Why do I have spider veins?

Spider veins are simply varicose veins that are located superficially in the skin.  Although a very common problem, women usually present with the question “But Doctor, why do I have spider veins?”

There are several reasons spider veins develop.  At the root of almost any varicose vein problems is the failure of the tiny valves on the inside of the vein.  These small valves on the inside walls of the veins keep the blood in the veins flowing in a one way direction back towards the heart.  Any factor that causes the valves to fail creates varicose veins or spider veins.  The most common factors encouraging the development of spider veins include multiple pregnancies, prolonged standing or stress on the legs, hereditary influences and the effect of either natural or supplemental estrogen.  As would be expected from reviewing this list of risk factors spider veins are much more common in women than men. 

During pregnancy the unborn child compresses the inferior vena cava and creates some degree of outflow obstruction of venous blood from the lower extremities leading to engorgement of the veins, valve failure and the eventual development of varicosities.  Wearing support hosiery during the later stages of pregnancy can often help counter this problem but cannot totally prevent spider veins in most at risk women.

Women in professions that require prolonged periods of standing such as hairdressers, flight attendants, teachers and store clerks are at significant risk to develop spider veins.  Venous pressure in the legs increases during periods of standing but decreases significantly with walking due to the pumping action of the calf muscles.  If long hours of standing cannot be avoided properly fitting graded support hosiery can be a life saver. 

Estrogens provide women with their beautiful feminine characteristics but they also have an effect to relax the smooth muscles that line the walls of veins causing them to more easily dilate under pressure creating varicose or spider veins.  This effect seems to be especially common in women who have taken estrogen replacement medication for a prolonged period.

Spider veins are commonly treated by one of two methods, serial laser or Sclerotherapy treatments.  Having personally used both methods, I can honestly say Sclerotherapy has proven to be the most effective form of treatment for my patients.  Sclerotherapy involves the placement of small amounts of a solution into the veins which is designed to cause spider veins to shrink and disappear.  Treating the spider veins by this method is safe and causes no harm to the surrounding normal veins. 

Most patients require two or three Sclerotherapy sessions spaced several weeks apart to most effectively treat the spider veins.  Winter months are usually a great time to begin treatment to be ready for spring shorts and bathing suit season.  Please visit Dr. Burkett’s website for additional information or to schedule a consultation.

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Facelift: “I just want to look as young as I feel!”

Patients considering facelifts often present to my office a little distressed about the whole subject.  They usually say “I don’t want to look unnatural or operated on; I just want to look as young as I feel.”

Patients typically have a number of reasons for not wanting to “look so old.”  Many patients have worked hard all of their lives and are now ready for retirement and travel and want to be very socially active.  These patients want to feel confident in their appearance and see a more youthful face that can be obtained through a facelift as simply an extension of good grooming.

Still some women voice the common question, “I wonder if I am being vain or selfish to consider a facelift?”  My answer to this question is “If you feel it would help your appearance and make you feel more confident, I am sure you have earned it!”  I feel most women I meet in my private office in Mansfield, Texas have been extremely self sacrificing for their spouses and children all of their lives and they have earned a facelift and much more!

The pleasant surprise is a facelift is not a difficult procedure to have performed.  Post operative discomfort is minimum with recovery and return to normal activity is relatively rapid.  Today’s facelift procedures are designed to deliver a much more natural, refreshed non-operated appearance.  I personally experience a tremendous amount of gratification in simply helping my patient’s just look as young as they feel.  Please visit Dr. Burkett’s website for more information or to schedule a consultation.

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Do I need a tummy tuck or just liposuction?

 Patients often ask me, “Do I need a tummy tuck or just liposuction?”  The answer to this question is often easy.  There are usually three problems that make patients unhappy with their stomach, too much fat, too much skin, or loose abdominal muscles.

