What varicose veins really are.
Your leg veins carry blood upward, against gravity, back toward the heart. To do that, they rely on one-way valves — tiny flaps inside the vein that open to let blood through and close to keep it from falling back down. When those valves weaken or fail, blood flows backward and pools in the lower leg. That backward flow is venous reflux, and the pressure it builds is chronic venous insufficiency.
Over time, that pressure stretches the veins until they bulge and twist under the skin. The visible varicose veins are the downstream consequence of valve failure higher up — usually in the great saphenous vein or its branches. That's why every plan starts by mapping what's happening beneath the skin, not just treating what's visible on the surface.
Venous insufficiency is common, and it is often undertreated because patients assume these symptoms are simply part of getting older. They're not. Left untreated, it can progress to skin discoloration, venous ulcers near the ankle, and an increased risk of deep vein thrombosis (DVT).
Symptoms and risk factors.
Common symptoms
- Leg aching, heaviness, or cramping — often worse after standing and better with your legs up
- Swelling in the ankles and lower legs that can leave sock-line marks by evening
- Restless legs, especially at night
- Itching or burning over a vein
- Visible bulging, rope-like veins on the thighs or calves
- Reddish-brown discoloration or hardening of the skin near the ankle
- Non-healing wounds near the ankle (venous ulcers) in advanced disease
Who's at higher risk
- A family history of varicose veins or venous insufficiency
- Women — especially during and after pregnancy
- Jobs with long hours standing or sitting — nursing, teaching, food service, manufacturing
- Age, excess weight, or a prior deep vein thrombosis (DVT)
Sudden swelling and pain in one leg can signal a blood clot — seek medical care right away. Call 911 for chest pain or shortness of breath.
How we diagnose it.
You don't need a referral — call us directly and we'll get you on the schedule. The evaluation happens in three steps, and nothing is decided without you.
1. Consultation and exam
Your first visit is a conversation and an exam with one of our surgeons: your symptoms, your history, and a careful look at your legs. Vein consults are available at both our Lake Charles and Sulphur offices.
2. Mapping ultrasound — its own appointment
If your story and exam point toward a vein problem, a painless, non-invasive venous reflux ultrasound is scheduled as a separate appointment in our Lake Charles office, performed by a vascular technologist. It shows which valves are failing, how severe the reflux is, and which veins are driving your symptoms — and it's the study insurance requires before approving treatment.
3. Follow-up visit and your plan
At your follow-up visit, one of our surgeons reviews the map with you, explains what it shows, and builds your treatment plan — including what your insurance requires before a procedure.
Treatment options.
Modern vein treatment is minimally invasive. Which option fits depends on the anatomy your ultrasound shows, and many patients benefit from a combination.
The preferred treatment for a failing trunk vein like the great saphenous vein. A thin laser fiber is threaded into the vein through a single needle puncture under ultrasound guidance and seals it closed; blood reroutes through healthy veins. Local anesthesia, about 45 to 60 minutes per leg, performed at Imperial Calcasieu Surgical Center. Most patients walk out the same day and are back to a desk job within one to two days.
An FDA-approved microfoam injected into the diseased vein through one or two needle sticks — no incisions. Especially useful for twisting or branching varicose veins a laser fiber can't easily reach. Performed in our Lake Charles office in under an hour; most patients return to work the same day or the next.
Removes bulging surface varicose veins through tiny 1–2 mm punctures under local anesthesia, with no stitches and minimal scarring. Often combined with EVLT when both are indicated.
Compression stockings and self-care
Graduated compression stockings, leg elevation, regular walking, and weight management ease symptoms and are often required by insurance before a procedure — but they can't repair a failed valve. For significant reflux, treating the diseased vein is the only way to address the root cause.
After EVLT or Varithena, you go home in an ACE wrap, switch to a compression stocking the next morning, and wear it for two weeks. A follow-up DVT ultrasound at one to two weeks checks the deep veins for blood clots. Full instructions are on the Patient Info page.
We don't perform vein stripping — EVLT and Varithena have made it essentially unnecessary.
Insurance coverage.
When varicose veins are caused by documented venous insufficiency and produce symptoms like pain, heaviness, or swelling, treatment is medical — not cosmetic — and is covered by most insurance plans, including Medicare and Medicaid. Most plans look for three things:
- Documented symptoms
- Reflux confirmed on ultrasound
- A completed trial of compression stockings — typically six to twelve weeks
Our team verifies your benefits and handles prior authorization before your procedure. Purely cosmetic vein treatment is typically self-pay, with CareCredit financing accepted. See the plans we accept, or call (337) 425-9300 and we'll check your specific plan.