He is certified by the American Board of Surgery and is a fellow of the American Academy of Cosmetic Surgery and the American Society for Laser Medicine and Surgery. Among other memberships, he is a member of the American Society of Transplant Surgeons and American College of Phlebology.
Dr. Giraldo cofounded Advanced Vein Center in Pittsburgh, Pennsylvania, and Medilaser, Cosmetic Surgery and Vein Center in Frisco, Texas. He specializes in the treatment of varicose veins in the context of cosmetic surgery.
who are good candidates for wearing graduated compression garments?
Compression stockings aid those with chronic venous disorders, edema, stasis, skin changes and for those who have had or will be having a vein procedure. On the other hand, anyone, especially those who stand for long periods of time on their feet, can benefit from compression stockings.
This non-surgical procedure is frequently used to treat visible spider veins and small varicose veins near the surface of the skin. Spider veins, tiny red or purple dilated blood vessels, and reticular veins, larger blue vessels, form when venous blood flow is abnormal. Although smaller than
Sclerotherapy is a technique that uses chemical agents injected into the
veins that cause them to collapse or obliterate. This is a non-painful
procedure that is very well tolerated without anesthesia at all. The
sclerosing agent that Medilaser, Cosmetic Surgery and Vein Center
utilizes is POL, a former local anesthetic used in epidural anesthesia
for obstetric procedures in the past. It is commercially available as
Asclera, the only FDA approved POL available in the United States. It is
safe and effective having minimal reported complications as per today.
Patients undertake their injections in a friendly and relaxed
environment without pain at all. The procedure is completed in 30-45
minute sessions. Depending on the severity of the condition, regularly
more than one session is needed to achieve maximum desirable results.
who are good candidates for sclerotherapy?
Anybody who has visible unwanted veins is a good candidate.
which unsightly veins can be treated with sclerotherapy?
Spider veins that are located in the chest and legs can be treated.
what about small vessels in the face?
Medilaser uses laser technology to treat spider veins in this location.
Breast - Particularly after pregnancy or augmentation procedures, frequently developed are engorged blue veins. These vessels are easily obliterated with one or more sessions of Asclera injections.
Hand and arm superficial veins - Obliteration of these veins using sclerotherapy produces remarkable rejuvenation results. This procedure is popular among women who are concerned about their aging hands.
is the procedure covered by health insurance?
Usually it is not. However, with good documentation of medical necessity some insurance companies agree to cover few sessions of sclerotherapy.
what causes spider veins?
Spider veins are typically caused by abnormal blood flow and weakening of the blood vessel wall. Any condition or activity that places pressure on the veins (like weight gain, prolonged sitting or standing) can contribute to their development.
Spider veins increase with age and thus are quite common in the elderly. There is also a genetic basis, since spider veins do tend to run in families. In pregnancy, spider veins are quite common and have been associated with an increase in the female sex hormone, estrogen. Estrogen is known to weaken the walls of the veins and may contribute to the development of spider veins.
Once developed, spider veins generally get worse and do not resolve on their own. Weight gain, lack of exercise and a sedentary life style is associated with progression of spider veins.
Appropriate candidates for laser vein removal are those individuals who have spider veins, who are non-smoking individuals, are physically healthy, and has no disease of the blood vessels or problems with bleeding. Since in laser vein removal lasers directly contact the skin, those with a tendency to form keloid scars are not ideal candidates. Skin tone can also be affected by laser vein removal treatment, so it is best to talk to your doctor about the type of laser appropriate for you.
is the treatment Painful?
During your treatment, you may feel a slight tingling sensation as the laser fires.
what preparations are needed?
Avoid sun exposure, aspirin, alcohol and not smoke for at least a week prior to the procedure. On the day of the treatment, avoid all creams, lotions and moisturizers on the area that is going to be treated.
is the treatment covered by insurance?
No. Spider veins do not cause symptoms and are of a cosmetic concern only.
Approximately 25 million people in the United States have this condition. Moreover, half of women over 50 and more than three quarters of women over 65 have reported suffering various degrees of leg varicose veins, pain or swelling. In general, veins are responsible for taking blood against gravity back to the heart. When veins are incompetent as in reflux disease, blood does not flow to the heart completely. Some of it leaks back with gravity and pool in the leg veins. This causes for the veins to bulge and stretch resulting in unpleasant side effects such as: aching and throbbing pain, itching, numbness, heavy and tired legs, night cramps, and restless leg syndrome. Varicose veins are bulging dilated vessels that are located in various parts of the body especially legs and female genitalia. Although there is an important family trait, varicose veins are a frequent complication of pregnancy, birth control pills and certain occupations where standing for prolonged periods of time is required.
Traditionally, venous reflux disease was treated with a painful surgery known as vein stripping. Now, patients can be treated at Medilaser, Cosmetic Surgery and Vein Center with a minimally invasive procedure known as Venefit™ Targeted Endovenous Therapy, formerly Closure Procedure™, which uses readiofrequency energy (similar to laser but with lesser side effects or complcations). This method corrects the abnormal venous circulation that causes varicose veins, spider veins and leg pain. Using ultrasound technology to visualize the veins to be treated, the entire procedure is carried out under local anesthesia, through a 3 mm puncture incision. Patients are awake and comfortable during the procedure, which is completed in less than 30 minutes at a time. Within one hour, they are back performing their routine activities or work. There is minimal pain if any after the surgery.
who are good candidates for the venefit™ procedure?
Anyone with venous reflux disease, who experience bulging veins, leg pain, swelling, discomfort, cramps, heaviness and restless leg syndrome and have ultrasound documentation of their condition. Since the procedure is performed under local anesthesia in the office setting, the risk of complications is minimal.
what is the difference between laser ablation and radiofrequency ablation?
Although they are similar, minimally invasive techniques (endovascular treatments under ultrasound guidance and local anesthesia) differ in complication rates and collateral damage. Radiofrequency is a much safer technique, because it uses heat related collagen contraction to close the treated vein in comparison to laser which causes severe vascular damage and blood boiling inside the treated vein.
is this procedure covered by health insurance?
Yes, most insurance plans cover the evaluation and treatment of this medical condition regardless the cosmetic benefits associated with it. Our billing specialists will assist you to make sure there is not a financial burden to you or your family.