Post-Vein Procedure Instructions

Congratulations! You've met with your board-certified Center for Vein Restoration doctor, reviewed your customized vein treatment options, and developed a plan to restore healthy, beautiful legs. By preparing for your leg vein surgery using these recommendations ahead of time, you will ensure that your vein treatment is successful and that your recovery is as smooth as possible.

1. Make sure your doctor knows about any medications you are taking and follow your doctor's instructions about adjusting medications before your outpatient vein surgery.
2. Ask your doctor if you should stop taking aspirin or other pain relievers such as Motrin, Advil, and Aleve the days/week before your surgery. Tylenol is often a good alternative.
3. Shower before your procedure, but refrain from using any moisturizer, lotion, or cream.
4. Wear comfortable, loose-fitting clothes, and bring compression stockings (if your doctor recommends).
5. Make arrangements for a ride home after your procedure. Speak to your CVR staff if this is a problem.

Day-of and during the first two weeks after vein treatment

All our treatment options are performed as an outpatient in a comfortable vein clinic setting. Depending on your treatment plan, most procedures are completed in under an hour and allow you to return to regular activity immediately with few restrictions.

Our procedures are performed in a sterile environment, and the infection risk is extremely low. However, to further reduce the risk, we ask that you avoid soaking in pools, hot tubs, or bathtubs for 7-10 days after the procedure. Showering is fine, but we ask that you wait 24 hours before removing the ace wrap placed during your procedure.

Pain management

If you need to take something for pain, we recommend starting with 400mg of Ibuprofen every 6-8 hours with food. If you cannot take non-steroidal anti-inflammatory drugs due to an allergy or other medical condition, take Tylenol, up to 500mg every 12 hours.
If your discomfort is so severe that you can't sleep or walk, despite taking pain medication, please call our office or answering service for further assistance.

Can I exercise after my vein treatment?

You may resume normal activities right after your procedure but may experience some discomfort and bruising along the treated vein. The bruising may be significant in the thigh but typically resolves in 1-2 weeks.

We recommend waiting 7-10 days before resuming vigorous exercise such as running, weightlifting, or bicycling. Until then, a modified workout is recommended. We also recommend abstaining from lifting anything over 20 lbs. for the same timeframe.

Walking is encouraged, and treadmill use is acceptable, but no running or vigorous activity, and no weight-bearing exercises specific to the legs and arms, as those will exert extra force onto the lower extremities. Because the vein is in the healing process, any additional force may cause the treated vein to reopen.

What can I expect in the days following vein treatment?

Localized areas of inflammation can be common after varicose vein treatment. Typically, these areas are red, swollen, tender, and have a warm sensation. As the treated vein closes, it can cause an inflammatory reaction. This can occur within one week after laser or radiofrequency ablation or 3-6 weeks after foam sclerotherapy treatments.

Trapped blood

Feeling hardened, tender knots in the areas of treatment are also normal, especially after an ambulatory phlebectomy. We typically refer to this as “trapped blood” because it occurs when blood is stuck within the treated vein and starts to clot.

Trapped blood isn’t dangerous to your health but can feel tender and warm to the touch. To relieve discomfort and promote healing, we recommend applying a warm, moist compress a few times a day and performing gentle massage. This will help assist in the natural reabsorption of these areas, expediting the process.

Depending upon the degree of discomfort, a thrombectomy can be performed for immediate relief. This would require local anesthesia of the area and a stab puncture in the skin to express and squeeze out the trapped blood. If you notice warmth or redness in the leg that's associated with severe pain, fever, or increased swelling in one leg that's new, please call your CVR office.

Skin discoloration

Skin discoloration can occur when the treated vein lies close to the skin’s surface. Byproducts of blood have a staining component and, once treated, are absorbed by the overlying skin, causing discoloration. Throughout the healing process, this will lighten, but it can take several months, depending on the size of the vein.

What to expect during the first week after a vein procedure

A sensation of tightness or pulling along the length of the treated vein is normal and to be expected. Why? Prior to treatment, the veins are very flexible. Once treated, the vein contracts and becomes scar tissue, often described as a “cord-like” sensation. This can develop 1-4 weeks after treatment and resolves over time.
A few patients may experience a loss of sensation localized to the treatment area, especially along the shin bone and ankle region. This is due to nerve irritation and will resolve gradually throughout the healing process.

