Many times patients have questions that could be answered rather quickly without having to come into the office. The questions below are frequently asked questions that have been compiled by our doctors and staff at the Vein Care Pavilion of Nashville. All of these questions have been answered by the Vein Guys™, Drs. Roth and Davis concerning cosmetic and functional vein care issues. If you have any other questions, or would like to schedule an appointment, we invite you to call us.

Q: What should I ask or look for when choosing a vein centre?

A: First and foremost, choose a vein clinic or vein centre that has Board Certified Vascular Surgeons and Plastic Surgeons. These specialities are the most qualified to take care of medically necessary and cosmetic vein problems. Our vein surgeons, The Vein Guys perform all our vein procedures at the Vein Care Pavilion not physician assistants or aestheticians. Go to a vein practice that does this every day not just on the side and make sure the vein doctors have the numbers to back up their statements. The Vein Care Pavilion has performed well over 27,0000 vein procedures over the years. The vein practice should have Certified Ultrasonographers or Certified Registered Vascular Technicians performing all the vein scanning in the vein office. The Vein Care Pavilion has 5 Certified RVT's performing scans every day. Choose an office that ultilizes the VNUS Closure procedure which is considered the Gold Standard for the removal of varicose veins. Last, ask your friends about which vein doctors are having real success with spider vein treatments and varicose vein treatments, this is your best referral source. The Vein Care Pavilion and the Vein Guys have a 98% success rate with very high patient satisfaction.

Q: Why should I come to the Vein Care Pavilion for my minimally invasive vein procedures?

A: Drs. Roth and Davis are nationally recognized vein specialists with the VNUS Closure System and other vein treatments. Together, they have performed thousands of vein removal procedures and can take care of any vein on a patient's face, body or legs. Some of the minimally invasive vein therapies offered at the Vein Care Pavilion are ultrasound guided foam sclerotherapy, VNUS Closure, VNUS ClosureFAST, Trivex System, NLite Laser and other unique procedures developed specifically by Dr. Roth and Dr. Davis as a result of their years of experience. Vein surgery innovations are continually being developed by our vein doctors by virtue of the volume and types of surgeries they perform each day at the Vein Care Pavilion.

Q: What are the Classic Symptoms of Vein Disease?

A: The obvious symptoms are bulging, ropey or rope-like varicose veins and spider veins. Other symptoms include aching, throbbing, itchy, numb, burning, cramping, swollen, tired, fatigued, skin discoloration, open sores or ulcers, heavy legs, ankles and/ or feet. Also, cramps that wake you up at night or a diagnosis of RLS (Restless Leg Syndrome)have recently been included as symptoms. If you have any ONE of these symptoms you probably have vein disease and need to schedule an appointment at the Vein Care Pavilion for an insurance or Medicare covered consultation and evaluation. Remember, you don't necessarily have to have visible varicose veins or spider veins to have vein disease. These symptoms may be gradual or rapid in onset and in most cases, there is a history of vein problems in your blood-related family.

Q: Is Varicose Vein Treatment Cosmetic or do Insurance Companies take care of this vein removal procedure?

A: Insurance companies and more importantly MEDICARE have in recent years recognized vein disease as a legitimate, covered medical expense. If you are experiencing any symptoms of vein disease it is worth finding out if your vein problems can be paid for by your insurance company. All you have to do is make an appointment at the Vein Care Pavilion for a consultation followed by an in-office venous ultrasound test. If you test positive for vein disease, Medicare and Most Insurance Companies will cover the consultation, venous reflux test and the varicose vein/ spider vein treatments Dr. Roth and Dr. Davis perform at the Vein Care Pavilion.

Q: What types of patients do you typically see at your Vein Treatment Center?

A: Every week, our surgeons typically see seven different types of patients. The first, is the obvious vein patient that has bulging, ropey or rope-like veins on their legs. The second, is a patient that has really bad leg pain or swelling and a few outwardly noticeable spider veins. The third, is a patient that has open non-healing wounds/ulcers on their lower legs and ankles. The fourth, is a patient that has experienced some form of trauma to their legs and this has caused the venous system to become diseased. The fifth, is a patient that has skin discoloration of the legs and/or ankles. The sixth type is a patient that has cramping or RSL ( Restless Leg Syndrome) and cannot seem to sleep at night because of this condition. Most of these patients also experience varying degrees of aching, throbbing, itchy, numb, burning, swollen, cramping, tire, fatigued, heavy legs and/or feet. The last, is a patient who strictly has cosmetic veins on their legs, body or face and would like to see a doctor who is cosmetically trained like our plastic surgeon to diagnose and treat their veins correctly.

