What Causes Varicose Veins?

Varicose veins occur due to the malfunction of vein valves, resulting in backward blood flow (venous insufficiency).

• Genetic predisposition
• Prolonged standing or sitting
• Sedentary lifestyle
• Obesity (excess weight puts pressure on veins)
• Pregnancy (increased pressure on veins)
• Hormonal changes (more common in women)

What Are the Symptoms of Varicose Veins?

• Visible blue-purple veins on the legs
• Pain, burning, and heaviness
• Swelling (edema)
• Night cramps and restless legs
• Itching and skin discoloration

If untreated, varicose veins can cause serious problems like bleeding, vein blockages, and leg ulcers.

What Are the Types of Varicose Veins?

1. Spider Veins (Telangiectasia)

• Thin, red-purple dilated veins
• Usually a cosmetic concern, but may cause discomfort

2. Reticular Varicose Veins

• Moderately thick, blue-purple veins close to the skin

3. Large Varicose Veins (Enlarged Main Veins)

• Bulging, prominent, twisted veins
• If venous insufficiency progresses, leg ulcers and skin changes may occur

How Is Varicose Vein Treatment Done?

1. Non-Surgical (Minimally Invasive) Treatments

Most preferred methods for mild to moderate varicose veins:

1. Sclerotherapy

• A special solution is injected into the vein to close it
• Effective for spider and medium-sized veins

2. Laser or Radiofrequency Ablation (EVLA / RF)

• Laser or RF energy is delivered to the vein to close it
• Effective in large varicose veins and venous insufficiency

3. Foam Sclerotherapy

Uses a more concentrated foam version of sclerotherapy, effective for closing larger veins.

4. Medical Compression Stockings

• Supports circulation, reduces swelling and pain
• Does not cure varicose veins, only relieves symptoms

2. Surgical Treatments (For Advanced Varicose Veins)

• Stripping Surgery: Surgical removal of large varicose veins. Not commonly used anymore.
• Microphlebectomy: Removal of varicose veins through small incisions.

What is Lipedema?

Lipedema is a chronic condition caused by the abnormal accumulation of fat tissue, especially affecting the legs, hips, and sometimes the arms. It is mostly seen in women and can be triggered by hormonal changes (puberty, pregnancy, menopause).

Lipedema should not be confused with obesity or lymphedema, as it involves fat that does not reduce easily with diet and exercise. While the legs thicken, the feet are usually unaffected, which helps distinguish lipedema from other types of swelling.

What Are the Symptoms of Lipedema?

• Symmetrical fat accumulation (especially in the legs)
• Easy bruising and tenderness
• Pain and pressure sensitivity to touch
• Heaviness and swelling in the legs
• Restricted mobility in advanced stages

When lipedema progresses, it can combine with lymphedema (accumulation of lymph fluid) and cause severe swelling in the legs.

How is Lipedema Treated?

Conservative (Non-Surgical) Treatments

These do not cure the condition but can help alleviate symptoms.

1. Compression Therapy:

• Medical compression stockings or bandages support lymphatic circulation and reduce swelling.

2. Manual Lymph Drainage (MLD):

• Gentle massage techniques help stimulate lymph flow and reduce edema.

3. Physical Activity and Exercise:

• Swimming, light walking, and lymph drainage-specific exercises can relieve symptoms of lipedema.
• High-impact sports (like running) may worsen swelling, so low-impact exercises are recommended.

4. Diet Regulation:

• Anti-inflammatory diets low in salt and sugar (such as the Mediterranean diet) are recommended.
• The ketogenic diet has been shown to ease symptoms in some patients.

Surgical Treatment (Lipedema Treatment with Liposuction)

In advanced stages, the most effective treatment method is a special liposuction technique (water-assisted or laser-assisted liposuction).

• Removes abnormal fat cells without harming the body
• Can reduce pain and mobility limitations
• Uses special techniques to avoid damage to lymphatic vessels
• Post-liposuction physiotherapy and compression stockings help accelerate recovery

What Happens if Lipedema Is Left Untreated?

• Fat tissue increases, possibly leading to mobility restrictions
• Skin sagging and circulation disorders may occur
• In advanced stages, it may merge with lymphedema and cause severe swelling

What is Lymphedema?

Lymphedema is a chronic swelling (edema) condition caused by the accumulation of lymph fluid in the tissues. It usually occurs in the arms and legs, but it can also appear on the face, neck, or abdomen. When the lymphatic system does not function properly, fluid accumulates and causes swelling.

