Frequently Asked Questions & Answers

Varicose Veins • Hair Removal • Photofacial & Skin Tightening

Microdermabrasion • Laser Lipolysis • Skin Resurfacing

Varicose Veins

Q. How are Varicose Veins treated?

A. Before determining a course of treatment, our certified vascular technicians at the Vascular Laboratory will conduct an ultrasound examination of your leg. This allows our medical team to ensure that the cause of your discomfort is caused by varicose veins. Then, they can determine the best course of treatment for you. Treatment options include:

1. Compression Stockings: Some patients wear compression stockings for a determined amount of time and find that their veins are no longer problematic. Generally, all patients should try this approach before turning to other treatments.
   
2. Endovenous Laser Therapy (EVLT): EVLT is performed in our center by all of our vascular surgeons. During this minimally invasive procedure, the surgeon inserts a laser fiber through a tiny entry site and uses the laser to seal off the faulty vein. Because legs have so many veins, blood is simply rerouted from the closed vein to the he ones that remain open. The procedure takes about an hour, leaves no visible scar and allows most patients to return immediately to their normal daily activities the next day. EVLT is covered by most insurance plans and by Medicare. For more information about EVLT, please visit www.EVLT.com.

Q. Do Varicose Veins Serve any Useful Purpose?

A. In the vast majority of cases, varicose veins do not serve any useful function. In fact, they are dysfunctional veins. Removal of these veins may actually improve circulation. In extremely rare cases, when the deep veins of legs are blocked, varicose veins of legs may carry useful circulation and should not be removed.

Varicose veins usually enlarge and worsen over time. Severe varicose veins can cause health problems, including, severe venous insufficiency, blood clots, phlebitis, sores or skin ulcers, spontaneous bleeding, ongoing irritation, swelling and painful rashes of the legs. 

Q. What can be done to Prevent Varicose Veins?

A. Since the causes are still undetermined, prevention of varicose veins is debatable. However, maintaining a normal weight, walking, limiting the use of external female hormones, and wearing compression stockings may help limit the disease's progression.

Conservative measures such as walking, compression hose and leg elevation typically temporarily improve these symptoms.

Q. Does Insurance Pay for the Treatment of Varicose Veins?

A. Most insurance companies consider treatment of varicose veins that are symptomatic medically necessary and will therefore pay for the treatment. Consult with your vein specialist to find out more regarding your specific case. Usually spider veins are considered cosmetic and typically not covered by insurance.

 

Q. What can Happen to Varicose Veins if Left Untreated?

A. Varicose veins can be a serious disorder that restricts work and leisure activities for both men and women. Thrombosis (blood clots), spontaneous bleeding and skin ulcers are complications of varicose vein disease. Also, if varicose veins are left untreated, smaller veins may take on additional work which can be associated with worsening symptoms.

Q. When is Varicose Vein Treatment not Advisable?

A. As with any medical procedure, there are those individuals who may not be fit to ndergo certain vein treatments. Before deciding on any treatment options, make sure that you consult with your vein specialist in order to make sure that all potential issues have been raised. Patients should generally consider treatment when the veins are bothering them enough because of cosmetic concern, symptoms or complications due to the veins. There are contraindications to treatment. These include, but are not limited to inability to ambulate (walk), increased risk of developing blood clots, pregnancy, certain chronic medical conditions (such as diabetes), and significant medical illness. Check with your doctor before hand to make sure you are ready to undergo treatment.

Q. What Happens after Varicose Vein Treatment?

A. Recovery periods may differ from treatment to treatment. The wearing Gradient Compression Support Stockings are a part of all our vein treatments. Our physicians and nurses will determine how long you should wear the compression stockings, which is generally based on the type of veins and treatment you had. Most physicians recommend that you walk a lot after treatment. Depending on your treatment, other instructions may be given.

Q. Can the Varicose Veins Reoccur?

A. Varicose vein treatments are aimed at clearing the existing problem veins. As you age, it is common for other veins to develop varicosities. Most often these are new veins, although treated veins could re-open.

It is important to keep in mind that superficial venous disease and varicose veins is an inherited disorder that is chronic and progressive. Any treatment method is at best palliative, as venous insufficiency will generally develop in other veins as time passes. All of the current treatments have a certain degree of failure, but this may be minimized if the principles of performing a proper and thorough evaluation prior to treatment planning, determining the most effective treatment plan, and treating the reflux beginning with the proximal sources before the more distal are followed. The importance of minimizing sedentary behaviors, weight control, regular exercise, and the use of gradient compression therapy will also help to diminish the frequency and severity of recurrence.

