Frequently Asked Questions

Evaluating Vein Disease and Selecting a Doctor (8)

Yes. Thirty million Americans have vein disease and a large percentage of these people don’t know it. The Vein Guys see many patients who believe their vein problems are only cosmetic but soon realize they have a larger, underlying vein problem. Spider veins may be just the beginning symptom of vein disease.

The Vein Guys have an in-office vascular lab with certified registered vascular technologists to perform venous ultrasound tests. If venous reflux disease is causing your spider veins, treatment is available.


Vein disease is diagnosed through a physical examination and a venous ultrasound test. The ultrasound test will determine if there are any blood clots in the deep, superficial and perforator veins. Registered Vascular Technologists (RVTs) then use the ultrasound to evaluate the blood flow within the vein. They are able to see the direction of blood flow within the vein, which allows them to identify reflux. The Vein Guys have an in-office vascular lab with certified RVTs who conduct all of our venous ultrasound tests.


Board certified vascular and plastic surgeons and general surgeons who specialize in veins are the most qualified to treat vein problems. They are the only doctors with extensive training in vascular surgery. Vascular and plastic surgeons are trained general surgeons who have completed fellowships in vascular surgery and micro-vascular surgery respectively.


The most important thing to look for in a vein care center is qualified medical staff – board certified vascular surgeons, plastic surgeons, general surgeons with a vascular specialty, and certified ultrasonographers and/or certified registered vascular technologists (RVT). Vascular and plastic surgeons are general surgeons who have completed additional fellowships in vascular surgery and micro-vascular surgery respectively, making them the most qualified to treat medically necessary and cosmetic vein problems.

Next, look for a vein care center with experience and commitment to quality – a practice that focuses on the treatment of venous reflux disease, chronic venous insufficiency, varicose veins and spider veins. Surgeons who focus solely on vein disease will have more experience with the newest and most effective procedures available, including the Venefit™ Procedure (formerly called the VNUS Closure™ procedure) which is considered the gold standard for the removal of varicose veins. Make sure that the practice doesn’t use reprocessed catheters, but uses new catheters for each procedure.

Finally, ask for referrals to find out what patients are saying about the effectiveness and quality of care they have received. At The Vein Guys, our surgeons perform all of our vein procedures, and we have certified registered vascular technicians performing scans every day. The Vein Guys’ surgeons focus only on treating vein related issues and have completed more than 12,000 vein procedures over the years. The Vein Guys have a 98% success rate and very high patient satisfaction.


The Vein Guys have performed thousands of vein procedures, yet we treat each patient as an individual. We offer the most recent advancements for treatment of varicose veins, spider veins, and leg pain in addition to treatment for therapeutic and cosmetic vein problems. Our board certified surgeons are nationally recognized vein specialists that perform all of our procedures, and are highly experienced with the Venefit™ procedure (formerly called the VNUS Closure™ procedure). After thorough discussion and a complete diagnostic evaluation, we will offer a comprehensive treatment plan to meet your needs. The Vein Guys are committed to providing you with the best treatment options and highest quality, individualized patient care.


There are seven different types of patients and vein issues that we typically see and treat:

  • Patients with bulging, ropey or rope-like veins on their legs (varicose veins)
  • Patients with severe leg pain or swelling and a few outwardly noticeable spider veins
  • Patients with open non-healing wounds/ulcers on their lower legs and ankles
  • Patients who have experienced some form of trauma to their legs which caused the venous system to become diseased
  • Patients with skin discoloration of the legs and/or ankles
  • Patients with cramping or RLS (Restless Leg Syndrome) who cannot sleep at night because of this condition. Most of these patients also experience varying degrees of aching, throbbing, itchy, numb, burning, swollen, cramping, tired, fatigued or heavy legs and/or feet
  • Patients with strictly cosmetic veins on their legs, body or face who want a cosmetically trained surgeon to diagnose and treat their veins

The Vein Guys is a medical vein practice that offers the most comprehensive vein treatment options, unlike some practices that have a limited variety of vein care services. Venous reflux disease, chronic venous insufficiency, varicose veins and spider veins are issues commonly remedied at The Vein Guys. The Vein Guys operate offices in Atlanta, Nashville and Augusta and offer the most recent advancements for treatment of varicose veins, spider veins, leg pain and leg veins in addition to treatment for therapeutic and cosmetic vein problems.


Dr. Roth felt each community as a whole would benefit from the FDA approved leg vein removal procedure, Venefit™ (formerly called the VNUS Closure™ procedure). 30 million Americans have vein disease and suffer unnecessarily each day with painful symptoms that affect their quality of life. The Vein Guys treat vein disease, eliminate leg pain and enable patients to return to the active lifestyles they desire.


