- Around Town
- Holiday Fun in the City: NYC & PHL
- Oceanfront Restaurantís New Wine Program Creates Big Waves in Jersey Shore Wine Scene
- Fall Guide 2014 - Activities
- Ask The Experts
- AskThe Experts - Lawrence Durso
- Ask the Expert - Vincent Dicks CEO - Career Gaudium
- Ask The Expert - Joe Adelfio of Closettec NJ
- Bay Wellness
- Bay Wellness - How Can An Ultrasound Help?
- Bay Wellness - Making Weight Loss a Family Affair
- Bay Wellness - Don't Forget
- Best Bets
- Best Bet - Champion Chiropractic
- The Guide 2015 - Massage Envy Spa
- The Guide 2015 - Glo Bar Skin Art Studio
- Cover Story
- Making The Grade: Ross Kasun
- Making Headlines - Jim Driscoll
- John Green - ABC News Award-Winning Producer
- Day Tripper - The Appalachian Trail
- Day Tripper - Overnight Adventures
- DayTripper: Manasquan Reservoir
- Fall Guide
- Fall Guide - Kids Activity
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- Fall Guide 2014 - Fall Events
- Featured Artist
- Featured Artist - Nate Chadwick
- Featured Artist - Tim Dorland: A Glass Act
- Featured Artist - Grace Your Space
- Gift Guide
- The Guide 2015 - Beach Tavern
- The Guide 2014 - Cosmetic Medic
- Gift Guide - Restorative Health Alliance
- Health Talk
- Physician Profile: Dr. Hiren Patel
- Health Talk - Anthony Sparano, M.D.
- Health Talk - Angelo Pollari KryoLife Staten Island
- Health, Wellness & Beauty
- Health 2014 - Your Smile Sends A Message
- Health - Associated Pain Specialists
- Guest Blogger >> Sonya Moretti, WHNP-BC, NAMS
- Holiday Buzz 2014
- Bright Lights & Holiday Magic
- Chanukah Traditions In Transition
- Dining Out For The Holidays
- People On The Move
- Colts Neck Member Of Jack & Jill Monmouth County Chapter
- People On The Move - Kevin LeMastra
- People On The Move - Ray Andersen
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- Where Heritage Meets The Sea
- Weigh In - My Favorite Jersey Beach
- Weigh In - What Annoys You Most About The Beach?
- The Bay
- The Bay - A Body In Motion
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- The Guide
- The Guide 2014 - XCEL Club
- The Guide 2015 - Bentley Edison
- Our Pick - Marshall P. Allegra, MD
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- The Home - ACD Custom Granite
Ask The Expert - Total Vein and Rejuvenation Center
Total Vein and Rejuvenation Center
788 Broad Street
Shrewsbury, NJ 07702
741 NorthfieldAvenue, Suite 100
West Orange, NJ
Call for appointment or free consultation
Dr. Joseph Fretta started his internal medicine practice in 1983, and his venous practice in 1987. He has treated over 27,000 patients over the last 24 years, who suffer from large varicose veins causing leg ulcers to the smallest spider veins on the legs, body and face. He has been a member of the American College of Phlebology since 1987, and founded the NJ Vein and Cosmetic Center in 1990. Dr. Fretta has trained many doctors from out of state in the treatment of varicose veins. He has now renamed his practice Total Vein and Rejuvenation Center, where multiple aesthetic treatments are also offered.
Why is treating varicose veins important?
Varicose veins are the result of non-functioning check valves in the leg. Each leg has 60-154 check valves that are located from the ankle up to the groin. The purpose of the valves is to guide the venous (not arterial) blood flow uphill against gravity back to the heart. If any of the valves no longer function properly blood flow reverses downward instead of upward, causing the vein below the valve to swell. The swelling will be progressive and the next valve will become non- functioning and cause the vein below it to swell and so on. As a network of veins swell, so does the leg and the swollen leg causes tissue damage known as fibrosis. Therefore, the patient suffers swelling, skin discoloration, leg heaviness, and pain. And more seriously, pooling of blood in the leg.
What are the treatments for varicose veins?
Four major superficial veins are treated: the greater saphenous vein in each leg which runs from the inner groin to the inner ankle and the small saphenous veins which run from the back of the knee crease to the heel. These can be treated by EVLT (endovenous laser ablation therapy). This is the insertion of a spaghetti-size fiber optic strand inserted through a pin prick incision, usually from the mid inner calf, threading up in the vein until it reaches the groin. This treatment is relatively painless and is done under ultrasound guidance. Once the catheter is in position the laser is fired as the catheter is being withdrawn. Thus, the entire vein is cauterized and permanently closed. Other major vein branches that evolved off any of the four major veins mentioned can be removed by a procedure called ambulatory phlebectomy. This entails removing a large varicose vein through a series of pinhole size incisions, through which a tiny instrument can be used to pull the vein out. Much like pulling a shoe lace out of the shoe fromhole to hole.When thinking of varicose veins, picture a tree. After we remove the trunk, we remove the branches and finally through sclerotherapy we can inject away the twigs (spider veins).
What is sclerotherapy?
Sclerotherapy is still the gold standard for treating spider veins and large blue reticular veins. This is done using tiny hair thin needles that feel like mosquito bites to inject medication into said veins, to irritate its inner lining causing it to constrict and close. The spider veins disappear usually three weeks after the injection. After removing varicose and/or spider veins can they come back? When thinking of veins, think not only of a tree, but of a river. You must treat the source of the flow first. For example, the larger veins must be treated before you can treat the tiniest branches (spider veins). When done in this manner the treatment is permanent, unless there is a change in the patientís clinical setting, such as a pregnancy, excessive weight gain, change of occupation (which may require excessive standing or lifting) or trauma to the leg.
As a forward thinking physician who keeps up with the latest options available, can you share the latest trends with our readers...
Surface lasers are again coming into fashion for the treatment of spider veins. This is usually for doctors who delegate the procedure to a nurse, rather than perform the procedure themselves. Sclerotherapy is still the gold standard.
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