Hair Removal

Q. How does laser hair removal work?

A. Concentrated light energy is absorbed by the pigment in the hair follicle creating heat that destroys the supporting cells of the follicle leading to follicle inactivity.

Q. In the procedure painful?

A. There is discomfort. Many patients compare it to a rubber band popping the skin. To minimize discomfort we place a cool gel on the skin and utilize the Zimmer cooler. The Zimmer cooler delivers forced cold air onto the skin to protect and soothe during treatment.

Q. How should I prepare for treatment?

A. You should avoid tanning for 14 days prior to treatment. Do not pluck, wax or in any other way remove hair before treatment. You should however shave or closely clip the area to be treated.

Q. Is it suitable for everyone?

A. Dark skinned individuals are difficult to treat and will be assessed individually and guided accordingly. Grey hair will not respond to treatment. Lighter hair (blonde) often will respond because the follicle contains more pigment than the hair.

Q. Are there any side effects?

A. Typically, no. Some people may experience transient redness and mild swelling but this is uncommon and always clears within 24 hours. Burning of the skin is avoided by determining the proper settings for your particular skin type.

Q. How many treatments does it take?

A. Because the hair grows in cycles, in will take several treatments in all cases. Hair at different sites has variable cycles. We recommend a package of five treatments. We have a one year guarantee to treat to your satisfaction that comes with the package of five treatments.

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Photofacial and Skin Tightening

Q. What areas can be treated?

A. All areas can be treated. The most popular areas are areas that have been exposed to ultraviolet rays throughout life such as the hands, chest, face, etc.

Q. What results should I expect?

A. You will immediately see sun spots and age spots become darker. Over the next several days they will begin to flake off and fade away. Small veins will turn dark purple or red immediately and fade away over several days. The skin will become smoother and pore size will be reduced. Rosacea will diminish within a couple of days. A more pronounced affect is obtained by pre-treating with microdermabrasion followed by a package of three to five photofacials, depending on the severity of your skin damage. However a significant difference will be seen with a single treatment.

Q. What is treatment like?

A. The photofacial takes from 30 minutes to 45 minutes, depending on the area to be treated. The pulses can sting, therefore to minimize discomfort we place a cool gel on the skin and utilize the Zimmer cooler. The Zimmer cooler delivers forced cold air onto the skin to protect and soothe during treatment.

Q. Who benefits most from a photofacial?

A. People with sun damage such as pigmented spots or freckles, people with visible small veins on the face or neck, people with coarse or dull appearing skin, and people with rosacea.

Q. Is there any down time from the procedure?

A. Most people can return to normal activities and engage in social contact immediately. There may be some redness of the skin, but this typically resolves within a few hours.

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Microdermabrasion

Q. What is microdermabrasion?

A. Microdermabrasion is a scientific method, using fine, inert (micro) crystals to progressively abrade the skin's surface. The crystals impact the surface of the skin as a gentle vacuum is used to suction the surface of the skin. It is used for skin resurfacing and treating a range of skin abnormalities. This unique approach removes dead and flaking skin cells and stimulates the production of fresh, young skin cells and collagen. All skin types can be treated.

Q. What can expect from treatment?

A. Your skin will feel softer and smoother. Color and texture will improve. Acne scars and other imperfections will be softened. Pores will be cleansed and blackheads removed. With this treatment there is no discomfort and no down time. The procedure takes about 20 minutes and is followed by application of soothing cream and sunscreen.

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Laser Lipolysis

Q. What is CoolLipo?

A. CoolLipo fat treatment is the latest method for removing fat and tightening skin with a laser. The technique was first discovered in Europe and has recently become available in the USA. The technique has been used extensively in South America, Europe and Asia for the past 10 years. The technique involves the use of a laser energy to rapidly dissolve the fat and tighten the surrounding skin almost anywhere in the body. The procedure is done in an office and does not require the use of a general anesthetic.

Q. Why is CoolLipo so effective tightening skin?

A. CoolLipo uses the optimal skin tightening laser wavelength of 1320nm. This wavelength has proven to be superior over other wavelengths, such as that found in Smartlipo, because it targets the water in the dermis of the skin.  Other lasers used for this purpose target melanin in the skin and can cause burns.  If loose skin is a problem, this is the answer.

Q. Who is a candidate for CoolLipo?

A. CoolLipo is an excellent technique for removal of fat from difficult areas of the body. It is more efficient at removing fat from localized pockets which have proven resistant to conventional liposuction or exercise. The ideal patient is one who is in good health, not obese, has an active lifestyle and has a pocket(s) of fat they wish to remove.