Types of Lymphedema

1. Primary (Congenital) Lymphedema:

• Caused by developmental abnormalities of the lymphatic vessels
• Usually appears at birth or in young adulthood
• May be hereditary

2. Secondary (Acquired) Lymphedema:

• Removal of lymph nodes after surgery (especially in cancer surgeries)
• Damage to lymphatic vessels after radiotherapy
• Infections or trauma
• Progression of lipedema

Arm lymphedema after breast cancer and leg lymphedema after gynecological cancers are common.

Symptoms of Lymphedema

• Unilateral or bilateral swelling (may be asymmetric)
• Hardening and tightness of the skin
• Restricted mobility
• Pain and heaviness
• Increased risk of skin infections (lymphangitis)

Lymphedema Treatment

Conservative (Non-Surgical) Treatments

Lymphedema cannot be fully cured but can be managed with treatment:

1. Manual Lymph Drainage (MLD):

• Special massage techniques move lymph fluid back into circulation

2. Compression Therapy:

• Prevents fluid buildup with compression garments or bandages
• Pneumatic compression devices can be used in advanced cases

3. Exercise:

• Swimming, light walking, and yoga are recommended
• Intense exercise can worsen lymphedema

4. Skin Care and Hygiene:

• Dryness and cracks increase infection risk
• Moisturization and hygiene are essential

5. Diet and Weight Control:

• Salt intake should be reduced, and healthy eating should be maintained

Surgical Treatment (For Advanced Cases)

Surgical methods may be used in advanced cases that do not respond to conservative treatment:

• Lymph Node Transfer: Healthy lymph nodes are transferred to the affected area
• Lymphovenous Bypass: Damaged lymph vessels are connected to small blood vessels
• Liposuction: Removes hardened fat and fibrous tissues

What Happens if Lymphedema Is Left Untreated?

• Swelling increases, mobility is restricted, and pain occurs
• Tissue hardens, infection risk increases
• Skin ulcers and severe infections may develop

Early intervention prevents the progression of lymphedema.

What is Ozone Therapy?

Ozone therapy is a treatment method that involves the medical use of ozone gas (O₃). It is believed to have antioxidant, anti-inflammatory, and immune-boosting effects.

How Is Ozone Therapy Applied?

1. Major Ozone Therapy: Blood taken from the patient is mixed with ozone and re-injected intravenously.
2. Minor Ozone Therapy: A small amount of blood is mixed with ozone and injected into a muscle.
3. Rectal Ozone Application: Applied via absorption through the intestines.
4. Ozone Sauna: Absorbed through the skin.
5. Joint and Muscle Injections: Used in pain treatments.
6. Ozonated Saline and Water: Can be administered intravenously or as drinking water.

What Are the Benefits?

• Strengthens the immune system
• Improves circulation and increases oxygenation
• Has antibacterial, antiviral, and antifungal properties
• Acts as a pain reliever and anti-inflammatory
• Supports cell regeneration

Which Conditions Is It Used For?

• Chronic fatigue syndrome
• Fibromyalgia
• Circulatory disorders
• Diabetic foot ulcers
• Infectious diseases
• Rheumatic diseases
• Chronic pain syndromes

Side Effects and Risks

• May increase oxidative stress if not administered in the correct dose
• Incorrect application may lead to respiratory issues
• Rarely causes headache, fatigue, or nausea

Ozone therapy must be administered by an experienced healthcare professional. Individuals considering this treatment should consult a doctor.

What is Mesotherapy?

Mesotherapy is a treatment method in which vitamins, minerals, amino acids, enzymes, and other active substances are injected into the middle layer of the skin (mesoderm) using micro-needles. Used for both aesthetic and medical purposes, mesotherapy can be applied in various areas such as skin rejuvenation, preventing hair loss, and pain treatment.

Applications of Mesotherapy

1. Aesthetic Mesotherapy

• Skin Rejuvenation (Anti-aging): Skin renewal is achieved using hyaluronic acid, vitamins, and antioxidants.
• Spot Treatment: Applied to reduce pigmentation problems on the skin.
• Cellulite and Local Slimming: Helps break down fat cells and reduces the appearance of cellulite.
• Under-Eye Light Filler: Used to reduce dark circles and puffiness.

2. Hair Mesotherapy

• Applied to the scalp to prevent hair loss and promote stronger hair growth.
• Contains biotin, zinc, amino acids, and vitamins.

3. Medical Mesotherapy

• Pain Treatment: Used for conditions such as muscle and joint pain, rheumatic diseases, and migraines.
• Sports Injuries: Helps muscles and connective tissue heal more quickly.

Benefits of Mesotherapy

• Delivers effective results as it is applied directly to the target area.
• Non-surgical since it is performed via micro-injections under the skin.
• Provides visible effects in a short period of time.
• Supports skin and hair health by increasing blood circulation.

