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VASCULAR LESIONS

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Plastic surgeons are often called upon to deal with vascular lesions, aiming to improve the body image of a male or female patient.

Vascular lesion:
•    Mostly occur around the face or the feet.
•    Concern men and women.
•    Can be of larger or smaller diameter.
•    Can be of red or dark blue coloration.
 
WHERE VASCULAR LESIONS ARE LOCATED

Vascular lesion are usually located around the calves or the thighs as far as the body is concerned; when located on the face, they may appear on the cheeks, nose, or any other area. Apart from these locations, however, on rare occasions, they can appear in any other area of the body.

TYPES OF VASCULAR LESIONS

In terms of type, vascular lesions are divided into couperoses and varicose veins.
The term couperoses refers to thin, red or possibly slightly darker coloured vessels, which tend to appear similar to a spiderweb in form, having a diameter of approximately a millimetre.

Usually, these tend to be located on the lower limbs and can be encountered in several areas where they form a very thick network of thin vessels.

Every group of vessels tends to be supplied by one or more larger vessels, known as feeding blood vessels. Feeding vessels are particularly important to this treatment, as the doctor must aim to eliminate the feeding vessel in order to cure the entire network of couperoses that depend upon it.

Contrarily, couperoses on the face appear as a diffuse redness, when seen from afar, whereas when the face is carefully examined the observers will note several thin, diffuse blood vessels with a diameter that is usually less than a millimetre.

When referring to issues of the vascular veins (which some label as phlebitis), we mean the thicker vessels that are mainly located in the lower limbs, around the calves and thighs. These vessels have a diameter of more than half a centimetre, and very often have a sigmoid course (in the shape of an S). This dilation of the vessels is caused by damage to the central veins. This means that these veins have undergone some damage to their walls, causing them to dilate and not be able to work properly, meaning they cannot properly carry blood back to heart from the feet and legs. Any problems in the vein network can be confirmed via an ultrasound scan known as triplex. Correction is surgical, and performed by practitioners who specialize upon such problems. The plastic surgeon is not authorized to correct these veins, but can co-operate with a specialized doctor, in order to deal with the couperoses and varicose veins in their totality.


TREATMENT OF COUPEROSES
Essentially there are two main methods to treat couperoses, thesebeing sclerosant injections and lasers.

a) LASERS
A laser is a devise which emits energy. There are specialized lasers for dealing with couperoses, which emit energy that can be absorbed selectively by the vessel. Once the vessel has absorbed this energy, it superheats and its walls break apart. The organism then absorbs the destroyed blood vessel. It is very important to apply the correct laser to the correct vessel. Particularly when dealing with couperoses in the facial area, treatment is performed exclusively using lasers. In very few cases can facial blood vessels be cured using sclerosant injections. Since the vessels of the face are very thin, the correct type of laser must be used. As the laser’s energy is also absorbed by black and other dark colours, it is important that the patient’s skin be as pale as possible in order for this method to be effective.



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b)SCLEROSANT INJECTIONS
Sclerosant injections utilize a drug that destroys the walls of blood vessels. When attempting to cure couperoses, it is precisely this destruction of the vessels’ walls that is desirable. The organism can then absorb the destroyed walls and erase the couperose. During this procedure, the doctor inserts a small quantity of the sclerosant substance into the vessel. The vessel empties of blood and fills up with the substance instead, which then proceeds to break down its walls. The larger the diameter of the vessel, the more concentrated the sclerosant substance that the doctor will have to use. It is most important for the doctor to locate the feeding blood vessel, which, if destroyed, will ensure that all others vessels that branch out from it are erased. 

A comparison cannot be made between the two methods, as some couperoses are treated better by sclerosant injections, while others are more easily dealt with using lasers. Thankfully, both methods are easily available to employ, which can guarantee the best result. 



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THE RESULTS OF TREATING VASCULAR LESIONS

The process of correcting couperoses, whether it comes to sclerosant injection treatment or laser treatment, demands several repetitious sessions. It cannot be performed in one sitting. Of course, each session will see a visual improvement to some degree. Usually, the number of repetitions required is between 3 and 10. These repetitions are made approximately every one-and-a-half to two months. For this reason, it is best for the patient to pursue the treatment early on, well before the summer period, when they will be chiefly concerned about the result.

After the treatment, it is best for the patient to use pressure socks. These socks are particularly applied to varicose veins and tend to be provided at pharmacies or footwear stores.

Walking is allowed, and couperose treatment should not prevent the patient from engaging in their daily activities; they should be able to return to them immediately. For the sake of precaution, however, more taxing activities should be avoided for up to one day following the operation.

As far as appearance is concerned, the locations of the couperoses will be somewhat inflamed and possibly dotted with bruising in places, which should fade away altogether after 10-15 days.

Couperoses that have been treated do not reappear, provided there isn’t a deeper problem with the blood vessels. However, if the patient has a tendency to suffer from couperoses, it is likely that some will appear that would have appeared in any case, whether or not the patient had undergone the treatment.

Provided there is no deeper problem with the blood vessels, the results are very satisfactory. A little patience is simply required, as the procedure is quite time-consuming.