This myth is not correct as varicose veins
do not always come back after surgery, but there are wide variations as to how often or rarely varicose veins
should come back after treatment. It is worth you going through the explanation below, because if you choose the right specialist
who uses the right technique
for your veins, and uses the correct protocol for that technique, then you can minimise the chance of ever getting varicose veins
Firstly, there are three ways that veins can recur (come back) after surgery.
The first way is that the initial operation was incomplete and not all of the affected veins were treated. This is very common after treatment by doctors who are not vein specialists and to do not use duplex ultrasound
to find out all of the causes of venous reflux. Such doctors often still strip veins
and do not check for pelvic venous reflux or for perforator
vein reflux in the lower legs - and if they do check and find it, often do not treat it. Therefore if venous reflux is still present in any veins after the operation, recurrent varicose veins
are almost guaranteed. Thus varicose veins
treated by this sort of doctor will almost certainly come back after treatment.
The second way is that the correct veins are identified and treated but using techniques that do not permanently stop the venous reflux in that vein. Many doctors still strip veins
despite research from The Whiteley Clinic in the UK which showed in 2007, that when the Great Saphenous Vein (GSV)
is tied and stripped away
, it is found to be growing back again in 23% of people at one year. Subsequent research by the same clinic has shown the vein is re-growing in 82% of people at five years.
As the new veins that grow after stripping
do not have valves in them, they always reflux. This means that when these veins re-grow, the same varicose veins
usually come back again. Although the new endovenous techniques, when used properly, have much better results, it does depend on the correct technique being used in the correct vein and the technique being performed optimally. Clinics that specialise in vein treatments with doctors that spend the majority if not all of their time perfecting their vein techniques tend to get far better results than doctors who only perform vein surgery occasionally and who are only trained in one or two techniques.
The third and final way that veins can recur after surgery is due to the natural deterioration in the venous system with time. We know from population studies that approximately 3 to 4% of people who come from vein forming families will develop new varicose veins
every year. Therefore it is not surprising that even if perfect surgery is performed on patients with varicose veins
, 3 to 4% of them will develop new varicose veins
, in different veins from those that were treated, each year.
Therefore in summary, the risk of veins coming back again varies widely and depends to a very large extent on the expertise of the doctor responsible for the investigation and treatment of varicose veins
. In non-specialist practices where duplex ultrasound
is either not used or only used in a limited fashion, and the veins are then stripped
or inappropriate endovenous techniques
are used, the recurrence rates are going to be very high and veins will indeed appear to come back very regularly after treatment.
In specialist vein clinics
where trained staff perform duplex ultrasonography
full-time every day, working hand in glove with doctors and surgeons who are trained in all the new endovenous techniques
and thus have a wide selection of treatments to choose from, then the treated veins should not recur and the only risk that varicose veins
will come back again should be 3 to 4% per year. In such cases, when these recurrent varicose veins
are scanned, these should always be new varicose veins
and should not be found to be arising from the veins that were previously treated.