How Many Sessions of Mesotherapy Are Needed?

• Typically, 4–6 sessions are recommended for skin rejuvenation.
• Hair mesotherapy may take 6–10 sessions.
• For local slimming, 6–8 sessions can be applied.

Sessions are usually performed every 1–2 weeks and are determined based on the individual's needs.

Side Effects and Risks

• Mild redness, bruising, or sensitivity may occur in the treated area.
• Allergic reactions may rarely be seen.
• There may be a risk of infection if performed in non-hygienic environments.

Mesotherapy should be performed by specialist doctors or experienced healthcare professionals.

What is Wound Care?

Wound care includes treatment procedures applied to support the healing of cuts, burns, surgical wounds, pressure ulcers, or chronic ulcers and to prevent the risk of infection. Proper wound care reduces the risk of infection, accelerates the healing process, and minimizes scarring.

Types of Wounds and Treatment Methods

1. Acute Wounds (Cuts, Scrapes, Burns, Surgical Wounds)

• Cleaning the Wound: The wound should be washed with water and soap or cleaned with antiseptic solutions. Alcohol or hydrogen peroxide should not be applied directly to open wounds (as it may damage tissues).
• Stopping the Bleeding: Apply pressure with a clean gauze pad or bandage to stop the bleeding.
• Closing and Protecting the Wound: Small wounds may be left open, but if there's a risk of infection, they should be covered with a sterile bandage. Large or deep wounds may require stitches.
• Products to Support Healing: Antibiotic ointments, hydrogel, or hydrocolloid dressings can be used.

2. Chronic Wounds (Pressure Ulcers, Diabetic Foot Ulcers, Venous Ulcers)

• Chronic wounds usually result from diabetes, circulatory disorders, or prolonged pressure.
• The wound should be regularly cleaned and monitored for infection.
• Debridement (removal of dead tissue) may be necessary.
• Special wound care products such as hydrogels, foam dressings, or negative pressure therapy may be used.
• Compression stockings or proper positioning should be used to improve blood circulation.

3. Infected Wounds

• If there's redness, swelling, warmth, pus drainage, or a bad smell around the wound, it may be infected.
• The wound should be cleaned with sterile solutions, and antibiotic ointment may be applied if needed.
• In severe infections, oral or intravenous antibiotics may be necessary.
• If there is necrotic (dead) tissue, surgical cleaning may be required.

Important Points in Wound Care

• ✔ Care should be done in a clean and sterile environment
• ✔ A doctor should be consulted if the wound is infected
• ✔ Diabetic patients should be extra cautious with wound care
• ✔ Specialist intervention is necessary if the wound doesn't heal or worsens

What is Surgical Wound Care?

Surgical wound care includes procedures performed to prevent infection at the surgical site, accelerate healing, and minimize scarring. Surgical wounds may be stitched, stapled, or open, and each requires special care.

Surgical Wound Care Process

1. First Days After Surgery (Acute Phase)

• The wound dressing should usually remain in place for the first 24–48 hours.
• Dressing should be done as recommended by the doctor.
• Hands must be washed, and sterile gloves should be used.

2. Dressing and Cleaning

• During dressing changes, the wound should be cleaned with sterile gauze or antiseptic solution.
• Physiological saline or povidone-iodine should be used instead of alcohol or hydrogen peroxide.
• Dried blood and fluids around the stitches should be gently cleaned.

3. Watch for Signs of Infection

• Excessive redness, swelling, or warmth
• Yellow-green discharge or bad odor
• Severe pain or bleeding
• Fever and fatigue

4. Stitches and Staple Care

• The time for removing stitches depends on the location and type of wound:
• Face: 5–7 days
• Body and scalp: 7–10 days
• Joint areas: 10–14 days
• Back and feet: 14–21 days
• Stitch or staple areas should be kept dry.

5. Factors Supporting Wound Healing

• ✔ Diet rich in protein and vitamins (Vitamin C, zinc, etc.)
• ✔ Avoiding smoking and alcohol
• ✔ Avoiding excessive movement and tension (prevents wound reopening)
• ✔ Protection from sunlight (to prevent scarring)

Products Used in Surgical Wound Care

• Sterile gauze pads and bandages
• Physiological saline or antiseptic solutions
• Antibiotic ointments (if prescribed by a doctor)
• Hydrogel or silicone-based dressings (to reduce scarring)

What is Sclerotherapy?

Sclerotherapy is a minimally invasive treatment method used to treat varicose veins or dilated capillaries (telangiectasia) by injecting a special medication directly into the vein. It is especially common for treating leg varicose veins and spider veins.

