Vein Conditions Treated
Vein Conditions Treated in Santa Monica Vein Center
Venous disease exists on a spectrum — from cosmetically bothersome spider veins at the surface to large, symptomatic varicose veins caused by deep venous valve insufficiency. Understanding where a patient sits on that spectrum determines which treatment is appropriate. Dr. Karamanoukian evaluates each patient's complete vein anatomy before recommending any treatment protocol.
Spider Veins
Spider veins (telangiectasias) are the smallest visible vein abnormalities — fine red, blue, or purple vessels less than 1mm in diameter that appear in web-like patterns most commonly on the thighs, calves, and ankles. Spider veins are primarily a cosmetic concern but can cause mild burning or itching. They respond well to liquid sclerotherapy in 2–4 treatment sessions at the Santa Monica Vein Center.
Reticular Veins
Reticular veins are blue-green feeder vessels 1–3mm in diameter that lie just beneath the skin surface and feed spider vein clusters. Treating spider veins without addressing the underlying reticular feeders leads to rapid recurrence. Dr. Karamanoukian identifies and treats reticular veins with sclerotherapy as part of a comprehensive vein treatment protocol — a key factor in producing durable results.
Varicose Veins
Varicose veins are enlarged, twisted vessels greater than 3mm in diameter that bulge visibly above the skin surface. They result from failure of the one-way valves within the saphenous vein system, causing blood to pool and the vein to dilate progressively. Varicose veins cause aching, heaviness, swelling, and fatigue in the legs — symptoms that worsen with prolonged standing. Treatment options range from ultrasound-guided sclerotherapy to ambulatory phlebectomy and surgical vein stripping.
Venous Insufficiency
Chronic venous insufficiency (CVI) is the underlying hemodynamic dysfunction responsible for most varicose veins. When the saphenous vein valves fail, blood refluxes backward down the leg with each heartbeat, increasing venous pressure and progressively dilating the veins. Symptoms include persistent leg swelling, skin discoloration, and in advanced cases, venous stasis ulcers. Dr. Karamanoukian evaluates for venous insufficiency with duplex ultrasound before treating any significant varicose vein presentation.
Facial Veins
Visible veins on the nose, cheeks, and temples are a common cosmetic concern among patients in the Santa Monica and Los Angeles area. Facial telangiectasias and reticular veins respond well to surface laser vein treatment or fine-needle sclerotherapy performed by an experienced vein specialist. Dr. Karamanoukian selects the appropriate modality based on the location, size, and skin type of the facial vessels being treated.
Hand Veins
Prominent dorsal hand veins are a frequent concern among patients seeking a more youthful hand appearance. While hand veins are normal anatomical structures, excessive prominence — particularly after volume loss in the hands with age — can be aesthetically undesirable. Dr. Karamanoukian offers sclerotherapy for hand vein reduction as part of a comprehensive hand rejuvenation approach at Kare Plastic Surgery in Santa Monica.
Symptoms that warrant evaluation: Leg aching, heaviness, or fatigue that worsens through the day; visible bulging or rope-like veins on the legs; persistent ankle or calf swelling; skin discoloration or thickening around the lower leg or ankle; itching or burning over visible veins; a history of superficial thrombophlebitis. Any of these symptoms in the context of visible leg veins warrants a vein consultation with Dr. Karamanoukian at the Santa Monica Vein Center. Call (310) 998-5533.
Varicose Vein Treatment Options at the Santa Monica Vein Center
Sclerotherapy
Sclerotherapy is the gold-standard treatment for spider veins and reticular veins — and one of the most effective non-surgical treatments for smaller varicose veins. A sclerosant solution is injected directly into the target vein using a fine needle, causing the vessel to collapse and be gradually reabsorbed by the body. Dr. Karamanoukian customizes the sclerosant concentration to the caliber of each vein being treated. Sessions last 30–45 minutes and require no anesthesia. Patients wear compression stockings for 1–2 weeks following treatment.
Ultrasound-Guided Sclerotherapy
For deeper reticular veins and perforating vessels not visible from the skin surface, Dr. Karamanoukian uses duplex ultrasound guidance to visualize and target the vein in real time during injection. Ultrasound-guided sclerotherapy allows precise treatment of the deeper feeder vessels that drive spider vein recurrence — a critical component of comprehensive vein care that many surface-only treatment providers do not offer. This technique is performed in-office at the Santa Monica Vein Center with no recovery time.
