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Assessment, treatment and new approaches to facial veins

02 November 2021
Volume 10 · Issue 9


Patients with prominent or cosmetically embarrassing facial veins may often seek an aesthetic opinion for removal. The authors present a methodology to approach classifying facial veins by describing the veins in terms of position, colour, size and flat or bulging appearance. Tiny telangiectasia (also known as thread or spider veins) or smaller discrete blue/green or green veins are regularly treated by heat, using electrocautery, radiofrequency, intense pulsed light or extra-corporeal laser. However, the authors present the use of microphlebectomy, endovenous laser and arterial ligation for larger facial veins and arteries that are often thought to be too big or complex to treat.

Facial veins that cause embarrassment or distress in patients are one of the most common presentations to aesthetic practitioners. Such veins range from small red or purple telangiectasias through to green veins that may be flat or bulging, to large colourless blood vessels that bulge conspicuously.

Traditionally, aesthetic practitioners have been happy to treat individual telangiectasia, multiple telangiectasias, rosacea or small blue/green veins with a number of different electrical or light-based modalities. However, as the field of aesthetic phlebology increases, more patients are presenting with larger bulging veins of the temple, forehead or face that cannot be treated with these traditional approaches.

In this article, the authors will briefly detail current practice but will primarily concentrate on some of the new and exciting techniques for treating larger and more complex facial veins and blood vessels.

Any classification is only useful if it helps practitioners to understand appropriate treatment strategies for each category. For facial veins, the most useful four pieces of information are position, colour, size and flat or bulging appearance.

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