Skin discoloration, thickening and ulcers of the lower legs are often caused by incompetent perforator veins in the calf.  Douglas H Joyce, D.O., Triple Board Certified in Cardiovascular & Thoracic Surgery, General Surgery and Phlebology (Venous Disease), is one of the world’s most experienced perforator vein surgeons. He was one of the first surgeons in the world to realize the link between perforator incompetence and severe venous disease resulting in such debilitating conditions as chronic venous insufficiency.  Under his care, formerly untreatable, long-term leg ulcers have been healed. Leg ulcer patients often come from all parts of the country seeking treatment by Dr. Joyce due to failure of vein treatment clinics to offer help for their chronic venous disease condition. Their story is almost always the same: they are told that nothing more can be done for their leg ulcers other than symptomatic treatment in wound care centers. Once they learn about Dr. Joyce's remarkable leg ulcer treatment results, they come from all over to the Joyce Vein & Aesthetic Institute in Punta Gorda, Florida to benefit from Dr. Joyce’s venous leg ulcer treatment expertise.

Dr. Joyce began using the SEPS procedure to treat perforator disease in 1998. Over the next seven years, he refined the procedure and used it to treat over a thousand patients, one of the highest patient series in the world. The SEPS procedure uses a tiny camera or endoscope inserted through a small incision below the knee to visualize the compartment where the perforator veins are located. Tiny titanium clips are then placed around the malfunctioning veins, closing them and enabling healthy veins to take over. Approximately 94% of leg ulcers can be completely healed with SEPS. The SEPS procedure must be performed in the hospital under general anesthesia.

Over the past several years, Dr. Joyce has pioneered the use of radiofrequency and more recently, laser ablation for treating incompetent venous perforators in the office setting. These less invasive office procedures have proved to be highly effective and well tolerated. They have totally replaced the SEPS operation for the treatment of perforator disease. Laser perforator ablation takes less than 20 minutes of surgical time and most patients can go home with minimal restrictions.