Leonardo Sousa Da Silva

Background Prominent veins in the temporal and periorbital regions of the face are a significant cosmetic concern, impacting self‐confidence and often prompting patients to seek treatment. While transcutaneous laser and sclerotherapy are effective for treating flat or superficial veins, bulging veins frequently require surgical removal via phlebectomy. Despite growing interest in facial vein treatments, there is limited published research evaluating patient satisfaction following facial phlebectomy. This study aimed to assess patient satisfaction in our first cohort of patients. Methods A retrospective review was conducted on 22 patients who underwent facial phlebectomy, primarily for temporal and periorbital veins, between June 2015 and October 2021. The procedure was performed under local anesthesia using micro‐incisions and hook phlebectomy. Post‐treatment outcomes were assessed using a structured questionnaire, collecting qualitative feedback and quantitative data via a 5‐point Likert scale (1 = worst, 5 = best). Results Of the 22 patients, 13 responded to the questionnaire (59% response rate), with 12 providing usable data. Respondents' mean age was 45.4 years (range 28–64), with 10 females and 2 males. Mean satisfaction scores were: (1) Vein disappearance: 3.8/5. (2) Scar appearance: 4.4/5. (3) Overall satisfaction: 4.2/5. (4) Willingness to recommend: 4.1/5. No complications such as infection, numbness, persistent pain, or significant scarring were reported. Conclusion Phlebectomy for temporal and periorbital veins is a safe and effective procedure for larger facial veins unsuitable for transcutaneous laser treatment. High satisfaction rates and minimal complications support its continued use as a cosmetic treatment option. Further research involving larger cohorts, objective assessments, and fixed follow‐up intervals is recommended to validate these findings and optimize patient outcomes.

Aim: To analyse the patterns of reflux in incompetent left ovarian veins (LOV) in women with associated symptoms and/or signs, to assess whether the progression of reflux is descending or ascending. Methods: We retrospectively reviewed pelvic venous duplex ultrasound reports from women assessed for suspected pelvic venous reflux (PVR) and/or pelvic venous disorders (PeVD) (previously pelvic congestion syndrome) at our unit between January 2016 and July 2017. All examinations included transvaginal duplex ultrasonography (TVUS) and transabdominal duplex ultrasonography (TADUS), performed by vascular technologists using our published protocol. LOV reflux was categorised as: (i) total reflux, (ii) distal reflux with proximal competence, or (iii) proximal reflux with distal competence. Results: In total, 317 women presenting with leg varicose veins with duplex evidence of reflux coming from the pelvis and/or symptoms of PeVD underwent TVUS and TADUS. Of these, 165 had reflux in the left ovarian vein (LOV); 108/165 (65%) demonstrated total LOV incompetence, 2/165 (1%) had proximal reflux without any distal reflux, and 55/165 (33%) showed distal-only LOV reflux. However, two of the distal-only LOV reflux had collaterals arising from the renal venous system. One of these has a true nutcracker syndrome. Of the two patients with proximal-only LOV reflux, one had symptomatic nutcracker syndrome, and the other had previously undergone left oophorectomy and was missing the distal LOV. Conclusions: These results show that two reflux patterns predominated: total LOV reflux and distal-only LOV reflux. Isolated proximal reflux was rare. This distribution is consistent with a distal-to-proximal (ascending) pattern of reflux progression within the LOV. However, further prospective longitudinal studies are required to determine whether distal-only reflux represents an early stage in an ascending progression pathway.