Don’t Be Afraid

To Show Your Legs

Varicose and spider veins are not just a cosmetic concern. They may be a sign of underlying vein disease. Many patients qualify for medical insurance coverage. At Vanish, we’ll develop an individualized treatment plan to get the results you want.

Cosmetic Spider Veins

This treatment is great for spider veins, telangiectasias, and small reticular veins that are unsightly but asymptomatic. We inject an FDA-approved medication called polidocanol or sotradecol as a liquid or foam into the vein. This requires no anesthesia and causes minimal discomfort. Most patients require no more than thirty minutes per session and see results in as little as 2-3 treatments. You will need to wear compression stockings for 24 hours after treatment and then during awake hours for one week. Purely cosmetic treatments are typically not covered by insurance.


Varithena is a form of foam sclerotherapy that can be used to inject larger varicose veins under ultrasound guidance. It is another alternative to surgical stripping or laser/radiofrequency ablation. The doctor uses ultrasound imaging to guide the placement of a small needle and monitors the foam as it collapses the vein on injection.

Endovenous Thermal Ablation

Endovenous thermal ablation is a minimally invasive, in-office treatment alternative to surgical stripping of the great or small saphenous vein that is insufficient and causing reflux or backward flow of the blood. After injecting a small amount of local anesthesia, we use ultrasound technology to guide the catheter into the vein. There are a few small needle sticks to the skin to anesthetize the area around the vein prior to using radio-frequency or laser technology to seal and collapse the vein. Following the procedure, a bandage or compression hose is placed on the treated leg. Patients are able to walk immediately after the procedure and most individuals are able to return to work the next day. This procedure usually takes less than hour in the office and is a proven technology with high success rates compared to previous surgical treatments.

Ambulatory Phlebectomy

Ambulatory phlebectomy is a method of surgical removal of surface varicose veins. Ambulatory phlebectomy is performed using local anesthesia. The area surrounding the varicose vein clusters is flooded with anesthetic fluid. A needle is then used to make a puncture next to the varicose vein and a small hook is inserted into the needle hole and the varicose vein is grasped and removed. The punctures typically leave nearly imperceptible scars. After the vein has been removed by phlebectomy, a bandage and/or compression stocking is worn for a short period. Ambulatory phlebectomy is often performed in conjunction with endovenous ablation and is good for tortuous, bulky veins that are close to the skin.

Leg Swelling & Ulcers

Chronic venous insufficiency can manifest as leg swelling (lymphedema), skin discoloration (lipodermatosclerosis) and venous ulcers. These problems are difficult to treat and lead to significant patient dissatisfaction. Compression stockings are the mainstay of conservative treatment but venous ablation or sclerotherapy of the superficial veins or so-called “perforators” are well-studied treatments that can alleviate and prevent future development or progression of disease. A comprehensive duplex ultrasound of the legs will be completed in the office to map the veins that cause these problems.

VenaSeal - Medical Adhesive Technology

The VenaSeal procedure an FDA-approved for use in the U.S. and utilizes a specially formulated medical adhesive that closes the vein after injection. This unique approach is performed under ultrasound guidance and requires one needle stick. Patients report minimal-to-no bruising post procedure and there is no need to wear compression stockings after the procedure. VenaSeal is currently covered by Medicare and may be covered by private insurance.