as effective or as durable as EVLA and we do not recommend this as a primary treatment for the majority of patients. We do use foam sclerotherapy for residual varicosities remaining after EVLA. Some patients with recurrence of varicose veins after EVLA may only need foam sclerotherapy.
Complications are rare, but can include venous thromboembolism, visual disturbances, allergic reaction, thrombophlebitis, skin necrosis, scarring and hyperpigmentation or redness of the treatment area. Development of tiny red vessels (“matting”) in the treated area is unpredictable but can be treated with repeat sclerotherapy or laser.
Initial consultation and assessment by our Doctors is $200. An accurate cost will be provided at the time of consultation. The average cost per treatment is about $900, and there is a Medicare rebate of $93 (costs and rebate may vary without notice)
What is Endovenous Laser Ablation?
Endovenous Laser Ablation / Therapy (EVLA or EVLT) is the gold standard treatment for varicose veins and has replaced vein stripping and surgery in the majority of cases. It was developed in the United States in 2000 and has revolutionised the treatment of varicose veins with long-term published results demonstrating excellent safety and effectiveness. Under ultrasound guidance, a laser fibre is inserted through a needle into the varicose vein. Laser light produces heat within the diseased vein causing it to collapse, die and be naturally resorbed by your body. EVLA treats both the cosmetic appearance and the symptoms associated with varicose veins.
EVLA is performed under local anaesthetic in our rooms and usually takes 1 – 2 hours depending on how many veins need to be treated. Most of our patients describe the EVLA procedure, and the recovery period following it, as uncomfortable rather than painful.
An ultrasound scanner is used as guidance throughout the procedure giving the doctor a live view of your veins at all times.
First, a small injection of local anaesthetic is given to numb the skin over the abnormal vein. A needle is then inserted into the vein and a thin guidewire threaded through the needle. Once the guidewire is in the correct position, a thin plastic tube (catheter) is pushed over the wire and fed along the vein. The guidewire is removed and the laser fibre is then inserted through the catheter into the vein.
Once the laser fibre is in position, local anaesthetic is administered along the length of the vein to numb the leg and to protect the tissue around the vein. This involves a few injections along the leg. Once the leg is fully anaesthetised, powerful laser light is delivered to the inside of the vein. This heats the vein sufficiently to destroy it. This will take around 5-10 minutes per vein. This is repeated on all of the varicose veins.
During the laser there should not be any significant pain, however, you may feel some aching in the leg, and some patients may notice odd tastes and smells.
A compression stocking is applied after the procedure and, after a cup of tea, you are allowed to leave the clinic, take a fifteen-minute walk and get back to normal activities.
You will have to keep your stocking on for 1 week. Over the next few weeks you may experience some tightness as the vein shrinks. You may also get some bruising, but this is unlikely to be severe.
Most patients experience little or no pain and can get back to normal activities straight away. A small minority of patients experience significant pain requiring analgaesic medication and they may have to take several days off work. This most likely occurs a week or so after the procedure rather than straight away.
Symptoms associated with your varicose veins (such as aching, throbbing, itching etc.) should begin to resolve quite quickly following the EVLA treatment.
You will normally have a follow-up examination 4-6 weeks after EVLA treatment to confirm that it has successfully fixed your underling vein problem. The majority of patients will, however, require some form of treatment at follow-up.
Do not be surprised if the varicose veins are still there at this stage. They usually are reduced in size, but may look just as large as they did before treatment. Don’t panic! Although EVLA will have fixed the underlying problem, most patients will require foam sclerotherapy or phlebectomy to remove the varicosities or treat the smaller vessels.
YES! The laser fibres we use to perform EVLA are thin and flexible, and can treat twisty veins. Some surgeons tell their patients that their veins are too twisty and they will need surgery. This may be because they are using a radiofrequency device, which is a more rigid instrument. The majority of veins can be treated by EVLA.
YES! The first line treatment for perforators is EVLA. If EVLA is not possible then perforators can be treated by using Foam Sclerotherapy or occasionally with open ligation. We treat perforator veins at the same time as the other veins are being treated with EVLA. There is no additional charge for this.
If the duplex ultrasound does not reveal any significant valve problems in your feeder veins, or the veins are very small, EVLA treatment may not be required. If your veins are too small for laser then it is likely that foam sclerotherapy will be performed instead.
Very few complications have been described. Potential problems could include deep vein thrombosis, deep vein trauma, skin burns, scarring, nerve injuries and laser eye injuries. In practice these are all very rare.
Initial consultation and assessment by our Doctors for varicose veins, including ultrasound, is $250. There is a Medicare rebate of $120 (costs and rebate may vary without notice). Our EVLA prices are fixed at $2500 per leg, irrespective of the number of varicose veins needing treatment with EVLA.
Following EVLA, additional treatment will often be required to “mop up” the smaller vessels. We will often have some idea of the likelihood of this prior to EVLA, however, the cost of further treatment will depend on the extent of residual smaller vessels and the treatment they require. This will be assessed and discussed at follow-up.
Dilated, abnormal veins can be both cosmetically unsightly and medically significant. At Elysium we have the ability to treat vessels of all sizes from tiny capillaries and venules to large varicose veins. Excel V laser is quick and efficient at treating fine cosmetic vessels, however, foam sclerotherapy and endovenous laser ablation remain the gold standard of treatment for larger caliber vessels. At Elysium Vein Clinic, Dr Hugo performs all of our large vein treatments.