Treatment for Vein Disease (10)

Most insurance companies and Medicare recognize vein disease as a legitimate, covered medical expense and will cover the cost of vein treatment after a period of conservative management. If you are experiencing any symptoms of vein disease it is worth finding out if your insurance provider will cover the cost of treatment.

The Vein Guys will provide a consultation and an in-office venous ultrasound test. If you test positive for vein disease, Medicare and most insurance companies will cover the cost of the consultation, venous reflux test and varicose vein treatments. However, most insurance companies require a 6-week to 3-month period of “conservative management” before the Venefit™ Procedure (formerly called the VNUS Closure™ procedure) can be scheduled. We will work with you to develop a conservative management plan which may include elevating your legs, minimizing prolonged periods of standing or sitting and wearing compression stockings.

The Vein Guys accept Medicare and most major insurance plans, however we do not accept Medicaid.


During the initial consultation, you and the doctor will review your medical history and current health, and discuss your concerns and expectations. The doctor will ask about symptoms you may be experiencing, but may not actually examine your legs at this time. Only about 40% of patients with vein disease have visible veins, so it is more important for the doctor to understand the other symptoms you are experiencing. The next step is a comprehensive ultrasound test conducted by one of our Registered Vascular Technologists. The doctor will discuss the results of the test with you at a follow-up appointment and will then develop a comprehensive treatment plan for you. You can review the Treatment Process by clicking here.


Yes. The Venefit™ procedure (formerly called the VNUS Closure™ procedure) is the market leading treatment for vein disease, venous insufficiency and varicose veins. The procedure uses temperature-controlled radiofrequency energy to close the diseased vein and was clinically proven to have less post-operative patient pain and bruising than laser treatment.

Click here to see the clinical trial results proving the benefits of using the Venefit™ procedure (formerly called the VNUS Closure™ procedure).

The Vein Guys have a 98% success rate with the Venefit™ Procedure. Together, Dr Benak, Dr Milligan and Dr Davis have performed thousands of Venefit™ procedures at their vein treatment centers. We take every precaution to reduce the possibility of complications. We carefully review your medical history and current health condition before recommending a treatment plan. It is important that you fully disclose all health related information so we are able to make an accurate assessment of the risks involved.


Several important factors come into play when deciding if this procedure is the right option for you. The most important factors are your health and if you display symptoms of vein disease. The most visible sign of vein disease is the bulging, blue rope-like varicose vein. However, many of the signs are less noticeable, such as aching, throbbing, itchy, numb, burning, cramping, swollen, tired, fatigued or heavy legs, ankles and/or feet and skin discoloration, open sores or ulcers.

If you have any of these symptoms you need to schedule an appointment for a diagnostic evaluation, including an ultrasound venous reflux test to determine if you have vein disease. If you do have vein disease, The Vein Guys will recommend the best treatment option for you.


The diseased or damaged valves in the leg vein are ablated, or closed off, along with the vein itself during the Venefit™ Procedure (formerly called the VNUS Closure™ procedure). There is a misconception that these valves are repaired, but that is not the case. Endovenous ablation, or closing off of the vein and valves, is the intended outcome. Your body automatically reroutes blood flow to healthy veins. The diseased vein that is closed off during the procedure is eventually dissolved within the body.


The Venefit™ procedure (formerly called the VNUS Closure™ procedure) will affect your circulation in a positive way. By closing off veins that do not work properly the venous system can work more effectively. Blood is rerouted to healthy veins and circulation is improved.


Yes. Recent studies show that the Venefit™ procedure (formerly called the VNUS Closure™ procedure) out-performs both EVLA and traditional vein stripping. The Venefit™ procedure has been shown to have fewer side effects and post-procedure complications such as deep vein thrombosis (DVT), pain, bruising and skin burns. The Venefit™ procedure is considered the gold standard for vein removal, and is faster and has a higher success rate than laser treatment.

Venefit™ and EVLA both use heat to close the diseased vein. The difference is in the heat and the heat source. EVLA uses laser energy at 700° C, perforating and destroying the vein walls and boiling the blood inside the vessel. Venefit™ uses temperature-controlled radiofrequency energy at 120° C to shrink and collapse the vein. The outcome of radiofrequency ablation is more predictable than laser because the heat source is monitored by the generator, a certified registered vascular technician and the surgeon. The risk of complications is significantly reduced with Venefit™.

Dr. Steven Roth has first-hand experience with both procedures and has written a nationally recognized paper published in the Journal of Vascular Surgery highlighting his work and research on the differences between the Venefit™ Procedure (formerly called the VNUS Closure™ procedure) and Laser Closure procedures.


