We use the most modern laser treatment, utilizes two types of lasers.

We see several venous lake laser treatment patients a week that travel great distances to get to us.  Nearly every patient has found me online and nearly every patient has spoken to dermatologist and many have already tried several different treatments.  For instance, this yelp reviewer had seen several dermatologists already as well.  Many speak of treatment options including tying off microscopic blood vessels (run don’t walk away from a doc still using that outdated treatment method!).  Some have already tried a laser treatment.

The problem is that the right laser must be used!  I have seen several patients that have had failed treatments from their dermatologist using CO2 lasers.  Those are soft tissue lasers that dermatologists use all the time because they target water and thus destroy all tissue non-selectively.  When treating a venous lake, we want to target blood and not tissue.  Fortunately, the laser we use targets blood.  Blood is a common occurrence in the mouth (don’t floss for a week and then floss hard and find out for yourself).  Therefore, it should not come as a surprise that the dental field relies on lasers that are specific to blood.  The discovery that our blood lasers would work great on blood lesions wasn’t a monumental discovery, just someone putting 2 and 2 together.

Before you come

Call our office and you will likely be instructed to send us a photo.  2 or 3 photos are better than one.  The front office will give you the email of where to send it.  That is often all we need for diagnosis.  Dr. Bauer will follow up with you if he has any additional questions.  Once we confirm you have a venous lake we can get you scheduled.  Please do not pick at it or pop it right before you come.  It makes it harder for us to treat it effectively.  We want to see it at it’s worse!  The energy of our laser targets the blood so if you pop it, the venous lake will be harder to treat.

Live far away?  All we ask is that you send a follow up photo of the venous lake!

Cost of venous lake treatment

We charge and collect up front around $1200 (2023) for this treatment and do NOT submit to dental insurance. They consider this esthetic and do not cover.  The fee changes every year so if the correct year is not listed it will cost a small amount more. This fee includes all follow up treatments (very rarely does anyone need a follow up treatment) if needed and covers the lesion no matter how large or how many lesions you have.

If you have a HSA or FSA account, we recommend using that.  We currently do not submit to medical insurance for this, but we give you the paperwork to submit yourself.  However, don’t get your hopes up.  It’s hard enough to even figure out how to submit, let alone get payment for something like this.  The diagnostic portion of medical ICD-9 code for this procedure is Venous lake (456.8).  Since this is considered cosmetic, you will have to have a very generous health insurance plan for it to be covered. I’m not sure anyone has ever succeeded in getting medical to pay for it, none that I am aware of.

Healing time for venous lake lip treatment

Having done as many venous lake treatments as we have, we have learned a few modifications in the procedure that are resulting in even faster healing times.  It often takes 3-4 weeks to see total resolution of the area but occasionally we see healing as little as two weeks.  If the venous lake is deep into your lip (usually can’t tell until we work on it), a small white fibrous area forms under the skin and takes several more weeks to a couple months to completely disappear.  You will be able to find it if you look very closely but the white area will not be detectable to others.  No scar, no obvious evidence of anything having ever been there is the norm!

What does a venous lake laser treatment look like during the healing period?

The laser is cauterizing blood and tissue so it looks and heals similar to a burn at first and then a scab.  The larger the area that needs treatment the worse it will look during the healing phase.  It can be swollen and be red, black, white, grey, and/or red.  This patient sent a healing photo just short of two weeks of his two venous lake lesions.  The worst of his healing was over by then. To learn more about the healing period check out our page on healing.

Success rate of venous lake removal with laser is 100% and 90-95% remain gone at 5 year mark.

We are able to remove 100% of venous lakes with the laser and have a 90-95% success rate at 5 years. In other words we have around 5-10% recurrence rate by 5 years.  The majority of those that we have seen recur come back very faint and small and would most likely never be noticeable by the individual if they did not know to look for slight blue variations in that area. In other words, even the recurrences are practically unnoticeable. A small percentage, maybe 1-2%, come back and can although we can treat again they are too deep within the lip to completely eliminate. We do offer complimentary retreatments for 5 years. There is no long term data in existence for this treatment. Our oldest treatments are close to 10 years but there is not enough to comment on the 10 year success rate.

Complications of venous lake laser treatment

Having treated hundreds of these over the last decade we have seen most of the likely complications that can occur. Some we can avoid by changing and improving our protocols, some we can not avoid.

Our reported complication rate is under 5%. The complications we have seen are infection, bruising, fibroma (scar like tissue) formation, and temporary numbness in the area. We have also seen a 5 year recurrence rate of around 5%. Recurrences that we have seen were usually very minor.  All recurrences and complications have occurred on larger venous lake lesions.

Recurrence of the venous lake

The photo below is of a venous lake recurrence 2 and 1/2 years later. This doesn’t look like a large lesion but it is. The way you can tell by looking that it is large is that it is actually producing a swelling in the lip.  This lesion is deep under the tissue so doesn’t look as blue. These are difficult if not impossible for the laser to completely treat, because they are so deep. Treatment will improve the appearance but may not ever be able to completely treat.

Below it the same patient 3 weeks after her second complimentary treatment. It looks good now but I think it will recur yet again. We treat for 5 years for free after the initial treatment.

Firboma formation after venous lake laser treatment

This occurs sometimes and is usually too small to notice. It feels like a small bump in the lip. We have very few people where it was large enough to be visible without pursing the lips. We went back a few months later and were able to remove the fibroma with the laser without issue. However, the fibroma is often small enough that we can miss it with the first surgery (happened on the case below).

Bruising from venous lake treatment

As with any surgery, bruising can occur. This is very rare but can happen. Bruises take 7-14 days to heal.