Dr. Jose John MaliakalLaparoscopic & Laser Surgeon

Patient guide

Tired, heavy, or aching legs from varicose veins are something I see all the time, and it's rarely as serious as it looks. With laser or medical glue, many people today can avoid traditional vein stripping surgery.

Ask about this privately

This page is general information from Dr. Jose John Maliakal, not a diagnosis. Your treatment plan is decided together at consultation.

What people usually notice

  • Your veins look bulging, twisted, or a bit like ropes under the skin
  • Your legs feel heavy or ache, especially by evening or after a long day on your feet
  • Some swelling around your ankles or lower legs
  • Itchy, dry, or discoloured skin over the veins
  • Cramps in your calves, often at night
  • A burning or throbbing feeling along the vein

When I would want you seen sooner

  • Sudden, severe swelling in one leg, with pain, this needs urgent assessment to rule out a blood clot
  • A varicose vein that starts bleeding and doesn't stop with gentle pressure
  • The skin over the vein turning red, warm, or hard, or a fever alongside it
  • A wound or ulcer near the ankle that isn't healing, or is getting worse

With any of these, go to the nearest emergency department. Don’t wait for an OPD slot.

Your options

Laser treatment (EVLA)

often day care

Endovenous Laser Ablation

I pass a thin laser fibre into the faulty vein under local anaesthesia and use it to seal the vein shut from the inside. It's a gentler alternative to traditional vein stripping surgery for many patients.

VenaSeal

often day care

Cyanoacrylate (medical adhesive) vein closure

Here I use a medical adhesive to close the faulty vein from inside, no heat involved, and often you won't need compression stockings afterward. Whether this suits you is something we work out together at your visit.

After the procedure

Everyone is a little different, and I will confirm your own plan when I see you. Broadly, this is what to expect.

  1. Day of procedure

    This is usually day care, so you walk out the same day. I'll confirm the details with you at your consultation.

  2. First few days

    Some bruising, tightness, or mild discomfort along the treated vein is normal. It usually settles down with simple measures and some gentle walking.

  3. 1 to 2 weeks

    Most people are back at their desk within a few days to a week. If you've had EVLA, I'll usually ask you to wear compression stockings for a while after.

  4. Longer term

    I like to see you back for a follow-up, to check the treated vein has closed properly and to see if any other veins need attention down the line.

Good to know

Do I really need a procedure, or will stockings and lifestyle changes be enough?

For milder cases, I often start with compression stockings, watching your weight, and staying active. We only consider a procedure if your symptoms don't settle or the veins are more significant, and we decide that together at your consultation.

What's the real difference between EVLA and VenaSeal?

Both close the faulty vein from inside without open surgery. EVLA uses laser heat, VenaSeal uses a medical adhesive instead. Which one suits you depends on how your veins look, and I'll talk you through the options.

How soon will I be able to walk, or go back to work?

I usually get you walking again soon after the procedure, and most people are back to their normal routine within a few days. It does vary a little from person to person, and depends on your work.

Once this vein is treated, could new ones show up later?

Treating one vein doesn't stop other veins from becoming varicose down the line, since it's really about your overall vein health. That's why I like to see you for regular reviews, so we catch anything early.

Will my insurance cover this?

For insurance and fees, please check directly with the hospital's billing team when you book or come in for your consultation. They'll have the exact details for you.

Come and see me

Let us have a chat

If you are worried about a symptom, thinking about treatment, or you just want a clearer answer, send me a WhatsApp message and we will help you arrange a time at Thangam Hospital.

Thangam Hospital of PMRC

West Yakkara, Palakkad, Kerala 678004

OPD 9:00 AM – 4:00 PM

Please confirm the day’s OPD on WhatsApp before travelling.

Message me on WhatsAppCallGet directions

After you message, we will confirm the day's OPD, help you pick a time, and tell you what to bring: any earlier reports and scans, your current medicines, and your insurance card if you have one. Please avoid sending sensitive medical reports on WhatsApp unless we ask you to.