Healing is still happening. Therefore, improvement in your symptoms will continue. It's likely that some swelling may still be visible, but this should diminish more and more over the next 3-6 months.

Some patients continue to feel a “tight” sensation in the treated vein, which is still normal at this point in the healing process. Expect this to resolve gradually.

Residual knots and trapped blood areas are possible, but the tenderness you initially felt in the area is starting to decrease. This is normal, and continuing with warm compresses and gentle massages is recommended.

Around this point in time, you may be scheduled to come in for your one-month post-procedure follow-up scan. New findings may be revealed during the ultrasound study, as venous insufficiency is chronic (meaning a persistent or long-lasting disease). Some veins may require multiple vein treatments to correct. This will be discussed with you after your scan.

Insurance companies may or may not pay for another round of visual sclerotherapy. Your CVR vein doctor will discuss other treatment options with you if this isn't an option.

Most post-procedure symptoms (numbness, discoloration, and hardened areas) have resolved or been significantly reduced at this point in the healing process.

If you notice these symptoms are worsening in any way, or if new symptoms appear, such as aching pain, swelling, heaviness, or fatigue, we recommend you make a follow-up appointment, as this could indicate underlying venous disease that may need to be treated.

Because venous insufficiency is a chronic, progressive disease process, new refluxing veins (veins that no longer circulate blood properly) can become dysfunctional after treatment. That’s why you'll need annual follow-up appointments. We provide these surveillance and monitoring services to our patients. If you develop new or worsening symptoms, you should contact your Center for Vein Restoration office to make an appointment for an evaluation.

Post-Procedure Care for Laser & Radiofrequency Treatment

Although the healing time for laser and radiofrequency treatments is minimal, we advise following several steps after your procedure to ensure a smooth and successful recovery.

1. Avoid prolonged sitting or standing.
2. Refrain from strenuous activities and heavy lifting for two weeks.
3. Compression stockings will help with the closure procedure. Wearing them for three days after the procedure is mandatory. (You can take them off at night.). The more you wear them, the better you'll feel!
4. Schedule your follow-up Duplex (ultrasound) scan to occur 3-7 days after your procedure.
5. If you are sitting for more than three hours at a time, be sure to get up and move around every hour.
6. Talk to your doctor about whether or not to take baby aspirin.
7. You may shower, but no tub baths, swimming, or hot tubs for the first week.
8. In rare occasions, bleeding through the bandages may occur. If this happens, lie down, elevate your leg, and apply direct pressure until the bleeding has stopped. If the bleeding persists, please call your CVR physician.
9. It's normal to experience some tenderness and possibly some bruising along the areas where local anesthesia was administered.

Post-procedure care for ultrasound-guided foam sclerotherapy

Like laser and radiofrequency treatments, the healing process for ultrasound-guided foam sclerotherapy is easy. That said, following our post-procedure instructions is extremely important to have the best vein care experience possible.

• Wear your compression stockings day and night for three days following your vein treatment. Compression pushes the medication used during your procedure out of the vein and reduces staining. You may remove them temporarily to shower.
• After three days, continue to wear your compression stockings daily for two weeks, except for showering and sleeping. After two weeks, wear your compression stockings at your discretion.
• Avoid hot showers, tub baths, hot tubs, and swimming for one week. Pat the skin dry after showering.
• Soothing aloe vera gel or cool packs may be used to ease any discomfort, and Tylenol or ibuprofen may also reduce any post-treatment irritation. However, please avoid the use of aspirin.

Post-procedure care for ambulatory phlebectomy

Recovery time is immediate; however, temporary bruising or swelling may occur after the procedure. Walking after this surgery is encouraged. Choose only low-impact, light activity after ambulatory phlebectomy due to site tenderness. This discomfort will most likely last only for the first 48 hours following vein treatment.

Be sure to keep the post-operative bandage in place for 24 hours after surgery before replacing it with daytime compression stockings for 1-2 weeks.

The small slit-like incisions made during an ambulatory phlebectomy heal quickly and should be practically imperceptible after 6-12 months.

Post-procedure care for visual sclerotherapy

Following the injections that occur during visual sclerotherapy, a compression stocking needs to be worn to help keep the vein closed. Otherwise, normal daily activities can commence immediately after treatment.