Varicose veins can cause pain and become unsightly; if not treated, they can be detrimental to health, can stain the skin and lead to ulceration and worse.

Veins are absolutely everywhere in the body. They can be embarrassing to many and can pop up at any age and in the strangest of places.

It seems the latest trend is hands, with Madonna and Angelina Jolie now having their hand veins attended to, a cosmetic procedure Paul Baskerville has been carrying out for over 20 years, having over 30 years’ experience in diagnosis and treatment of vein and circulation conditions.

Q How did you begin your career as a vascular surgeon?
A I studied at Oxford University and trained at St. Thomas’ and St. Bartholomew’s. I was appointed as a consultant vascular surgeon at King’s College Hospital London in 1988 where, among other roles, I was clinical director of surgery and director of surgical practice. In 2000, I was elected president of the British Association of Day Surgery.

Q Have you worked in the NHS?
A Yes, full time for thirty years. I set up in private practice at the Vascular and Vein Unit twenty years ago which has recently evolved into The Baskerville Clinic in Wimpole Street. Up until last year I treated both private and NHS patients.

Q Does the NHS recognise the importance of varicose veins?
A To be honest, the NHS is excellent at being ‘reactive’ to cases such as deep vein thrombosis, however, in recent years it has become increasingly overstretched and therefore reluctant to treat less serious conditions, such as varicose veins.

Q How has vascular surgery developed since you started practicing?
A Thirty years ago, 70% of people were diagnosed without access to ultrasound scans, so were possibly having incorrect treatments. Treatment would have been open surgery – with a hospital stay of two to four days. After this, patients would have worn bandages for three weeks and been left with visible scarring. Returning to work could have taken weeks.

Q How does that compare to current treatments?
A Firstly, colour duplex ultrasound scanning of the veins assesses blood flow enabling us to provide a pinpoint, guaranteeing long-term success for vein treatments. There are now also different treatment options for veins – often they involve some form of keyhole treatment or foam. I work with my patients to offer a choice depending on the results they want and I take into consideration their lifestyle, recovery time and skin type. Most patients have surgery as a day case. These days bandaging is minimal therefore less restrictive and worn for one week only. All patients are walking normally the day after surgery and about 50% will be back at work within a week. There is minimal discomfort and almost no visible scarring.

Q What can we hope for the future of vascular surgery?
A The future of vascular surgery will include less invasive surgery and even shorter recovery times.

Q What do you offer at The Baskerville Clinic?
A The Baskerville Clinic specialises in the diagnosis and treatment of a wide range of vein and circulation conditions such as varicose veins, hand and arm veins, varicose ulcers, varicose eczema, swollen legs, DVT, pelvic and labia veins.
Thread vein treatment is also very popular and microinjection (sclerotherapy) is very successful at removing these veins from most area of the body.

Q Typically, most people have an ‘MoT’ on their body each year, however, should we also have a ‘vein check up’?
A Veins are a very important part of our circulatory system and are responsible for the returning of deoxygenated blood back to the heart after arteries carry blood out. Having an ‘MoT’ as you call it could prevent complications developing later. As not all damaged veins produce early symptoms, an ‘MoT’ would highlight any problematic areas before symptoms occur. Many people have one vein that is unsightly or painful that needs to be looked at – but most people keep putting it off.

Q What could I expect from an initial visit to The Baskerville Clinic?
A Initially, we would undertake a complete overview incorporating your medical history, lifestyle and any concerns you may have. My initial examination will access the state of the veins and I would decide whether further investigations such as colour duplex ultrasound scanning is needed. A scan would be booked and a follow up appointment made.

Q Why should I see you if I want to get my veins done?
A From the minute you step through the door to the minute you are discharged from my care, I am solely responsible for your wellbeing and aftercare. This means no delegating of any care such as sclerotherapy (microinjections) to nurses or therapists.

Q How do you think social media and a need for perfection has affected your role as a doctor?
A We are certainly in a world where social media dictates. The way people are portrayed in modern society is as ‘perfect’ and many wish for perfection. Personally I think not all treatment is necessary and have had occasion to explain and convince a patient that treatment is not necessary and why I will not do anything at that time.

Q There has recently been coverage in the press about hand rejuvenation with celebrities such as Madonna and Angelina Jolie undertaking it. Is this a new procedure? And can you do it?
A No, this is not a new procedure and I’ve been removing veins from clients’ hands with very rewarding results for over twenty years, including some models and actresses. The technology has obviously evolved, but the idea is not new to the industry.

Q What are the characteristics of a typical patient who might want their hand veins removed?
A People who have very low body fat, are thin, have pale complexions, perhaps are exceptionally sporty or have reached the postmenopausal stage can often have raised hand veins they believe are unsightly. I must stress this is purely aesthetic and there is no medical reason why anyone should have hand veins attended to. However, as hands are constantly on view, the removal of these prominent veins can have a noticeable effect on a patient’s confidence and wellbeing.

Q Is the removal of hand veins a straightforward procedure?
A Hand veins are no different to veins on any other area of the body. The permanent removal of them is therefore much the same. There is surprisingly little discomfort and bandaging is minimal. Results are seen within a couple of weeks and can be quite remarkable.

Q It must be amusing for you to see this type of surgical procedure highlighted in the press recently, when you are an old ‘hand’ at it?
A Well, technology has evolved over the years allowing results to improve markedly. I have many patients wanting more ‘youthful’ looking hands.

Q Are veins covered under medical insurance?
A Most medical insurance companies will cover treatment of varicose veins if a sound medical reason can be given for the treatment. It is always advisable to check with an individual insurance company. Veins, like many other conditions covered, may require a referral letter from a GP before making an appointment. However, medical insurance companies will not cover what they see as cosmetic procedures such as thread vein injections.

Q I understand that you are also a legend in the ‘hernia’ world?
A Not sure about legend! My interest in this field coincides with the development of one of the earliest day surgery centres when I was a junior doctor in Kingston. I ran a hernia clinic at King’s College Hospital for many years, and I am constantly working on new techniques for improving groin hernia surgery, including reducing recovery times and post-operative pain. At The Baskerville Clinic I continue to treat different hernia conditions, including umbilical, recurrent and incisional hernias, as well as performing the new ONSTEP technique for groin hernias on which I have lectured and taught widely in the UK and abroad.

essence info

For those who are in doubt about veins in legs, or anywhere on the body for that matter, or have unsightly hand veins and want them removed, or happen to have a hernia, Paul Baskerville is by far the ‘peoples’ choice’. The Baskerville Clinic can be found at www.baskervilleclinic.com or to book an appointment contact Paul Baskerville’s PA, Geraldine Chope. Please be assured she is as informed as Mr Baskerville himself and is a fantastic first port of call for any concerns.
Email: geraldine@baskervilleclinic.com
Telephone: 020 7436 1931