Understanding Potential Side Effects After Varicose Vein Surgery

I. Introduction

Varicose veins are enlarged, twisted veins that commonly appear in the legs and feet due to weakened valves and increased pressure in the veins. They affect approximately 30% of adults in Hong Kong, with women being more prone to developing them than men. Varicose vein surgery is a medical procedure aimed at removing or closing these problematic veins to alleviate symptoms such as pain, swelling, and skin ulcers. While the surgery is generally safe and effective, it is crucial for patients to understand the potential side effects to make informed decisions and prepare for post-operative care. Being aware of these side effects can help manage expectations and ensure a smoother recovery process.

II. Common Side Effects

A. Pain and Discomfort

After varicose vein surgery, it is normal to experience some degree of pain and discomfort, particularly around the treated areas. This pain can range from mild to moderate and is often described as a dull ache or throbbing sensation. The intensity of pain varies depending on the type of surgery performed—minimally invasive procedures like endovenous laser treatment (EVLT) typically result in less discomfort compared to traditional vein stripping. To manage pain, doctors may prescribe over-the-counter pain relievers such as ibuprofen or recommend cold compresses to reduce inflammation. Elevating the legs and wearing compression stockings can also help alleviate discomfort by improving blood circulation.

B. Bruising and Swelling

Bruising and swelling are common side effects following varicose vein surgery, as the procedure involves manipulating the veins and surrounding tissues. Bruising occurs due to minor bleeding under the skin, while swelling is a natural response to tissue trauma. These symptoms usually peak within the first 48 hours and gradually subside over 2–3 weeks. To minimize bruising and swelling, patients are advised to:

• Keep the legs elevated whenever possible
• Apply ice packs for 15–20 minutes at a time
• Avoid prolonged standing or sitting
• Follow a gentle walking routine to promote circulation

C. Skin Discoloration

Skin discoloration, or hyperpigmentation, can occur after varicose vein surgery due to the leakage of blood pigments into the surrounding tissues. This condition is usually temporary and fades within a few months. However, in rare cases, it may persist for up to a year. Patients should monitor the discolored areas for signs of infection, such as increased redness, warmth, or pus. If these symptoms appear, seeking medical attention is essential to prevent complications.

III. Less Common, But Possible Side Effects

A. Nerve Damage

Nerve damage is a rare but possible side effect of varicose vein surgery, particularly when the procedure involves incisions near sensitive nerves. Symptoms may include numbness, tingling, or a burning sensation in the affected area. Most nerve injuries heal on their own within a few months, but severe cases may require physical therapy or medication to manage symptoms. Patients should report any unusual sensations to their surgeon promptly.

B. Deep Vein Thrombosis (DVT)

Deep vein thrombosis (DVT) is a serious condition where a blood clot forms in a deep vein, usually in the leg. While the risk of DVT after varicose vein surgery is low (less than 1%), it is crucial to be aware of the symptoms, which include:

• Severe leg pain or cramping
• Swelling that worsens over time
• Red or discolored skin

Preventive measures such as early mobilization, hydration, and wearing compression stockings can significantly reduce the risk of DVT.

C. Infection

Infections after varicose vein surgery are uncommon but can occur if bacteria enter the surgical site. Signs of infection include fever, increased pain, redness, and discharge. Treatment typically involves antibiotics and proper wound care. Patients should keep the surgical area clean and dry to minimize infection risks.

D. Allergic Reactions to Anesthesia

Allergic reactions to anesthesia are rare but can range from mild skin rashes to severe anaphylaxis. Patients with a history of allergies should inform their surgeon beforehand. If an allergic reaction occurs, immediate medical intervention is necessary.

IV. Long-Term Considerations

A. Recurrence of Varicose Veins

While varicose vein surgery is effective, recurrence can happen due to factors like genetics, obesity, or prolonged standing. To prevent recurrence, patients should maintain a healthy weight, exercise regularly, and avoid sitting or standing for long periods.

B. Scarring

Scarring is inevitable after surgery, but minimally invasive techniques result in smaller, less noticeable scars. Scar management techniques include silicone gel sheets, massage, and avoiding sun exposure.

V. Minimizing Risks and Managing Side Effects

Choosing a qualified surgeon, adhering to post-operative instructions, and leading a healthy lifestyle are key to minimizing risks. Regular follow-ups ensure timely detection of any complications.

VI. When to Seek Medical Attention

Seek immediate medical attention for symptoms like severe pain, persistent swelling, or signs of infection. Regular follow-ups are essential for monitoring recovery.

VII. Conclusion

While varicose vein surgery has potential side effects, most are manageable and temporary. The benefits of the procedure often outweigh the risks, leading to improved quality of life for many patients. By understanding and preparing for these side effects, individuals can achieve a smoother recovery and better outcomes.