What No One in Pittsburgh Tells You About Varicose Veins 

What No One in Pittsburgh Tells You About Varicose Veins 

What You Really Need to Know About Varicose Veins, Pittsburgh

This Article Will Help You to Get All the Facts About Varicose Veins

Here are my best practical varicose vein consumer tips on what to really expect from varicose vein treatments.

Getting to the whole truth is not just about what is said but it’s also about what’s not said.

Or never discussed on the Internet when you are doing research about varicose veins.

This great blog post is about those pesky little – how should I say it – annoying details that never get mentioned or written about.

Here is the list of essential hidden secrets you won’t find on the web.

I would like to make these matters perfectly clear to you before you start your journey on getting rid of the varicose veins in your legs.

When I personally research restaurants or prospective products that I want to buy, I find the negative comments the most helpful.

Things like, we had reservations but still had to wait an hour. Or the product broke. Or It didn’t really work.

Sometimes research on the web doesn’t tell you everything that you need to know ahead of time.

The following points will help you decide if vein treatments are for you.

Here’s a little appetizer. Many people in Pittsburgh don’t know that no insurance company covers spider veins. That’s because some vein centers bill for them fraudulently.

In addition, if your veins are asymptomatic, the cost of treatment may be a deterring factor.

Insurance only covers symptomatic varicose veins that interfere with your daily activities.

You also need to know all of the remaining facts to make an informed decision if you are deciding about vein treatment.

All the Facts About Varicose Veins That Are Never Discussed

These important facts about varicose veins can’t be found on a Google search.

They are not on the internet.

Pittsburgh vein centers won’t tell you these important details. I know because I asked people who came for a second opinion.

This article fills the gaps between what you are told at the vein center and what they omit on purpose.

Topics that are often omitted when discussing venous disease and vein treatments include:

  1. Pain during and after treatment
  2. Realistic expectations
  3. Chances of recurrence (new varicose veins)
  4. Risks
  5. Appearance afterwards
  6. Your cost after insurance pays their part

Hopefully, this blog post fills the void on common questions that people don’t know enough to ask.

Later when people discover these hidden facts, they say that they wished that they would have known these issues before they started the process.

Let’s dig in and discuss these topics in more detail.

#1 Pain After Varicose Vein Treatment

Pain from vein procedures is not an issue for most people.

That’s right.

However, a few people are so fearful and scared that they make it more difficult than it has to be.

These days, varicose vein procedures are all done in a doctor’s office with local anesthesia.

No one has to go to a hospital or surgery center anymore.

You don’t have to be put asleep for these treatments.

Modern vein treatments (especially radiofrequency closure) is virtually painless except for a few numbing pinches.

Because you don’t have to go to sleep for it, it’s also safer.

Afterwards, people usually return to work the next day with little or no discomfort at all.

As soon as the procedure is over, most people say that it was the fear of the unknown that made them nervous or apprehensive just before the procedure.

A common remark is “that wasn’t bad at all.” I expected much worse.

The problem occurs when some people work themselves up unnecessarily.

Anxiety and stress levels are high these days.

#2 Realistic Expectations

You can return to work as soon as you wish after these minimally invasive procedures.

Downtime is minimal.

Whether you wish to take a day off from work after a more extensive procedure is up to you.

Nothing you do from an activity standpoint will mess up your results.


Overdoing it right away may make you uncomfortable.

Standing or sitting too long may do the same.

We only ask that people refrain from taking any long car or plane rides for a couple of weeks.

#3 Chances of Recurrence of Varicose Veins

If the veins are completely addressed, most people get years or decades of relief from their varicose veins procedures.

When varicose veins are very large, a combination of a saphenous ablation procedure and a phlebectomy (removal of the surface veins through needle holes) gives the longest lasting results.

What is surprising to some people is that one varicose vein treatment is often not enough.

When the varicose veins are totally removed, those veins can’t come back. The same can’t be said about sclerotherapy or injections.

After injections of large veins, recurrence rates are higher.

After all, veins can’t come back if they were removed with the latest minimally invasive technique.

The same cannot be said about injections.

The biggest reason for failure after injections is not being able to get a strong enough solution to all parts of the diseased veins equally.

There are also safety limits on how much medicine can be injected per visit.

In addition, insurance companies are limiting the number of injection treatments that are covered.