Patients who present with primarily an excess tummy fat problem, but good skin tone, no lower abdominal skin roll and little muscle stretch from previous child birth are great candidates for simple liposuction to improve their abdominal contour.  Liposuction has the advantage of minimal scars, little down time and less cost compared to most tummy tuck procedures.

Unfortunately, most patients do have some combination of the big three-too much fat, skin, and loose abdominal muscles.  For those patients liposuction treatment alone of their tummies will be a major disappointment.  Tummy tuck or abdominoplasty is the correct answer.

 I perform the abdominoplasty procedure by first aggressively liposuctioning away all excess abdominal and flank fat deposits.  Next loose abdominal muscles (rectus diastasis) are tightened by a suture technique.  Finally all excess, loose abdominal skin is removed through a lower abdominal scar easily hidden below the panty line.

Although tummy tuck procedures are more involved and require more recovery time than liposuction, the dramatic improvements they can offer the problem tummy is usually felt to be well worth it.  What most of my patients really want is a fantastic surgical result and for many of them abdominoplasty is what truly delivers.

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Advantages of Tissue Expander Breast Reconstruction.

Patients considering breast reconstruction following mastectomy for breast cancer have several options from which to choose.  Breast can be reconstructed from tissue transferred from another part of the body, such as the abdomen (TRAM flap), the back (Latissimus Flap), or under favorable conditions the remaining tissue on the chest can be used for a very satisfactory reconstruction using a tissue expander technique.

Patients often ask what the advantages of tissue expander breast reconstruction are.  In cases of immediate breast reconstruction, using a tissue expander technique adds minimal time and morbidity to the patients’ initial mastectomy procedure.  Patients are usually able to leave the hospital much sooner and return to their daily work activities more rapidly as compared to more extensive tissue transfer techniques such as TRAM or Latissimus Flap procedures.

Another advantage of the tissue expander technique for breast reconstruction is the avoidance of additional truncal scars of either the lower abdomen or back that can often times be of an unfavorable quality.

A second simple outpatient procedure is required with tissue expander reconstruction to remove the initial expander device and place a permanent silicone gel implant.  At the time of this second procedure the patient and surgeon have an opportunity to further fine tune the final reconstructed breast size and shape through surgical modification and breast implant choice.  Please visit Dr. Burkett’s website for additional information concerning breast reconstruction or to schedule a consultation.

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The Neglected Back: Liposuction, Ultrasonic, and Body Lift options.

One of the most common problems seen in patients presenting for body contouring is unattractive rolls of fat and skin in the flank and back areas.  All too often patients are more focused on their abdomen because from their perspectives it is the most striking issue noted when they study their figure in the mirror.  The back is often neglected by both the patient and her surgeon.

Patients usually assume these problem back rolls are the result of excess weight gain and liposuction can be the quick and easy answer.  Unfortunately, in most cases, the problem is more complex and the solution for each patient needs to be individualized.  The major cause of back skin and fat rolls in many in individuals is actually skin laxity that develops with aging and weight gain and loss.

Patients presenting with mild to moderate back and flank rolls can be very effectively treated with a combination of liposuction (often ultrasonic aided) and release of the subdermal skin attachments that encourage the skin to create rolls.  This skin release procedure can be performed using small instruments through the same 3-5mm incisions used to perform the liposuction phase of the procedure, once released and excess fat is removed, the skin will redrape.  Compressive garments are then worn post-operatively for a period of 4-6 weeks.

In cases of more severe back skin rolls, as is often seen in massive weight loss patients, true surgical excision of the major rolls of tissue needs to be performed.  This procedure, called an upper body lift can dramatically remove very severe back skin rolls.  In this procedure, the loose redundant skin is pulled and tightened in an upward direction with the required scar hidden in the back bra strap area.

The previously “neglected back” is now beginning to receive the attention it deserves.  Patients who choose to address problem back rolls are finding it an invaluable addition to more traditional body contouring procedures such as abdominoplasty.  Please visit Dr. Burkett’s website for additional information or to schedule a consultation.

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