Q: Is the minimally invasive procedure VNUS Closure/ClosureFAST safe?

A: Together, Dr. Roth and Dr. Davis have performed thousands of VNUS Closure/ClosureFAST procedures at their vein treatment centers and have pioneered and been on the cutting edge of the newest vein technologies. VNUS Closure/ClosureFAST is the market leading treatment for vein disease, venous insufficiency and varicose veins. All procedures are accompanied by a certain degree of risk, whether they are for medical or cosmetic reasons. Our expert vein care team is dedicated to making your minimally invasive procedure a success. We carefully review your medical history and current health condition before deciding if it is safe for you to proceed with the individualized treatment plan established and recommended by our vein specialist surgeons. It is important that you fully disclose all pertinent health related information so that we are able to make an accurate assessment of the risks involved. We will take every precaution necessary to reduce the possibility of any complications. The Vein Care Pavilion has a 98% success rate with the VNUS Closure/ClosureFAST procedure.

Q: How do I know if the VNUS Closure/ClosureFAST surgery is right for me?

A: There several important factors that come into play when deciding whether this procedure is the right option for you. The most important factors are your health and if you display symptoms of vein disease.

For years the standard medical guidance to proceed on with the old technique of vein stripping was to visually see those bulging, rope-like veins on a patient's legs. Today, in many cases, the “new” classic symptoms are less noticeable. Below is a list of Warning Signs for Vein Disease:

  1. History of vein problems in your blood-related family.
  2. Fatigued, tired, heavy-feeling legs.
  3. Visible varicose veins and/or spider veins.
  4. Leg pain caused by prolonged standing or sitting.
  5. Itchy, tingling, numb, cramping or burning in legs or feet.
  6. Swollen ankles at the end of the day.
  7. Discoloration of the skin in the lower legs.
  8. Open sores or ulcers of the lower legs and ankles.

If you have any one of these signs, you need to schedule an appointment at the Vein Care Pavilion for an insurance-covered evaluation. Vein disease can be determined by a patient undergoing a simple Ultrasound Venous Reflux Test in our office. Be prepared to thoroughly discuss your goals and major concerns with Dr. Roth and Dr. Davis during your initial consultation.


Q: When you do the VNUS Closure Procedure what happens to the valves of the leg vein?

A: When the VNUS Closure Procedure is performed at the Vein Care Pavilion the diseased or damaged valves in the leg vein are ablated or closed off along with the vein itself. There is a misconception that these valves are repaired but that is NOT the case. Endovenous Ablation of the vein and the valves is the intended outcome for the procedure.

Q: Does it matter how old I am?

A: It is never to late to improve your quality of life. With that said, the vein doctors of the Vein Care Pavilion will always conduct a thorough physical examination and discuss in detail your medical history to determine if you are a good candidate for any of the many vein treatment options available to you as a patient. Due to the variety of minimally invasive procedures offered, there is no blanket rule on age although age will be taken into consideration when planning your procedure and/or operation. Patient safety will never be compromised at the Vein Care Pavilion. Over the years, patients of all ages(18yrs to 102yrs) have taken advantage of the cosmetic and corrective vein solutions offered by our vein specialists. We are committed to making your vein care experience a successful and above all a safe one.

Q: I am rather young so can I wait to have my veins done even though I have vein disease?

A: Vein Disease does not get better over time ,in fact, the symptoms get worse and can deteriorate into more serious conditions like Venous Stasis Dermatitis and Venous Stasis Ulcers. Our surgeons have worked on patients as young as 18yrs old and on a “young at heart” 102yr old gentleman. Blood-related family history plays a major role in vein disease and in many instances Drs. Roth and Davis have worked on 3 seperate generations of the same blood-related family. Futhermore, vein disease does not discriminate between men and women.

Q: What happens during my initial consultation?