Venous disease is incurable for most people. Depending on your genetics, weight and the extent of you vein problem, new varicose veins in other places can develop.

Following up with your vein doctor can prevent new developing veins from enlarging and keep them under control.

#4 Risks of Varicose Vein Treatment

I always ask people who come for a second opinion if the previous vein center or doctor discussed the risks of having vein treatments.

Invariably, the answer is no.

Risks are very low after varicose vein treatments.

The biggest concern is a blood clot. In my experience, this occurs in less than one per cent of people.

People at higher risk for a blood clot if they have had a previous blood clot or a family history of unprovoked clots. Those people must be on a blood thinner shot called Lovenox for one week to prevent blood clots around the time of the procedure.

Lovenox prophylaxis is very beneficial in these cases.

Numbness, skin discoloration and bumps where the veins used to be located are rare and if present resolve over time.

Other complications are usually only experienced after having these procedures performed by unqualified or inexperienced doctors.

Needless to say, research the vascular surgeon vein specialist who will actually do your procedure. Most people omit investigating the doctor and just choose the closest vein center.

People often ask, “Will taking away abnormal veins mess up my circulation.” After all they are large. They seem to be an important pathway for blood to get back to the heart.

“Don’t I need those veins that will be removed?” – is the question.

The answer is – No.

Other veins in your leg (like the deep veins) take over very easily. They are already present. Your body doesn’t have to make new veins.

After varicose vein treatments, your circulation will be improved.

#5 Appearance After Treatment of Your Varicose Veins

How fast the appearance returns to normal depends on the extent of your vein problem and the number of treatments required to treat them.

With huge varicose veins from the hip to the ankle, multiple treatments will be necessary. Staging extensive large varicosities is often necessary.

From a cosmetic standpoint, removing large veins through needle holes is superior. These nicks in the skin are so small that they don’t scar.

The alternative to removing varicose veins through nicks in the skin is sclerotherapy.

For large varicose veins, sclerotherapy results in a number of issues.

Initially, these injected veins become hard, sore, and painful. The bigger the vein, the more painful they become.

That’s just the beginning. As the pain slowly resolves over weeks to months, the skin overlying the vein turns brown.

This can take a year or two to resolve when the veins are large. Most people find this staining of the skin unsightly.

For these reasons, most vein doctors who are able and trained to do phlebectomy prefer it to sclerotherapy to treat the varicose veins that remain after a saphenous ablation is performed.

Saphenous vein ablations alone don’t take away your varicose veins.

Doctors who are currently performing Venaseal glue ablations of the saphenous vein will either not mention that or downplay the need for phlebectomy or sclerotherapy.

That’s leaving out crucial information which is the topic of this article.

#6 Is Insurance Gonna Cover My Varicose Vein Procedure?

I’ve saved the best for last.

Insurance companies are rapidly restricting varicose vein care.


Because they can.

They have all of the power to make your medical decisions – not the doctors.

If you have a high deductible, you’re probably not going to be able to use your insurance. Until your deductible is met, you will essentially be paying out-of-pocket.

After your deductible has been met, you will still have to pay the co-insurance part of the total bill. For the average person, that comes to about 20% of the cost of the procedure.

If you have your procedure done in a vein office that charges a facility fee, that could double the total amount that you will owe out of pocket.

Ask the vein office if they charge a facility fee.

In addition, the more veins that you have, the more procedures it will take.

For most people, my best advice is to have your painful varicose veins treated now.

Do it before insurance coverage for varicose veins becomes either even more restrictive or nonexistent.


There you have it.

Six important things that nobody talks about during a consultation in vein centers.

This is valuable information that is not available on the internet.

That’s the inside scoop.

These are lessons learned and inside information from a lifetime of treating varicose veins that are never discussed.

This essential information will help you ask for the best treatments available and keep your costs down.

Call us at 724-969-0600 or click here to learn more.

About The Author

Dr. John Happel

Dr. John Happel has been in practice as a surgeon since 1986 in the Pittsburgh region. He specializes in vascular surgery and has subspecialized in the treatment of varicose and spider veins since 1999. Dr. Happel is board certified in vascular surgery and recertified in vascular surgery in 2012. He was chosen in 1985 to fulfill the position for the vascular surgical fellowship at the world renowned Mayo Clinic.