Varicose veins frequently asked questions
When can I drive?
The important thing is to be able to drive as safely following your operation as you did before it. You should certainly not drive for 48 hours after a general anaesthetic and I would recommend you not to drive for the first week while you have your bandage on.
After this you may drive providing your leg is comfortable and you can do an emergency stop, etc. I would recommend that you wear a support stocking for driving and try to avoid long drives early on as this tends to mean that you are sitting with the leg down which encourages swelling.
Can the veins come back? Getting the right operation done
Although your doctor will wish to examine your varicose veins, examination alone is not always a reliable way to work out which veins are causing the problem. If the choice of operation is based solely on physical examination then there is bound to be an element of guesswork involved.
One of the advantages of seeing a specialist vascular surgeon is that he/she is more likely to have access to more specialised techniques such as Doppler or venous duplex scanning (see picture).
This picture shows a duplex scan of some veins you can see a surface vein joining a deeper vein (the veins are seen in blue). A duplex scan is an ultrasound test (like the ones used to scan babies in the womb). It gives clear pictures of the veins and shows whether they are damaged and whether the one-way valves in the veins are working properly.
This helps the surgeon make sure that the correct veins are removed at the time of the operation. It is obvious that if the choice of operation is based on an element of guesswork, then there is more chance of having further veins after the operation. However, no matter how well your operation is planned and performed, it is unrealistic to expect every single vein to be removed every time, particularly if you have large numbers of veins.
Making new varicose veins
The veins that have been removed at the time of your operation are physically taken away and cannot come back. However, the tendency to form varicose veins is part of the way you are, otherwise you would not have varicose veins in the first place. Having had a varicose vein removed from one part of your leg will not prevent you forming a new varicose vein if that is what you are destined to do. However, once the major feeding veins are dealt with, the chances of the veins being as bad as they were originally are small.
Only about one in ten people ever get further varicose veins that are bad enough to require a second operation. In other words, sooner or later, you almost certainly will form some further varicose veins and the operation should not be regarded as a cure. On the other hand, the chances are that the varicose veins will not be as bad as before your operation and probably won't require anything doing about them.
It is important to realise that varicose vein surgery, no matter how well it is done and which method is used, is not perfect. It is certainly not a permanent cure for varicose veins. Provided people are aware of that the aim is a major improvement over a reasonable period of time rather than perfection for ever, most people are satisfied with their operation and report an improved quality of life.
How will the blood get out of my leg once the veins have been removed?
This question is often asked; because there are two systems of veins in the leg and the operation only involves some of the veins on the surface, the deep veins which are by far the most important are left untouched.
In fact since the varicose veins are allowing blood to flow in the wrong direction they are actually making the venous circulation slightly worse and varicose vein operations if anything improve the return of blood to the heart rather than making it worse.
Please note that this website is intended to give you some background information and answer some of the more commonly arising questions about varicose veins. It is not supposed to cover every possible aspect of venous disease or every possible complication. If you have any further questions you should discuss them with your specialist.
Are there any risks to an operation?
All operations have a risk. If you want a zero risk then do not have an operation. The traditional surgery will normally require a general anaesthetic the risk of which in otherwise well people is nowadays extremely small.
Whatever treatment you choose with any operation there is the potential for bleeding or infection but the risk of this happening is low. As mentioned above, bruising is inevitable to some degree as the veins which are removed have some blood inside them.
People sometimes worry about getting blood clots (deep venous thrombosis) following varicose vein surgery. Although it is natural to consider this as the surgery involves the vein it is in fact an unusual complication. Nonetheless, it is prudent to stop the combined contraceptive pill six weeks prior to surgery as being on the pill slightly increases the risk of a blood clot.
HRT is acceptable but it is helpful to know if this is being taken. If people have a past history of deep venous thrombosis it is very important that this is brought to the surgeons' and anaesthetist's attention as special precautions will need to be taken.
The veins sometimes runs very close to a nerves supplying the skin around in this situation removing the vein can sometimes produce some numbness in the skin. This does not usually trouble people and often they don't notice it, but if it is looked for there will be some degree of numbness around the ankle approximately once in every ten operations. It usually recovers to some extent but not totally.
This is not intended to be a comprehensive list of everything possible that could happen but merely to cover more common problems or the ones that are more commonly asked about. It is worth pointing out that the large majority of people having varicose vein surgery have no complications.