Archive for the ‘Consumer Advice’ Category

Thursday, June 4th, 2009

Consumer Alert

Today a patient called for a consultation with Dr White to talk about her leg veins. While she was very motivated to get rid of her spider veins, she shared with me that she had received treatment for them in the past with a doctor who had recommended and performed the Endovenous Closure Procedure or EVLT. She was worried because she said that after this procedure she was left with numbness of her leg and was worried that our treatment would make it worse. She also said that the treatment had not helped her spider veins and had in fact made them worse. The doctor who treated her was not a vascular surgeon.

With every treatment modality for leg veins there can be complications, even ours. However, there is an issue that has been on my mind since I spoke to her. The public should know that it is almost never indicated to do Endovenous Laser Procedure for spider veins. This kind of treatment heavy handedness is like killing an ant with a wrecking ball. Effective treatment for spider veins require treatment with more finesse. The only time EVLT is indicated is when it has been determined that the patient’s saphenous vein is incompetent and almost never is it incompetent when there are spider veins. In fact, the saphenous vein is not always incompetent when there are big ropy varicose veins. Determining if the saphenous vein is competent requires a Doppler Exam and/or an Ultrasound. You can’t just look at veins and make that determination.

We recommend that if you have been told that you need an EVLT procedure and you only have spider veins, seek a second opinion and try to see a vascular surgeon for the evaluation. In fact, seek a third opinion with someone who does not have the EVLT equipment. Their motivation may be different.

Posted in Consumer Advice, Ropy Varicose Veins | No Comments »

Unsightly Varicose Veins, Spider Veins, Rosacea And Photoaging

Thursday, May 14th, 2009

HERE ARE THE BASICS:

Unsightly varicose and spider veins, rosacea and sun-damaged skin are nothing new – people have been battling them for centuries. With the advent of modern medicine, treatments arose that could combat these ailments, but were costly, invasive, painful and often carried no guarantees of extended success. Recent innovations, however, have changed much of that. Laser technology offers new and improved treatment with little to no down time and minimum discomfort. Here are some basics:

VARICOSE VEINS

Veins are hard to treat successfully. Because veins can return, even after treatment, many people have their veins treated every year. With the right professional help, this no longer needs to be the case. A vascular surgeon who specializes in varicose vein treatment can perform an exam using a Doppler or Ultrasound that will uncover the underlying cause for varicose veins. It is only with this knowledge that a treatment plan can be devised under which veins will not return.

Veinablation™ is a new definitive treatment for ropy, varicose veins that collapses almost 100 percent ropy varicose veins before the patient leaves the doctor’s office. With this technique, in 90 percent of cases surgery is not necessary. For the 10 percent of ropy veins that cannot be treated with Veinablation™, other minimally invasive procedures are now available. Veinablation™ eliminates the need for surgical stripping, Endovenous Laser Treatment and VNUS™ Radio Frequency Treatment. Veinablation™ is more cost-effect, more time saving, has no down time, and is less painful.

Veinablation™ is also extraordinarily effective treating spider veins, eliminating the need for multiple 10-minute sclerotherapy sessions. Veinablation™ can achieve 60-80 percent reduction of spider veins in just one treatment, with the remainder of veins eradicated with a short touch-up.

ROSACEA

Rosacea is a vascular disease of the face characterized by extreme redness and blushing. Despite millions of dollars being spent in research, its cause is still unknown-something is giving facial skin the message to grow many microscopic vessels, which leads to extreme redness. It is a progressive deforming disease that cannot yet be managed very successfully with medication. Intense pulsed light laser is considered by many to be the gold standard for treatment. Fotofacial™ is a series of five treatments spaced three weeks apart and lasting 45 minutes to an hour. It doesn’t hurt and there is no downtime after treatment. Improvements last for years and insurance sometimes covers part of the cost.

There is an added value to Fotofacial™. Surface collagen in the skin is stimulated by the treatment that causes pore size to diminish and improves texture and tone. Pigment associated with sun damage is reduced. The skin takes on a glow that most people hate to cover with makeup.

SKIN REJUVENATION

When the Intense Pulsed Light technology is paired with the Infrared Light technology in the Titan™ Anti-Aging Procedure, the effects can be dramatic. Adding infrared technology, deep collagen is smoothed and tightened causing a “lift” to cheeks, jowls and the forehead. The skin is plumped, laugh lines around the eyes and “marionette” lines around the mouth and chin are diminished. This is a good procedure for people who don’t want to undergo a facelift. Infrared technology is superior to RF(radio frequency) technology like Thermage and Polaris because there is minimal pain, a more even effect, no lumps or bumps, little to no swelling and no downtime. Fraxel™ and other fractional skin resurfacing procedures have down time and it is yet to be seen if skin holds up over time. Except for deep wrinkles around the mouth, outcomes appear equal to Titan ™ without the down time.

COMMON SENSE

Intense Pulsed Light and Infrared Light technology are only tools. How those tools are used effects outcomes. In all cases, seek care in a center that has an on-site physician and be evaluated by that physician. Some centers use the name of a doctor because the law requires that there be a physician supervising, but the named doctor may have little to no involvement. A business person with no medical experience may be the person on site dictating policy with standardized medical laser protocols from the laser company. To maximize your outcomes, your treatment plan should be designed specifically for you. Be sure you are evaluated by a doctor. That doctor should create and be in charge of your treatment plan. Either he or she or a qualified, experienced registered nurse should provide your treatment according to the doctor’s specific plan. It is a matter of quality of care and accountability.

Remember, laser treatment for medical conditions, even those that are cosmetic in nature, is a medical procedure that requires clinical training well beyond the use of laser technology.

Posted in Consumer Advice, Fotofacial, Ropy Varicose Veins, Spider Veins | No Comments »