33 Sewall Street, Portland, Maine 04102 207.956.6650
Varicose Veins

Varicose Veins


Varicose veins are more than unsightly, they can cause significant pain or discomfort. Varicose veins usually appear between the ages of 30 and 70 and get progressively worse. The good news is that varicose veins can be treated quickly using a minimally invasive technique in our office.

Risk Factors

  • Women are more likely than men are to develop the condition.
  • If other family members had varicose veins, there's a greater chance that you will too.
  • Being overweight puts added pressure on your veins.
  • Standing for long periods of time also puts added pressure on your veins.


Veins are an important part of the vascular system. Varicose veins occur when the valves in your veins malfunction. Varicose veins have lost their normal function and the ability to transport blood. When that happens, blood that should be moving toward the heart may flow backward. Blood pools in leg veins, and subsequently enlarge and become varicose.


  • Heaviness
  • Pain or Tenderness
  • Itching
  • Burning
  • Restlessness, Cramping
  • Swelling
  • Skin Discoloration

Treatment Options

Patients can make lifestyle changes, such as eating less, exercising more and wearing support stockings. This regimen can be helpful in reducing varicose vein symptoms. Conservative treatment will not remove existing abnormal veins, but it may be the treatment choice for patients who may not be able to undergo other treatment methods.

Treatment Options at Vascular & Interventional Physicians

Our treatments are designed to specifically address your type of varicose veins:

  • Sclerotherapy – This method uses a tiny needle placed into small spider veins. A liquid (sclerosant) is infused which causes inflammation of the vein and eventually scarring it down. This results in the vein no longer being open. This may require additional treatments and can result in discoloration over the vein which is temporary.
  • Microphlebectomy – This outpatient procedure uses small hooks to remove large varicose veins close to the skin surface. This procedure is done under local anesthetic and does not require any stitches. It is highly effective and durable. It may result in temporary bruising at the site of removal.
  • Ultrasound Guided Sclerotherapy – This method takes advantage of our expertise in using image-guidance to treat the deeper veins that cannot be seen or felt at the skin surface but contribute to surface varicose veins. Using ultrasound guidance, a tiny needle is placed into the deeper problematic veins and the same liquid sclerosant infused to cause them to scar down. Larger surface veins may also require this mode of therapy.
  • EVLT (Endovenous Laser Therapy) – This state-of-the-art therapy is a minimally-invasive outpatient procedure used to treat the more common sources of varicose veins. After applying a local anesthetic (similar to the numbing medicine used at the dentist’s office), the vascular physician places a thin catheter under ultrasound guidance into the abnormal vein in the leg. Laser energy is then used to heat the vein from the inside and seal it closed. Once this problematic vein is closed blood flow is diverted into the other normal healthy veins and the surface varicose veins disappear. Benefits of this procedure include:
    • No scarring
    • Short outpatient procedure
    • Little to no recovery time
    • Performed by vascular physicians with the most extensive EVLT experience in the region

Click here to SMG EVLT Brochure

Frequently asked Questions

What are varicose veins?

Veins throughout your body return blood back to your heart. For this to work efficiently, veins have one-way valves to prevent blood from flowing backwards due to gravity. If the valves fail to close properly, blood will collect in the veins. Over time, this will force the vein walls outward, resulting in enlargement, and sometimes bulging, of the vein giving it a rope-like appearance.

Varicose veins may cause cosmetic concerns only, but can sometimes cause legs to ache or swell.  Your legs may also feel heavy and tired, or as though they are burning. These symptoms can be more severe at the end of the day or after prolonged sitting or standing. In more severe cases, varicose veins can lead to skin changes resulting in eczema, pigmentation, ulceration, bleeding, or phlebitis.

How will EVLT™ treat my varicose veins?

EVLT™ is a quick, minimally invasive laser procedure that leaves no scar, has a short and relatively pain-free post operative recovery period, and is performed under local anesthesia in the doctor’s office.

The affected area of the leg is anesthetized locally and a thin laser fiber is inserted into the abnormal vein, delivering the laser energy in short pulses.

The laser energy damages the vein walls, shrinking them and thus closing the faulty vein so that blood can no longer flow through it. There are many veins in the leg, and after treatment the blood in the faulty veins will be diverted to normal veins in order to make its way back to the heart.

At the end of the procedure, the fiber is withdrawn and a compression bandage is applied and worn for 2 days.  A compression stocking is also worn for 2 weeks.

Is the procedure painful?

Discomfort during the procedure is minimal. You may have some bruising and soreness for 7-10 days after the treatment. Over-the-counter, non-aspirin, oral pain relieving medication can be taken as needed.

Will I be able to resume my normal activities after the procedure?

Yes. Walking immediately following the procedure is encouraged and normal daily activity can be resumed immediately, but vigorous activity such as gym workouts should be avoided for one week.  Patients typically return to work the next day.

What is the cost of the procedure?

This procedure may or may not be a covered benefit through your insurance. Our staff will notify your insurance company prior to the procedure to obtain prior authorization. If the service is not covered by your insurance, you will be notified of this and given more information regarding anticipated costs and payment arrangements. The overall cost includes the procedure, follow up ultrasound imaging, and follow-up visits (usually scheduled at 1 week, 1 month, 3 months and 6 months). Please feel free to call our staff for further information.

What if I have more questions?

If you have any questions or concerns about this procedure, please feel free to write them down and bring them with you to your next appointment with the physician. If you do not have an appointment scheduled, you may call our office at (207) 956-6650 and we would be happy to schedule one.

Technology Updated

Did You Know? We treat varicose veins and spider veins? Varicose veins are swollen veins which protrude in a rope-like manner under the skin. Normal veins, by virtue of one-way valves, channel blood against gravity up the leg and back to the heart. When a valve becomes defective, it allows blood flow to leak back down the leg resulting in congestion and swelling of the vein. This is a medical condition called Venous Insufficiency.
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