The Private Clinic
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Leg Lession 8
‘Standing all day can make your legs and ankles swell, but other causes of swollen legs are varicose veins and lymphedem, where the lymphatic system fails to transport fluid away from the legs.’ says Mr Constantinos Kyriakides, Consultant Vascular Surgeon at The Private Clinic of Harley Street (theprivateclinic.co.uk)
‘Sitting with your feet up, or even better, lying down with your feet up can provide relief’ he adds. Make sure your feet are higher than your heart.
Whether you’re for or against invasive aesthetic transformations, it’s a booming industry with new technologies advancing treatments all the time. 2019 looks set to see the demand for cosmetic surgery procedures further increase, with a trend for truly natural-looking results. We asked experts from The Private Clinic of Harley Street, one of the country’s leading cosmetic surgery groups … to share their new year ‘tweakment’ predictions, below.
Davood Fallahdar, consultant plastic and reconstructive surgeon at The Private Clinic of Harley Street explains that the ‘temporal facelift’, also known as the ‘mini’ or ‘secret facelift’, “will become one of the most popular cosmetic surgery procedures in 2019”. Apparently demand has been increasing in recent years, with many patients opting for it over a full facelift due to the natural and fresher look it offers.
“Unlike a full facelift, the treatment is carried out under local anaesthetic. This means that patients can return to work the next day and don’t have to suffer the abundance of unsightly bruising, swelling and bandages as seen with full facelifts, as the scar is hidden on the scalp, within the hair and not on the face.”
Dr Hao Hanson Yu, aesthetic doctor at The Private Clinic of Harley Street confirms that the era of dramatic cosmetic surgery procedures has truly passed, “with patients looking for not just a subtler look and an alternative to invasive forms of cosmetic surgery”. Cue fewer over-filled lips and a further rise in ‘tweakments’.
“Perhaps one of the most popular of these treatments will be the non-surgical nose job. This is a form of nose reshaping that uses dermal filler as an effective alternative to surgical rhinoplasty. The fillers are used to subtly enhance the contours of the patients nose and at the same time reshaping to provide more definition. Most patients experience little swelling and can go back to work immediately.”
We can thank the Meghan-effect for this one, given the speculation around the Duchess of Sussex’s bunion treatment this year, but luckily, it’s also driven by major advancements in the treatment for the condition. Mr Andrea Bianchi, orthopaedic surgeon at The Private Clinic of Harley Street explains that, “a pioneering, minimally-invasive keyhole surgery is now available that requires only a local anaesthetic and removes a bunion quickly without the use of screws or plates. Unlike any other bunion surgery available in the UK, patients can walk without crutches immediately after the procedure and are able to return to everyday activities almost straight away.”
He’s therefore expecting to see “a huge surge in the number of women seeking treatment for their bunions”. And why not?
A survey of 1000 UK men and women conducted via OnePoll found that over two thirds of Brits admit to feeling self-conscious wearing certain clothes because of their varicose veins and spider veins. Dr Dynesh Rittoo, vascular surgeon at The Private Clinic of Harley Street hypothesises; “I think this is down to the ever-increasing role of social media with everyone wanting to look as good as their favourite celebrity or influencer.”
The response? “I now treat varicose veins with a minimally-invasive method called Endovenous Laser Ablation (EVLA) which can be delivered under local anaesthetic and enables the patient to leave the clinic on the same day as their treatment.” Another ‘tweakment’ no one need know about.
Varicose veins are a blight that affects millions of us, with three in ten adults suffering from the condition.
[…]When it comes to treatment, the NHS has a strict grading system: only people whose varicose veins are at the higher end of the one-to-six scale (one being mild, while six is advanced) are eligible. Many turn to the private sector for treatment.
Here, Costas Kyriakides, a consultant vascular surgeon at Barts Health NHS Trust and The Private Clinic in London, and David Lewis, a consultant vascular surgeon at The Royal Gwent Hospital in Newport and Spire Cardiff Hospital, explain the different options — from traditional to high-tech.
HOW IT WORKS: Ligation and stripping has been the traditional way to treat varicose veins for decades.
Under general anaesthetic, two small incisions are made and a flexible wire is inserted into the vein and then pulled out, removing the vein in one section. A compression bandage is worn for up to a week to aid healing and patients are advised to stay off work for two weeks.