Laser Vein Ablation
Endovenous laser ablation (EVLA) uses thermal laser energy delivered via a thin fiber inserted into the vein to seal the vessel from within — the definitive treatment for great saphenous vein or small saphenous vein reflux causing significant varicose vein disease. Surface laser vein treatment uses external laser energy to target small facial and superficial spider veins without injection. Dr. Karamanoukian recommends the appropriate laser modality based on vein anatomy and treatment goals.
Ambulatory Phlebectomy
Ambulatory phlebectomy is a minimally invasive surgical procedure for removing large, bulging varicose veins through a series of micro-incisions — each less than 2mm in length — made directly over the vein. The vein is gently extracted through these tiny openings using a phlebectomy hook, leaving no sutures and only minimal visible scarring. Ambulatory phlebectomy is performed under local anesthesia in the office and allows patients to walk immediately. It produces a definitive result for large surface varicosities with a single treatment session.
"Varicose vein treatment is not one-size-fits-all. Spider veins need sclerotherapy. Reticular feeders need ultrasound-guided treatment. Large varicose veins may need phlebectomy. Getting the right treatment to the right vein — every time — is what produces results that last."
— Dr. Raffy Karamanoukian, MD FACS · Board-Certified Vein & Plastic Surgeon · Santa Monica Vein Center
Symptoms of Varicose Vein Disease
Varicose veins are not purely cosmetic. The following symptoms indicate underlying venous insufficiency that warrants clinical evaluation and treatment at the Santa Monica Vein Center:
Leg aching, heaviness, or fatigue — worsening throughout the day and with prolonged standing
Visible bulging, twisted, or rope-like veins on the thighs, calves, or behind the knee
Ankle and calf swelling that improves overnight with leg elevation
Itching, burning, or throbbing sensation over visible veins
Skin discoloration, hyperpigmentation, or lipodermatosclerosis around the ankle or lower leg
Night cramps or restless legs associated with visible varicose veins
History of superficial thrombophlebitis or prior deep vein thrombosis
Venous stasis ulcer or healed ulcer at the medial ankle or lower leg
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Frequently Asked Questions
Where can I get varicose veins treated in Santa Monica?
Dr. Raffy Karamanoukian at Kare Plastic Surgery and the Santa Monica Vein Center offers comprehensive varicose vein and spider vein treatment at 804 7th Street, Santa Monica, CA 90403. Services include sclerotherapy, ultrasound-guided sclerotherapy, laser vein ablation, ambulatory phlebectomy, and surgical vein removal. Serving Santa Monica, Los Angeles, Beverly Hills, Pacific Palisades, Brentwood, and Malibu. Call (310) 998-5533 to schedule a vein consultation.
What is the best treatment for varicose veins in Los Angeles?
The best treatment depends on the size, depth, and distribution of the veins. Spider veins and reticular veins respond best to sclerotherapy. Larger varicose veins may require ultrasound-guided sclerotherapy, ambulatory phlebectomy, or endovenous laser ablation. Severe venous insufficiency may require surgical intervention. Dr. Karamanoukian evaluates each patient's complete vein anatomy at consultation and recommends the most appropriate individualized protocol. Call (310) 998-5533.
Is sclerotherapy painful and how many sessions does it take?
Sclerotherapy involves small injections with a fine needle — most patients describe a mild sting with each injection that resolves immediately. No anesthesia is required. The number of sessions depends on the extent of vein involvement. Spider veins typically require 2–4 sessions spaced 4–6 weeks apart. Reticular and varicose veins may require additional sessions or a combination of treatment modalities. Dr. Karamanoukian provides individualized treatment plans at the time of consultation. Call (310) 998-5533.
Do varicose veins come back after treatment?
Treated veins do not return once successfully eliminated. However, underlying venous insufficiency is a chronic condition — new veins can develop over time, particularly with prolonged standing, pregnancy, weight changes, or genetic predisposition. Dr. Karamanoukian at the Santa Monica Vein Center provides long-term vein management and maintenance sclerotherapy to address new vein formation as it develops, keeping patients' results looking their best over time. Call (310) 998-5533.
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