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Modern endovenous laser therapy services augment scope of cosmetic surgery practices

Article-Modern endovenous laser therapy services augment scope of cosmetic surgery practices

Key iconKey Points

  • Cosmetic surgeons are uniquely qualified to compete in the market for vein treatment, clinician says
  • Lasers for vein treatment are less expensive than other cosmetic lasers
  • Procedures may be covered by insurance or Medicare if leg veins are treated not only for cosmetic reasons

Endovenous laser therapy has revolutionized the treatment of varicose vein disease and has paved the way for such treatment's implementation into any full-service cosmetic surgery practice, said David A. Hendrick, M.D., at the 2012 scientific meeting of the American Academy of Cosmetic Surgery.

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"Traditional surgical treatment of leg veins by stripping and ligation is associated with significant postoperative morbidity, a potential for scarring and a high rate of recurrence. In contrast, endovenous laser treatment is minimally invasive, very effective, and involves minimal to no downtime. Whereas I previously referred patients to a vascular or general surgeon if they were seeking treatment for leg veins, once I realized what laser treatment offered, I jumped on board with both feet," says Dr. Hendrick, who is in private practice in Salina, Kan.

Cosmetic surgeons are uniquely qualified to compete in the market for vein treatment, Dr. Hendrick says, and adding vein care to a cosmetic surgery practice is a natural fit. For cosmetic surgeons, their existing practice population and referral sources provide a ready-made patient stream.

In addition, cosmetic surgeons are already accustomed to using tumescent anesthesia, which is used in endovenous laser therapy, and those who have office-based surgery suites can perform the vein treatment with sedation, thereby offering patients increased comfort as well as convenience, he explains.

Laser vein treatment also makes good sense from an economic perspective, Dr. Hendrick says. "Lasers used for vein treatment are less expensive than other types of cosmetic lasers, and they have a higher return on investment since one patient may likely need multiple procedures. Furthermore, I found that laser vein treatment was recession-proof," he says.

Dr. Hendrick says he first began performing vein treatments in early 2008, at a time when many people were postponing other elective cosmetic surgeries. Once he was up and running, however, he says the vein treatment aspect of his practice did well and allowed him to maintain his practice revenue at a steady state.

PRACTICE ROAD MAP Dr. Hendrick says that once he decided to explore adding vein care, his first step was to choose the technology he would use. Although there are multiple laser platforms for leg vein treatment, and radiofrequency is also an option, he decided on the 1,320 nm Nd:YAG laser (CTEV, CoolTouch 1320), which, because of its wavelength and mechanism of action, seemed to offer the best safety profile in terms of minimizing damage to surrounding tissues.

After spending one week training with John Kingsley, M.D., who is a manufacturer-certified physician trainer for the CTEV laser, and learning to use Duplex ultrasound (which is needed for evaluation and during the laser treatment), Dr. Hendrick started to market this new service to his existing patient population through direct mail and email. Soon, he also began sending information packets to potential physician referral sources, and he ran some print ads. The latter caught the attention of a local reporter who wrote an article about the practice. Dr. Hendrick says his appointment book filled up rapidly.

"Leg vein problems are common in a cosmetic surgery patient population, and referrals also came in quickly from physicians and by word-of-mouth from successfully treated patients. Leg veins are a problem that many other physicians don't want to deal with, and the endovenous laser treatment has very high patient satisfaction because of its excellent results and minimal postoperative care and recovery," Dr. Hendrick says.

For marketing purposes, Dr. Hendrick notes he decided to brand his vein treatment services separately from the rest of his practice so that the procedure would be perceived as one that provides specific benefits that are distinct from improved cosmesis. He chose the name The Vein Clinic at Salina Surgical Arts Center.

"Leg veins are a cosmetic issue for some patients, but they can also be a cause of significant discomfort and lead to complications, including swelling, infection, bleeding and ulcers. Treating leg veins helps patients feel better about how they look but also has positive medical consequences," he explains.

When leg veins are being treated not only because they are a cosmetic concern for the patient, the procedure is usually covered by private insurance or Medicare, Dr. Hendrick explains. Eligibility criteria for coverage require that the patient be experiencing symptoms and failed conservative therapy, which might include wearing compression hose stockings for three months.

Disclosures: Dr. Hendrick reports no relevant financial interests.

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