EXPERT VERDICT: Mr Kyriakides says: ‘About a fifth of surgeons still use this technique, which is suitable for most fit patients. However, there’s a 10 per cent risk of infection and bleeding, and up to a 5 per cent risk of damage to surrounding deeper veins, arteries and nerves. It’s also associated with a higher rate of recurrence due to new vein formation or incomplete stripping of the vein.
‘Recovery time is longer than other options and it leaves a scar of about 2 in.’
AVAILABILITY: NHS and privately.
COST: From £3,000.
HOW IT WORKS: These minimally-invasive, 20-minute techniques use heat to destroy the varicose vein with either high-frequency radiowaves or a laser.
In each case, the patient has a local anaesthetic before a small incision is made above or below the knee. A catheter — a thin tube — is then inserted into the problematic vein, and via this, radiowaves or a laser are used to heat the walls of the vein, causing it to collapse and closing off its blood supply. (The vein eventually withers away and is absorbed by the body.) Blood immediately starts to flow along a different vein.
EXPERT VERDICT: Mr Kyriakides says: ‘In 2013, The National Institute for Health and Care Excellence (Nice) recommended endothermal ablation as a first-line treatment for varicose veins, and it’s now considered the gold standard treatment, followed by foam sclerotherapy.
‘Both options were introduced about 20 years ago and are around 98 per cent effective. They are best suited to patients with straight veins (which account for 95 per cent of varicose veins).
‘As it’s a minimally-invasive treatment, the risk of bleeding and infection is rare. The 1-2mm incision does not need stitching; adhesive strips can be used, leaving only a tiny scar. Patients can be at work the next day, although they might feel stiffness for three days.’
AVAILABILITY: NHS and privately.
COST: From £2,000.
HOW IT WORKS: This chemically destroys the lining of the vein, causing it to collapse. Guided by ultrasound, it involves a fine foam being injected directly into the vein, which causes it to scar on the inside and the walls of the vein to stick together, closing it off.
The procedure takes 30 to 60 minutes, and afterwards bandages and compression stockings are worn to reduce lumpiness developing where the vein was sealed off. The patient can be back to work the same day.
In a Nice study, this was successful in 84 out of 100 cases, which is a lower success rate than other minimally-invasive procedures — but it can be repeated.
EXPERT VERDICT: Mr …. says: ‘A form of this treatment has been around for decades. Now, foam rather than liquid is used, leading to more predictable results and fewer complications; the vein will disappear in six to 12 weeks.
‘It’s used to “tidy up” veins that aren’t dealt with by endothermal ablation. However, if too much foam is used, it can increase the risk of complications such as headaches, visual disturbance and stroke, although I’ve never had any issues with it.
‘There’s a 5 to 10 per cent risk of “staining”, where the destroyed vein leaves a mark on the skin. This usually fades after three months but can take up to a year.
‘Patients can return to normal activities within 24 hours.’
AVAILABILITY: NHS and privately.
COST: Between £1,000 to £3,000.
HOW IT WORKS: Under a general or local anaesthetic, a surgical instrument called a phlebectomy hook is used to pull out the vein in segments. The incisions are closed with glue or paper ‘stitches’.
EXPERT VERDICT: Mr Lewis says: ‘While we may treat the main trunks of varicose veins with endothermal ablation, multiple phlebectomies are favoured by many surgeons for smaller, side branches because the procedure is arguably less technically challenging than some other techniques.
‘A phlebectomy can be quick depending on how many veins are removed, but can cause more discomfort afterwards due to cuts and bruising. Patients need to wear compression stockings for about a week and can return to work in under a week.
‘As with all treatments, varicose veins can return, although phlebectomies have a success rate of 84 per cent. This is better than other techniques for “tidying up” if more tortuous veins remain after ablation has been used to take away straight ones.’
AVAILABILITY: NHS and privately.
COST: From £,1,000.
[…]HOW IT WORKS: This 30-minute procedure uses medical-grade adhesive to stick the vein together, via a hollow tube called an introducer. The maker says it is painless, with a recovery time of 72 hours, without the danger of thermal injury.
EXPERT VERDICT: Mr Kyriakides says: ‘This treatment has been in mainstream use for around five years and is like putting superglue in the veins to seal them off. The dead vein and hardened glue is then broken down and absorbed into the body.
‘One of the main advantages is that you only need a small amount of local anaesthetic where the catheter goes in and not along the length of the vein.
‘Published clinical studies showed it had an initial success rate of between 94 to 98 per cent six months after treatment.