A: During the consultation you and the doctors will discuss your concerns and expectations, review your medical history and current health, and make an assessment on whether the procedure(s) in question are right for you. This is a good time to ask specific questions about the procedure so that you are fully prepared for vein surgery or a specific treatment. We will discuss the results that can be achieved and pictures may be taken at this time to chronicle your treatment plan digitally. Preoperatively, when final decisions are made by you and the doctors, an informed consent will need to be signed stating that you are fully aware and understand what is involved with your pending operation, including the potential complications and secondary effects.

Q: Which type of vein doctor should I go see to evaluate and treat my vein problems?

A: Vascular surgeons and Plastic surgeons are the only vein doctors with extensive training in this specialty. Not only are these doctors general surgeons but they completed fellowships in vascular surgery and microvascular surgery respectively. The Vein Care Pavilion is the first and most experienced full time Total Vein Care Center in the South solely dedicated to cosmetic and corrective vein treatment solutions.

Q: Will the VNUS Closure/CIosureFAST affect my circulation if I have this procedure done?

A: VNUS Closure/ClosureFAST will affect your circulation in a positive way. By removing veins that no longer work properly, the venous system can begin to work more efficiently. Blood is rerouted to healthier veins that are not diseased so circulation is actually improved.

Q: Is there a difference between VNUS Closure, VNUS ClosureFAST and Laser Closure (EVLA,EVLT)?

A: Yes, recent studies conducted show that the VNUS Closure, VNUS ClosureFAST Procedures out perform both traditional vein stripping and Laser Closure. The VNUS Closure System has been shown to have fewer side effects and post-procedure complications like DVT's (Deep Vein Thrombosis), pain, bruising and skin burns. VNUS Closure and VNUS ClosureFAST has a faster procedure time and a higher success rate than Laser Closure. After this in-office vein treatment most of our patients can go back to work the very next day. The VNUS Closure System is considered the gold standard for the removal of diseased superficial veins and is the choice 70% of the time by most vein doctors. Dr. Steven Roth was one of the first surgeons to write a nationally recognized paper published in the Journal of Vascular Surgery highlighting his work and research on the differences between VNUS Closure and Laser Closure at the Vein Care Pavilion.

Q: What are some of the risk factors for getting deep vein thrombosis (DVT) in my legs and how can I prevent it?

A: Deep Vein Thrombosis or DVT in the leg is a life threatening venous disorder that occurs when thrombus or a blood clot developes in the deep venous system. When venous blood flow becomes more stagnant, the risk of developing a DVT increases. This is more commonly seen in individuals with venous reflux and varicose vein disease. Superficial venous blood clots (superficial thrombophlebitis) can lead to DVT because of the incompetent valve system linking the deep and superficial systems together and the propagation of clot through these faulty valve sites throughout the leg. One way to decrease your risk of a DVT is to correct the venous reflux and varicose vein disease by eliminating those veins with leaky valves. This is easily accomplished with endovenous radiofrequency ablation(EVRFA) or the VNUS Closure procedure we perform at the Vein Care Pavilion on abnormal superficial and perforator veins. This non-surgical approach is done in the doctor's office, under local anesthetic with i.v. sedation, takes less than an hour to perform with NO INCISIONS, and is virtually painfree. The patient can return to normal activity that day knowing they are going to have healthier legs in the near future.

Q: Are “skin burns” after a varicose vein laser procedure a normal outcome for Laser Closure(EVLT,EVLA)?

A: Absolutely not! This is considered a complication. Dr. Roth and Dr. Davis have chosen VNUS Closure and VNUS ClosureFAST which are radiofrequency not laser because of this very complication. With Radiofrequency Ablation of the Varicose Veins (EVRFA) the outcome is more predictable because the heat source is monitored by the generator, certified RVT, and Vein Surgeon. Therefore, the likelihood of complications is significantly reduced with this type of vein removal procedure. Have your veins done right the first time. The Vein Care Pavilion has a 98% success rate and has been setting the standard of excellence for vein centers since 2004 for patient care, safety and experience for the treatment of all cosmetic and superficial vein disorders.

Q: What does a “comprehensive vein clinic” mean at the Vein Care Pavilion?

