We next determine which pattern of great saphenous vein (GSV) or small saphenous vein (SSV) reflux exists for classification and treatment:

1. Segmental reflux - reflux source or origin from a tributary or perforating vein distal to the saphenous junction and reflux drainage through a tributary or perforating vein in the thigh, knee or calf.
2. Distal reflux - reflux source or origin from a tributary or perforating vein distal to the saphenous junction and drainage through veins at the ankle.
3. Proximal reflux - reflux source at the saphenous junction and drainage thorugh tributary or perforating vein at the thigh or calf, but proximal to the ankle.
4. Multisegmental reflux - Two or more reflux segments with five basic types - proximal segmental, proxmal distal, segemental segmental, segmental distal and proximal segmental distal.
5. Diffuse reflux - reflux source at the saphenous junction and drainage at the ankle and no discernable patern or from of the great sapehnous vein.
6. Perijunction reflux -
7. Normal pattern - absence of extension into the saphenous vein down to the ankle

This pattern utilized is from CA Engelhorn from Phlebology 2012; 27: 25-32.  

Dr. Raffy Karamanoukian, a Board Certified Plastic Surgeon appeared on The Doctors TV Show again on 1-30-2013 where he revised a face lift for a patient who also had issues with her ear lobes.

Watch the episode on The Doctors TV Show featuring Dr. Raffy Karamanoukian of www.KareMD.com and www.Surgery90210.com