Q. Which area is CoolLipo useful for?

A. CoolLipo has been designed to treat localized pockets of fat in the following areas:
• waist
• chin (double or hanging chin)
• inner and outer thighs
• hips
• buttocks
• upper arms
• face (not around eyes)
• male with breasts
• back of neck
• pubic mound

Q. How much fat can be removed each time with CoolLipo?

A. The procedure is excellent for removal of localized fat and as much as 3500 mls of fat can be melted away at a single session.

Q. Who is not a candidate for CoolLipo?

A. CoolLipo is not suited for individuals with:
• diabetes
• liver problems
• blood disorders
• kidney problems
• heart problems
• skin disorders

Q. Is the fat removal permanent?

A. The fat cells that are removed are permanently gone, however if the individual gains weight, the fat will come back in the adipose (fat) cells that remain.  The best way to maintain the post procedure look is to continue with an exercise program and watch one’s diet.

Q. How is the procedure done?

A. The procedure is done in the office. Prior to the procedure, the fatty areas are marked and a local anesthetic is used to numb the area. The laser energy is administered via a fiber optic cable that is about 1mm in diameter. This is inserted through a small puncture wound.  Following lysis of the fat cells with the laser energy, the fluid released is removed with similarly small suction cannulae.  The laser also causes small blood vessels to coagulate (gel) immediately on contact, resulting in less bleeding and swelling. The laser also affects the collagen in the skin which later causes the skin to tighten and shrink.  This is the primary benefit of laser lipolysis over other methods.

Q. What is the recovery like?

A. The majority of patients have minimal bruising and discomfort. A pressure dressing or a compression garment is worn depending on the location of the treated area. The compression dressing or garment helps to decrease the swelling. The bruising disappears in 2-3 days and vast majority of patients are able to resume their normal activities within 24 hours. A mild narcotic is given for any postop discomfort that is not relieved with Tylenol.

Q. When do I see the results?

A. The fat is immediately gone, therefore.  Most of the skin tightening will occur within one week. Over the next 6-8 weeks, the skin and surrounding fat will remodel and adjust to the body contour. The remodeling is a gradual process and the best results are seen after 2 months.  There is continued improvement for 6-9 months.

Q. When can one return to work after CoolLipo?

A. Some patients return to work the following day, however I recommend taking a few days off.  We typically perform the procedure on a Thursday or Friday so the patient will have the weekend off of work.

Q. What are the advantages of CoolLipo over other procedures?

A.
• CoolLipo offers minimal discomfort during the procedure
• Less discomfort
• Less down time
• Minimal blood loss or bruising
• Excellent skin tightening
• There are no side effects of general anesthesia
• Minimal to no scarring

Q. Is CoolLipo approved for use in USA?

A. The CoolLipo treatment received approval from the FDA (US Food and Drug Administration) for its skin tightening mode and laser lipolysis.

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Skin Resurfacing

Q. Am I a good Pixel Perfect candidate?

A. Anyone whose skin shows signs of aging is a candidate for Pixel Perfect. The most dramatic results are seen on people who have tried non-invasive therapies and are looking for something more aggressive. The best candidates have moderate sun damage, are in good health, have good health habits and typically take good care of their skin.

Q. Does Pixel Perfect work on all skin types?

A. Yes, Pixel Perfect can be performed on all skin types; however, it is a good idea to consult with your physician, as some skin conditions can interfere with proper treatment.

Q. How long will it take?

A. Pixel skin rejuvenation treatments usually take less than 30 minutes, but could be longer if your condition is more advanced. Your exact treatment regimen will depend on your individual condition.

Q. Is it safe?

A. Pixel Perfect treatments are safe and effective, without injections or surgery. You can expect your skin to be flushed and red after the treatment, but this is completely normal and short-lived. As long as you carefully follow your post-treatment instructions, this will be the limit of the difficulties you might experience.

Q. Will it hurt?

A. How much the procedure hurts varies from person to person. In general, the procedure can feel similar to a sunburn. Your doctor may prescribe an over-the-counter pain medicine to make you more comfortable. The sunburn sensation is likely to continue after the treatment. These symptoms are a normal part of the healing process and should improve quickly.

Q. What if I need a touch-up, later?

A. While Pixel Perfect reverses the appearance of aging, we can't stop the aging process. Depending on your starting point and your lifestyle following treatment, your new look can last several months or longer.

For most patients, a touch-up treatment after 6–12 months (usually using a different light-based skin rejuvenation technology) helps maintain a healthy glow

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