Varicose Veins & Thread Veins FAQs

What are varicose veins?

Varicose veins affect 30% of the population and are caused when one-way valves within the vein fail, creating a flow of blood down the leg rather than upwards towards the heart.  Blood begins to stagnate, and this creates the bulky, prominent appearance of the veins.

Although they are rarely dangerous, varicose veins can cause aching and discomfort as well as an unsatisfactory cosmetic appearance.

In the long-term, varicose veins can be associated with complications, including:

  • Skin changes
  • Phlebitis (painful inflammation)
  • Bleeding
  • Ulcers
What can I expect from the consultation with Mr Birchley?

At the initial consultation, we offer a comprehensive assessment by an expert Consultant Vascular Surgeon, a detailed ultrasound scan of your veins and a full discussion of your problem, concerns and aspirations.

This leads to an outcome individualised to you:

  • Advice only if most appropriate
  • Transfer to Mr Birchley’s NHS service if appropriate
  • Clinic-based treatment (catheter / foam)
  • Surgery under anaesthesia 

We provide clear pricing to self-pay patients.

Following the appointment, you have guaranteed 24/7 access to Mr Birchley direct by email for advice and support.

What treatments are available?

Varicose veins may be treated with surgery under anaesthesia or using endovenous techniques (usually a catheter and foam injections).


Surgery involves physically removing the visible varicose veins and the underlying incompetent vein through small incisions (phlebectomies). The advantages of surgery are:

  • Both legs can be treated at the same time if necessary
  • Removed veins cannot recur
  • A very good early cosmetic result

There are disadvantages which include wound problems, numbness and some discomfort in the first couple of weeks following surgery.

Endovenous treatment

Most patients have varicose veins consisting of two parts:

  • An underlying incompetent trunk
  • Visible veins

Treatment is designed to block the trunk and veins.

Clarivein catheters use mechanical rotation and injection of the chemical used in foam to block the trunk of the vein. This means they are as effective as laser and radiofrequency, but no injections are required and there is no risk of nerve damage.

In Mr Birchley’s experience, over 96% of patients treated with Clarivein need only one treatment per vein. This matches the performance of laser and radiofrequency.

Foam injections cause the visible varicose veins to block. They then go through a series of changes before disappearing:

  • No symptoms (1-2 weeks)
  • A little inflamed and tender (2-3 weeks)
  • Lumpy but not tender (may be several months)

The advantages of endovenous treatment include:

  • Walk in, walk out
  • No anaesthesia
  • No down time afterwards

The disadvantages include:

  • Only one leg can be treated at a time
  • It can take several months to benefit from the final cosmetic result
  • Top-up treatment of the varicose veins may be required
  • There is a 10% risk of skin staining
What are thread veins?

Thread veins, also known as spider veins, are tiny prominent veins just below the skin surface. They are very common, affecting around 80% of adults. They occur anywhere on the body but most often on the legs and face. They do not carry any risk to you, although they can sometimes feel hot and itchy. Procedures to remove thread veins are largely for cosmetic purposes only.

What treatment does Mr Birchley offer?

Microsclerotherapy is an effective treatment for thread veins and involves using a very fine needle to inject a chemical into the vein, causing it to seal itself shut and fade.  This procedure is done without anaesthetic using a VeinLite device, and with appointments taking 45 minutes or less allows patients to return to their normal activities immediately.

Microsclerotherapy is effective for the treatment of thread veins, but a few points need to be borne in mind:

  • A limited number of veins can be injected per session
  • It can take 6-8 weeks for the threads to fade
  • 20-30% of injected threads will need a second treatment
  • There is a risk of discolouration in the early stages

For these reasons, microsclerotherapy should be seen as a course of treatment. It is also important not to expect a final cosmetic result within the first three months after injections.

What treatment is included in the fee?

It is important to be able to clearly understand the fees you will pay and the treatment you will receive.

Surgery is sold as a package, so the fee covers the preassessment, surgery and follow-up. Although complications requiring treatment are thankfully very rare, these are also included.

Endovenous treatment is structured as follows:

Clarivein and Foam:
Appointment 1 (£2094) – Catheter treatment and foam
Appointment 2 at six weeks – Foam top-up if required

Foam alone:
Appointment 1 (£1298) – Foam sclerotherapy
Appointment 2 at six weeks – Foam top-up if required

Microsclerotherapy treatment is structured as follows:

Appointment 1 (£427) – Injections over multiple areas up to 30 minutes
Appointment 2 – Top-up Injections over multiple areas