A: We are not a Medi-spa or a Laser and Aesthetic Center that can only offer and perform certain vein procedures. Some practices and businesses have a limited variety of vein care services but the Vein Care Pavilion is a medical vein practice that delivers the most comprehensive vein treatment options to its patients. We are pleased to offer our patients a Vascular Surgeon and a Plastic Surgeon with years of vein expertise to correctly diagnose, choose and perform the correct procedure, and follow-up on a patient's post-operative care until their treatment plan is completed with the desired results. These vein solutions are covered by insurance in most cases and are all minimally invasive so a patient can resume their daily activities or go back to work the very next day.

Q: Do you treat Spider Veins?

A: Yes, Drs Roth and Davis inject spider veins on the legs everyday at their vein center the Vein Care Pavilion. Our surgeons eliminate spider veins by using a technique called sclerotherapy. Very small gauge injection needles are used for the patient's comfort. This technique is done by injecting various solutions called foaming agents into these small veins. Spider Vein injections take about 15 minutes and can be performed throughout the calendar year with this innovative foam sclerosant. On average, these veins are eliminated in 3 to 4 weeks.

Q: What causes Spider Veins on my nose/face and what spider vein treatment is available?

A: Usually on of three things; Rosacea, continual Sun Damage without the daily use of sunscreen, and Family History. The Nlite Laser with vascular upgrade has a proven track record for the treatment of all facial veins and telangictasias . In some cases this laser procedure is covered by insurance. Remember, the skin on the face/nose is very delicate. Your vein surgeon must have the knowledge and experience as to what laser setting is best suited for your individual veins and skin type to achieve good results without damage, burns or scarring. Clinical skin care prescriptions, peels and procedures are also available to aid prevention and help maintain the health of your skin. Our medical vein center utilizes ONLY on-site surgeons to perform all our vein procedures. We are a Total Vein Care Clinic in the South with locations in Nashville, Tennessee TN, Augusta/Evans, Georgia GA, and Raleigh/Knightdale, North Carolina NC.

Q: Is it better to use Laser or inject Spider Veins to get rid of them?

A: We utilize both procedures at the Vein Care Pavilion. However, the answer to this question is dependent on the careful examination of your skin type, the color and depth of the veins, along with the location of the spider veins on your body. Dr. Roth and Dr. Davis specialize in veins and they have the years of experience correctly diagnosing which spider vein treatment would be best for each patient. Recent statistics show that complications in the U.S. are up a whooping 42% because patients are having these procedures done by “Aesthetic Practitioners” and non-physicians. Various states around the country are now passing laws to regulate this sub-specialty of medicine. Our advise is to stick with th medical specialties that treat veins for a living– Vascular Surgeons and Plastic Surgeons.

Q: How does the Foam Sclerosant for Spider Vein Sclerotherapy work?

A: Foam Sclerotherapy is the latest development in the sclerotherapy field. Vein Doctors now have a new and more effective way to deliver the sclerosing agent directly to the problem veins. 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 tiny vein which sticks to the wall of the vessel causing the vein to close.

Q: If I just have Spider Veins should I still have an Ultrasound Venous Reflux test performed?

A: Yes, 75 Million Americans have vein disease and a large percentage of this number don't even know it. Many Vein Care Pavilion patients come in thinking their veins are strictly cosmetic but they soon realize they have a much larger or underlying vein problem. Their spider veins are just the beginning symptoms of vein disease. The Vein Care Pavilion is proud to offer an in-office accredited vascular lab with three RVT's(Registered Vascular Technicians) that scan patients everyday for arterial and venous reflux or vein disease. As a results driven vein care clinic we believe a proper diagnosis is vital to a successful outcome and optimal results. Together as a team, our surgeons and staff are uniquely qualified to correctly scan and evaluate each patient 's test .

Q: Why did you decide to form this unique vein practice?

A: Drs Roth and Davis felt each community as a whole would benefit from the FDA approved leg vein removal procedure VNUS Closure. 50 percent of Americans have vein disease and suffer unnecessarily each day with these painful symptoms. The symptoms effect their quality of life and can be corrected by their minimally invasive techniques. Together they felt their vein treatment centers would make available a full spectrum of cosmetic and functional vein options for a wide array of patients in and around the South. The Vein Care Pavilion has seen tremendous growth since 2003 and has become one of the top 5 vein centers in the country. This expansion has allowed Dr. Roth and Dr. Davis to open two other locations around the South in Nashville, Tennessee TN and in Raleigh/Knightdale, North Carolina NC.

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