Beautiful Legs After Vein Treatment
Drs. Michael Malinowski and Eric J. Hohenwalter

Michael Malinowski, MD, vascular surgeon, and Eric J. Hohenwalter, MD, FSIR, interventional radiologist, answer common questions about treating spider veins and varicose veins.
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We specialize in the treatment of varicose veins and spider veins. Patients receive treatment from a team of board-certified physicians who combine their expertise and many years of experience in vascular surgery and interventional radiology. Our goal is to help patients understand their vein problem and offer the highest quality care to alleviate vein disorders.

We are proud to serve the community as the only academic medical center in eastern Wisconsin.

Varicose Veins

Varicose veins form when valves in the vein become weak and don’t close properly. Veins can become bulged with pools of blood when they fail to circulate blood properly. These visible and bulging veins are often associated with symptoms such as tired, heavy or aching limbs. In severe cases, varicose veins can rupture, or open sores (ulcers) can form on the skin. Varicose veins are most common in the legs and thighs.

Spider Veins

Spider veins appear on the surface of the skin. They may look like short, fine lines, “starburst” clusters or a web-like maze. Spider veins are most common in the thighs, ankles and feet, and may also appear on the face. They may itch, burn or ache, and can be found alone or in combination with varicose veins. Causes of spider veins include genetics (many women with spider veins have mothers and/or female relatives with spider veins), pregnancy, prolonged standing and sitting, injury and high pressure from varicose veins. Spider veins are often a cosmetic vs. a health concern.

While spider veins and varicose veins occur in men and women, women experience these vein disorders more often. Estrogen, a female hormone, plays a role in the development of spider and varicose veins.

Treating Vein Disorders

Most problem veins — from the tiniest spider veins to the largest varicose veins — can be treated without surgery. Physicians use advanced technology and techniques to safely and efficiently treat vein disorders, with pleasing results for patients.

Treatments include:

  • Sclerotherapy — A procedure to treat spider and varicose veins that involves using a tiny needle to inject a solution directly into the veins. The solution irritates the lining of the veins, causing them to contract and collapse. Blood in these veins is directed back into deeper, normal veins.
  • Microphlebectomy — A technique to remove varicose veins by making tiny incisions in the skin through which the varicose veins are removed. Stitches are usually not required.
  • Endovenous ablation — A treatment for varicose veins that uses either radiofrequency (RF) or laser energy to cauterize a faulty vein, allowing the blood to be diverted to other normal veins. Endovenous ablation will not only improve the cosmetic appearance of the legs, but will help to relieve the aching, swelling and inflammation of the legs associated with varicose veins. The use of RF or laser energy is a major advancement over the traditional method of vein stripping, in which incisions are made in the groin area and near the ankle and a wire-like instrument is inserted into the vein to “strip” it from the inside. Ablation techniques are much less invasive, and patients are able to resume normal activities much sooner than with vein stripping.
  • Compression stockings — Compression stockings are recommended for those who have pain in their lower extremities due to swollen, enlarged veins. Compression therapy is often suggested as the first line of conservative treatment. FORME has a variety of stockings available for purchase without needing a prescription.

Depending on a person’s vein problem, treatment may involve one procedure or a few procedures. In most cases, patients can resume their normal activities the next day — or sooner. 

Patients with spider veins and varicose veins often have other health problems in addition to their vein disorder, such as heart disease, diabetes and kidney disease. Our team of physicians works closely with a variety of specialists and with patients’ physicians to ensure coordinated care. 

Your First Visit

During your first visit, one of our providers will conduct a comprehensive evaluation of your vein system, take your medical history, conduct a physical exam and do an ultrasound exam of the lower extremities. All of these processes combine to help the provider determine the optimal treatment plan for you.

Following the exam process, the provider will discuss your test results and review the treatment options appropriate for your disorder. Your treatment plan will be customized to your needs.

You will also receive an estimate of treatment fees. The diagnosis and treatment of significant health problems due to diseased veins are covered by most insurance companies if the problem is deemed “medically necessary.” We will determine if your vein disorder is causing health problems or if it is strictly cosmetic.

FORME Aesthetic and Vein Center

All vein services — physician consultations, treatments and follow-up visits — are performed at the new FORME Aesthetic and Vein Center. Here, our team of vascular surgeons and vascular and interventional radiologists, combine with advanced practice providers, medical estheticians, aesthetic nurses and board-certified specialists in dermatology, facial plastic surgery, oculoplastic surgery and general plastic surgery. Together, this multidisciplinary team delivers the latest in aesthetic, nonsurgical and surgical cosmetic and vein care options in a beautifully designed new space. FORME is located in the Tosa Health Center.

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