Varicose Veins

What are Varicose Veins?

Varicose veins are a very common condition in the United States and affect approximately 15% of men and approximately 25% of women.

These are large, ugly-looking “rope-like” veins that are often 1/4” or larger in diameter. Often, patients’ main concern is the cosmetic appearance of the involved extremity.

Symptoms of varicose veins include pain, swelling and throbbing, cramps, itching and burning, superficial phlebitis, and bleeding. Typically prolonged sitting or standing tends to make the legs feel worse. The varicose veins are easy to spot because they are dark purple or blue in color and sometimes appear twisted and bulging. The most common spot they appear is on the inside of the leg or on the backs of calves.

If left untreated they can result in skin inflammation (dermatitis) and ulcerations in the affected extremity. With the advent of the most current state-of-the-art medical treatments, there is simply no reason to tolerate this disfiguring condition.

Risk Factors that Increase your Chances of Developing Varicose Veins:

Standing for long periods of time. Blood doesn’t flow as well if you’re in the same position for long periods of time because your muscles are not contracting to push the blood back to the heart.

Obesity. Extra weight puts more pressure on your veins.

Age. The normal processing of aging causes wear and tear on the valves in your veins which regulate blood flow. The wear and tear may causes the valves to malfunction.

Sex. Women have a higher chance than men to develop varicose veins and spider veins. This is attributed to hormonal changes during pregnancy, and also premenstruation or menopause may be a factor. Some researchers have found that female hormones may relax vein walls. Moreover, the use of hormone replacement therapy or birth control pills may increase the risk of varicose veins.

Genetics. Check to see whether your family members have varicose veins, Heredity plays a big role.

Available Treatments for Varicose Veins in Manhattan

Main Title


A common form of treatment for spider veins is sclerotherapy. This is a procedure done in our Manhattan office where veins are injected with a solution, using small needles, which causes them to collapse and fade from view.


Micro-phlebectomy is a minimally invasive technique that removes bulging varicose veins through 2 millimeter opening in the skin, using special instruments.


Surgical stripping of the saphenous vein is done in a hospital setting, on an ambulatory basis and under general anesthesia. Because of the development of the endovenous ablation techniques, this surgery is almost never required.

Endovenous Laser Ablation

Endovenous ablation is the state-of-the-art method used to eliminate the incompetent saphenous veins. This new procedure is performed without a surgical incision.

Elastic Compression Stockings

For minor pain from varicose veins, a compression stocking may be beneficial. The compression stocking will assist the leg in the pumping of blood back to the heart.

Frequently Asked Questions about Varicose Veins

Main Title

What are spider and varicose veins?

Veins are the vessels that return blood to the heart once it has circulated through the body (as opposed to arteries, which carry oxygen-rich blood from the heart to the body). They have one-way valves that help keep blood flowing in the proper direction. If these valves stop functioning the way they are supposed to, blood can flow backwards and pool in the vein, causing it to stretch. These enlarged blood vessels are classified into two groups: spider veins and varicose veins.Spider veins are visible red or blue blood vessels that may spread like a web across the skin anywhere on the body, most commonly on the face and legs. Varicose veins are blood vessels with weak walls that swell or balloon outward, raising the skin surface.

Are varicose veins common?

Yes. More than 80 million people in the United States have spiders and varicose veins, including about 50 percent of women.

Can they be harmful?

Yes. Varicose veins can cause pain (including fatigue, heaviness, aching, burning, throbbing, itching, cramping and restlessness) and prevent proper skin nutrition, leading to eczema, inflammation and ulceration.

Does insurance cover the treatment of varicose veins?

Diagnostic ultrasound tests are covered by insurance. If the varicose veins are symptomatic, most insurances will cover for the treatment. If they are asymptomatic, insurances will consider this a cosmetic problem and will not cover the treatment.

Will I need an ultrasound?

For patients that have varicose veins, ultrasound is a test that needs to be done. It will determine where in the venous system the problem is , and by doing this will permit to plan the proper procedure for the particular patient.

If I suffer from varicose veins how good will the treatment result be?

If you have varicose veins, before obtaining treatment is very important to know if they are localized or if they are the result of the mayor saphenous veins been defective. In order to differentiate these two possibilities it is essential to perform an ultrasound-Doppler test. With localized varicose veins, injection sclerotherapy works very well, with excellent results. The procedure is painless and you can resume normal activities immediately.

Will the varicose veins disappear immediately?

Varicose veins treated with microphlebectomy have dramatic improvement seen in 2 weeks. When treated with sclerotherapy, results again are best seen at about three months. Patients treated with laser ablation (EVLT), show progressive improvement up to three months. About 50% of patients, if veins persist, will need a microphlebectomy in order to have the extremity completely free of varicose veins.

How long is the recovery time?

For sclerotherapy there is no recuperating time. Patient can resume normal activities immediately. For microphlebectomy and Laser ablation (EVLT), patient can resume most of the activities immediately. The only restrictions are heavy exercises involving the legs (i.e. running). This limitation is for one week.

Will I be able to work and exercise?

Yes, you will be able to work immediately after the procedure. With regards to exercise, as above mentioned, for EVLT and microphlebectomy you will be ask to refrain from running for one week.

What if the varicose veins are the result of defects in the saphenous veins?

In that case, it is essential to treat the saphenous vein, because that is the root of the problem. Till a few years ago, this was done with an operation called stripping that consisted of removing the vein. This required general anesthesia, had to be done in the hospital, had a painful recovery and it took about one-two weeks to return to normal activities. Now a days we have developed new minimally invasive techniques that use laser and that can replace the stripping operation in over 95% of patients.

What are the advantages of your laser technique?

The main advantages are that it is done under local anesthesia, in the office, with minimal or no pain, and the patient can resume normal activities the next day.

Can you briefly explain the laser procedure?

Through a needle that has been inserted in the saphenous vein under local anesthesia, a fiber optic fiber is passed all the way up to the groin and it is positioned in place using ultrasound. The fiber is connected to a laser generator, and as it is slowly withdrawn, the laser heats the vein and closes it.

How much pain will I have afterwards?

During the first week, there will be minimal or no pain. An over the counter pill such as Motrin will suffice. In the second and third week you may feel pulling in the area of the vein. This minor discomfort is the result of the vein undergoing a process of healing that results from the laser action.

What happens to the circulation, once the vein is closed?

The defective saphenous vein was not helping in returning the blood to the heart. Once closed, blood will find its way through one of thousand of other normal veins, and your circulation will be improved.

Will the laser procedure alone be enough to eliminate all my varicosities?

The purpose of the laser procedure is to close the saphenous vein and thus, eliminate the abnormal reflux that is responsible for the varicose veins. In about 60% of all cases, this by itself eliminates the varicosities. In the remaining 40% of patients, a second stage procedure (microphlebectomy or sclerotherapy) will be necessary for the complete elimination of the varicosities. This second procedure is usually performed about one month after the laser procedure.

What are the results of your laser techniques?

We have about 5 years of follow-up with this technique. The results have been excellent both in the short term and long term.

Will the result be permanent?

For varicose veins, recurrence rates increase over the years with about 5% at 5 years and 15 % at 10 years.

Will I need my veins for future heart surgery?

Contact Us Today

Get the help you need for your veins

What Sets Us Apart?

  • Over 6,000 patients treated
  • Over 22,000 surgeries performed
  • More than 40 Years of Experience
  • Dr. Schanzer carefully determines which veins are affected and to what degree