How is Sclerotherapy Performed?

1. Examination and Preparation

• First, the doctor evaluates the condition of the varicose veins.
• If blood-thinning medications are being used, the doctor should be informed before the procedure.

2. Procedure Steps

• The patient lies on their back or in a slightly reclined position.
• A fine needle is used to inject a sclerosing agent (e.g., polidocanol, sodium tetradecyl sulfate) into the vein.
• This substance irritates the vein walls, causing them to shrink and eventually disappear.
• The procedure usually takes between 15–45 minutes.
• Multiple veins may be treated in a single session if necessary.

3. After the Procedure

• The patient can walk immediately after the procedure.
• Wearing compression stockings or bandages is recommended.
• Avoid extreme heat, strenuous exercise, and direct sunlight.
• Mild bruising, redness, or tenderness may occur; these usually fade within a few weeks.

When is Sclerotherapy Used?

• Small to medium-sized varicose veins
• Capillary dilations (spider veins)
• Hemorrhoid treatment (in some cases)
• Lymphatic vessel disorders

Note: For large varicose veins, laser treatment or surgical intervention may be more effective.

Advantages

• It is a non-surgical method that is quick and easy to apply
• Short recovery time
• Safe and effective treatment

Side Effects and Risks

• Temporary bruising, redness, and swelling
• Rare allergic reactions
• Mild hardness or discoloration in the treated vein

The procedure must be performed by an experienced physician.

What is Thread Lifting (Non-Surgical Face Lift)?

Thread lifting is a non-surgical aesthetic procedure. It is a lifting technique that uses special medical threads to eliminate sagging on the face or body. This method aims to achieve a younger and firmer appearance by suspending tissues upward using biocompatible threads placed under the skin.

How is Thread Lifting Performed?

1. Examination and Planning: The physician evaluates the facial structure and determines the areas where the threads will be placed.
2. Local Anesthesia: The treatment area is numbed so that the patient feels no pain.
3. Thread Placement: Threads are inserted under the skin with the help of fine cannulas or needles and are pulled in the predetermined directions to achieve the lift.
4. Observation of Results: An immediate lifting effect is seen, and natural tightening occurs over time with collagen production.

Who is a Good Candidate for Thread Lifting?

• Those with mild to moderate facial sagging
• People who do not want surgery or are not suitable candidates for surgery
• Those who want to lift their jawline, cheeks, or eyebrows
• Those with sagging in the neck area

Advantages and Disadvantages

• ✅ It is a non-surgical method with a short recovery time.
• ✅ Results are visible immediately.
• ✅ Stimulates collagen production, resulting in firmer skin over time.
• ❌ Its longevity is shorter compared to surgical facelifts (usually lasts 1–2 years).
• ❌ Rare side effects include bruising, swelling, or infection.

This method is especially effective as a rejuvenation option for individuals aged between 35 and 55.

What is a Liquid Facelift?

A liquid facelift is a non-surgical facial rejuvenation method. This technique uses injectables such as Botox, fillers, and sometimes PRP or mesotherapy to enhance facial contours, reduce wrinkles, and give the skin a more youthful appearance.

How is a Liquid Facelift Performed?

1. Examination and Planning: The physician evaluates the patient's facial structure and determines the areas to be treated.
2. Local Anesthesia (If Needed): Most applications do not require anesthesia, but numbing cream can be used for sensitive areas.
3. Injections:
   • Botox: Used to reduce expression lines in the forehead, around the eyes, and between the eyebrows.
   • Fillers (Hyaluronic Acid, Calcium Hydroxyapatite, etc.): Applied to enhance the cheeks, jawline, nasolabial folds, and cheekbones.
   • Additional Supportive Treatments: PRP (stem cell therapy) or mesotherapy may also be used.
4. Observing the Results: Effects are noticeable immediately, but it may take a few weeks for the fillers to fully settle.

Who is a Good Candidate for a Liquid Facelift?

• Individuals with mild to moderate wrinkles
• Those seeking a non-surgical rejuvenation option
• People who want more defined facial contours and a fuller appearance
• Those who feel their skin is starting to lose elasticity

Advantages and Disadvantages

• ✅ A quick, non-surgical method with no recovery time required
• ✅ Provides a natural and youthful appearance
• ✅ Can be customized with different combinations of fillers and Botox to suit individual needs
• ❌ The results are not permanent, typically lasting between 6 months and 2 years
• ❌ Overfilling or improper application may result in an unnatural look

The liquid facelift is especially ideal for individuals between the ages of 35 and 55. It is an effective aesthetic method for achieving a refreshed and youthful appearance without surgery.