‘It is very effective — though maybe not so for large diameter (more than 9mm) varicose veins as they may not seal. Its cost can be prohibitive. But as there is no need for a local anaesthetic in the thigh, it’s more pleasant for some patients compared, for example, to endothermal ablation.’
AVAILABILITY: Privately only.
COST: From £3,500.
For more information or to book a consultation with Mr Constantinos Kyriakides, Consultant Vascular Surgeon at The Private Clinic of Harley Street use our varicose vein online contact form.
[…]The Private Clinic is a specialist vein clinic for the treatment of varicose veins, thread veins, spider veins and facial veins. The Private Clinic have carried out over 7,000 procedures in treating Veins and in particular we are specialists in the minimally invasive treatment of veins. We focus on the underlying cause of your veins and you will only see a Consultant Vascular surgeon for Varicose Veins.
Our Varicose Vein clinics in Bristol’s Whiteladies road in Clifton, in Manchester Saint John’s street off Deansgate road and in Glasgow’s Park Circus off Woodlands road are all ideally located for the treatment of Varicose veins, thread/spider veins and facial veins . We are able to offer non-surgical varicose vein removal treatments to 99% of patients that come to see us in Bristol, Manchester and Glasgow and the best part is that these treatments are walk in walk out treatments. No need for lengthy hospital stays. This includes the varicose vein treatment EVLA (Endovenous Laser Ablation) or Endovenous laser treatment, Sclerotherapy (Foam & Liquid), VenaSeal and Phlebotomy. We also treat smaller Spider or Thread Veins and offer advanced Sclerotherapy and Cutera CoolGlide thread veins removal treatments.
For more information on our EVLA varicose vein minimally invasive treatment and our expert Consultant Vascular surgeons click here.
To see before and after photos for varicose veins click here.
We also have other specialist varicose vein clinics located in Leeds, Birmingham, Harley street, Bournemouth, Bexhill, Chelmsford in Essex and Northampton.
One of the most unheard of causes of eczema is varicose veins – which usually only affects the legs. Not many people are aware of Varicose Eczema, but it is quite common and can be very irritable for those suffering from it. To treat this type of Eczema, the root of the problem – the defective underlying vein – must be addressed. Read more >
Swollen, blue/black leg veins are a sure-fire way to make you cover up. But if varicose veins are making you miserable – and your legs unsightly – there are effective medical treatments available. Varicose veins develop when the small valves inside the veins stop working properly. If these valves get damaged or weaken, the blood gets trapped inside the vein and over time it becomes swollen and enlarged.
“Around three in 10 adults will, at some point in their life, develop varicose veins,” says Mr Constantinos Kyriakides, a Consultant Vascular Surgeon at The Private Clinic, Harley Street. “Although varicose veins are often treated for cosmetic purposes, they can also have greater health implications than most of us are aware of.” Aching, itching, and a feeling of heaviness in the legs are all common complaints. As with any invasive surgery, it’s always important to undergo a thorough examination before you decide on any procedures.
If you are suffering pain or discomfort from your varicose veins, it’s best to visit your GP for advice. However, unless the veins are causing you serious health concerns, it’s unlikely you’ll get treatment for them on the NHS. If you want veins removed for cosmetic reasons and are prepared to go privately, sclerotherapy is a tried-and-tested treatment for smaller veins. This involves injecting a chemical into the vein to close it completely, so that it no longer carries blood. Although it can improve the appearance of your legs, they may still ache. And after the injection, you’ll have to wear support stockings for three to six weeks.
For more serious veins, the best treatment is called Endovenous Laser Ablation (EVLA) – a walk-in, walk-out procedure, performed under local anesthetic. Although it’s expensive (prices start at around £2,150) it’s minimally invasive and is an arguably more effective alternative to the more invasive vein stripping method, which although cheaper, is a major surgical procedure that usually requires general anesthetic and up to six weeks ‘down time’.
“The results of EVLA have been shown to last longer than those which can be achieved through vein stripping, while research has shown that veins which have been stripped grow back in almost a quarter of cases,” comments Mr Kyriakides. With an EVLA treatment, first an ultrasound scan is used to mark the position of the veins. Local anesthetic is injected around the vein to ease any discomfort and then a fine probe is then inserted through a very small incision, usually close to the patient’s knee. Next, laser energy is delivered in short or continuous pulses to seal the faulty vein so that blood can no longer flow through it. The procedure usually takes less than 30 minutes and you can go home afterwards.
