Minimally Invasive Vein Surgery: From Cardiovascular Surgery to Innovative Outpatient Techniques
As my professional background indicates, my original training in cardiovascular surgery (heart and arteries) did not exclude vein surgery, which in the 1980s and 1990s primarily involved varicose veins of the lower limbs.
The standard procedure in this field, known as “stripping” - which was highly invasive and hemorrhagic, with often painful postoperative complications - required several days of hospitalization and the prolonged use of a bandage after surgery. It was in reaction to this type of approach, which stood in stark contrast to the elegance of the cardiac and arterial surgeries I was performing elsewhere, that I became one of the leading pioneers in France of a different type of venous surgery - both outpatient and minimally invasive - using alternative methods, with a publication on this topic as early as 1991 and another landmark study on over 1,222 cases in 1994.
I was also the author of the first publication in France on the treatment of saphenous veins—the primary cause of varicose veins—using endovenous laser therapy (2001).
More information
- Media Coverage and Initial Requests for Cosmetic Treatment of Hand Veins
- The turning point : toward surgery for unsightly, non-pathological swollen veins
- 25 Years of Experience in Cosmetic Vein Surgery: Refinement and Expertise
- A rare discipline in Europe and North America : a pioneering and regular practice
Media Coverage and Initial Requests for Cosmetic Treatment of Hand Veins
This work led to me frequently appearing in the media at the time (television*, radio, general-interest articles) regarding venous surgery. It was in this context that an event occurred that I had absolutely not anticipated or even imagined: a patient came to see me in late 1999 regarding the veins on her hands: “They look like a man’s, Doctor; it’s ugly—could you remove them?”
I replied that it was theoretically possible but that I had never done it before, and that in any case I wasn’t going to do it because while these veins were certainly unsightly, they were perfectly functional, whereas I was only operating on diseased veins that were no longer performing their normal drainage function, such as the saphenous veins in the lower limbs when they are the source of varicose veins.
Other similar requests followed, to which my response remained the same.
The turning point : toward surgery for unsightly, non-pathological swollen veins
The turning point came shortly thereafter: in late 2000, the wife of one of my good friends - a pretty woman but very thin, with little body fat - asked me to remove her long saphenous veins, which were visible on her legs, from her feet up to her groin, when she wore a swimsuit or shorts in the summer.
On Doppler ultrasound, the two veins in question were slightly dilated but generally healthy. I told her, “No, your saphenous veins are functioning well.” She pressed the issue twice in a row. Finally, while making it clear that it went against my ethics, I gave in to her request and operated on her : she was delighted with the result, far beyond what I had anticipated - truly radiant ! It was a revelatory shock for me.
By limiting myself to operating only on pathological conditions, I lacked the constant concern of the plastic surgeon who takes into account the psychological well-being of the people he treats. Realizing I was wrong, I began to say “yes” where I had previously said “no,” and in 2001, I became interested in this very specific outpatient surgery for unsightly swollen veins located other than the lower limbs.
At the time, there were no technical references on this specific topic that I could rely on. So I taught myself.
25 Years of Experience in Cosmetic Vein Surgery : Refinement and Expertise
I never made a big deal out of this practice, which relied on word-of-mouth limited to my patient base and resulted in only a few procedures per year (fewer than ten).
Twenty-five years of practice have nevertheless led me to deepen my knowledge in this field, correct some of my mistakes, refine the technique, and improve the results.
A rare discipline in Europe and North America : a pioneering and regular practice
I always thought that other surgeons had been led, like myself, to operate on these unsightly veins. To my great surprise, it seems that very few of us have ventured into this very specialized field.
I may even be currently the most experienced - and, it appears, the only one - to practice it regularly, at least within the European Union.
