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More than 80 million people in the United States have problems with their veins. Veins 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 three groups: varicose veins, telangiectasias and reticular veins. Varicose veins are enlarged and engorged veins that generally cause pain, swelling, discomfort and, in severe cases, skin changes and ulcerations. Telangiectasias are commonly called spider veins and are those unsightly red, bluish or purple little vessels that appear mainly on the lower extremities and face. Reticular veins are those greenish, widened veins that eventually may develop into varicosities.


Sclerotherapy is the gold standard of treatment for most of the venous disorders. The procedure involves injecting a sclerosing solution through a tiny needle into the vein. The solution causes the vein to collapse and is then absorbed by the body. Treatments involve several injections over the course of several sessions, depending on the type, number and severity of the veins being treated. By the end of the treatment program, the veins are no longer visible. Because sclerotherapy also relieves symptoms associated with these venous disorders and prevents further complications, Dr. Galiano recommends having them treated earlier rather than later.

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Endovenous Laser Treatment (EVLT)

For the larger and deeper veins, the Advanced Laser and Wellness Centers offer the Endovenous Laser Treatment (EVLT). During the procedure, a tiny fiber is inserted into the vein via a needle. Pulses of laser light cause the vein to collapse and seal shut, effectively reducing visibility on the skin surface and eliminating pain and other complications. EVLT is approved by the FDA for treatment of the greater saphenous vein, the large vein which runs throughout the leg. This laser targets the vessel walls instead of the blood which translates into less patient discomfort, less discoloration on the overlying skin and higher likelihood of success at closing the incompetent vein.

Before After


Laser and Intense Pulsed Light for Spider Veins

For selected cases when sclerotherapy is not feasible and/or the patient has "needle phobia", the Advanced Laser and Wellness Centers offer both lasers and IPL technology. Depending on the patient's skin type, area to be treated, and size of the vein, specific wavelengths are selected to treat the unsightly veins. Veins, broken capillaries, and cherry angiomas on the face and body can be treated with very little discomfort and the treatments typically take only minutes to perform. No bandages or compression garments are needed and normal activities can be resumed immediately. As with almost any vein procedure, several treatments may be necessary.

Segmental Phlebectomies

When the problematic veins are not accessible with the EVLT or sclerotherapy, Dr. Galiano may perform a segmental phlebectomy. The process involves injecting local anesthesia around the varicosities and through a tiny incision, extract the diseased vein. Some form of compression will be applied temporarily. Again, the patients will be able to return to their normal activities immediately. Microphlebectomy, sometimes called ambulatory phlebectomy or stab avulsion, is a minimally invasive method of treating small varicose veins. A special hook is used to remove the vein through multiple tiny incisions that do not usually require stitches and leave minimal scarring. Recent advances have made it possible to perform the procedure using only local anesthesia and light sedation in a doctor's office as an outpatient. After the microphlebectomy you will be asked to wear compression garments temporarily. The incisions typically heal within two weeks.

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