Absolutely not! This is considered a complication. This complication is one of the reasons The Vein Guys use the Venefit™ procedure (formerly called the VNUS Closure™ procedure). This procedure uses radio frequency, not laser to shrink and collapse the diseased vein. The outcome of radio frequency ablation is more predictable than laser because the heat source is monitored by the generator, a certified registered vascular technician and the surgeon. The risk of complications is significantly reduced.


Yes, The Vein Guys treat spider veins on the legs every day using foam sclerotherapy and ultrasound guided sclerotherapy. These techniques involve using a very small syringe to inject solutions called foaming agents into the veins, thickening the vein and sealing off blood flow. The procedure takes about 15 minutes, and typically veins are eliminated in 3 to 4 weeks. An evaluation and an ultrasound test can determine if your spider veins are cosmetic in nature or a result of venous insufficiency.


Foam sclerotherapy is the latest development in the sclerotherapy field and is a more effective way to deliver the sclerosing agent directly to the problem vein. Foam sclerotherapy is a technique that involves injecting foamed sclerosant chemical within a blood vessel using a very small syringe. The “foam” works by forming a bond between the red blood cell and the foaming agent. This in turn creates a goo-like substance inside the vein which sticks to the wall of the vessel causing the vein to close. The procedure takes about 15 minutes, and typically the veins are eliminated in 3 to 4 weeks.


Veins and Vein Disease (5)

Deep vein thrombosis (DVT) in the leg is a life threatening venous disorder that occurs when thrombus, or a blood clot, develops in the deep venous system. The risk of developing DVT increases when venous blood flow becomes more stagnant. This is more commonly seen in individuals with venous reflux and varicose vein disease. In these individuals, superficial venous blood clots (superficial thrombophlebitis) can lead to DVT because of the incompetent valve system linking the deep and superficial systems together.

One way to decrease your risk of DVT is to treat the venous reflux and vein disease, eliminating the veins with the faulty valves. The Vein Guys correct vein disease through a minimally invasive procedure called Venefit™. The procedure is performed in the office in about 15 minutes and patients typically return to normal activity within a day.


Veins carry de-oxygenated blood from the outer parts of the body back to the heart and lungs. The blood in the legs has to fight against gravity to travel up the leg. The vein valves play an important role in this process, preventing a back-flow of blood. Vein disease, also called venous reflux disease, is the weakening of the vein walls and valves, which allows a backflow of blood down the veins. The blood pools in the leg causing an increase in pressure in the veins, which results in the symptoms of vein disease. These symptoms include varicose veins, spider veins, swelling, edema, pain, aching, throbbing, burning, numbness, cramping and heavy feeling legs or ankles.

Vein disease is hereditary. Other factors that can lead to vein disease are pregnancy, prolonged periods of standing or sitting and obesity. Luckily, vein disease can be treated.


Spider veins are close to the skins surface and may look thin and wispy like spider webs or thick and squiggly like branches. They are similar to varicose veins, only thinner. Although we tend to think of spider veins as a cosmetic problem, many times there is an underlying medical cause that has created the spider veins. If you have spider veins along with any other symptom of vein disease (stinging, throbbing, aching, numbness, etc.) then you may have an underlying issue. An evaluation and an ultrasound test can establish if spider veins are cosmetic in nature or a result of venous insufficiency.


Varicose veins are large, bulging, blue, rope-like veins in the legs. They can occur when the valves in the leg veins become weak or diseased and no longer function properly, causing blood to pool in the legs. Varicose veins are the most obvious and visual symptom of vein disease, but you do not have to have visible veins to have vein disease.


The obvious visual symptoms of vein disease are bulging, ropey or rope-like varicose veins and spider veins. But you do not have to have visible varicose veins or spider veins to have vein disease. Other less noticeable signs include:

  • History of vein problems in your blood-related family
  • Fatigued, tired, heavy-feeling legs
  • Leg pain caused by prolonged standing or sitting
  • Itching, tingling, numbness, cramping or burning in the legs or feet
  • Swollen ankles at the end of the day
  • Discoloration of the skin in the lower legs
  • Open sores or ulcers of the lower legs and ankles
  • Cramps that wake you up at night or a diagnosis of Restless Leg Syndrome (RLS)

The symptoms of vein disease may be gradual or rapid in onset, and in most cases there is a family history of vein problems. If you have any ONE of these symptoms you may have vein disease and need to schedule an appointment at The Vein Guys for an insurance or Medicare covered consultation and evaluation.