Patient satisfaction results from identifying and properly treating the patient’s primary concerns, i.e., medical and/or cosmetic issues. Not all symptomatic patients are aware of their symptoms because the onset may be insidious. Symptoms may include leg heaviness, pain or tenderness along the course of a vein, pruritus, burning, restlessness, night cramps, edema, skin changes, and paresthesias. After treatment, patients are often surprised to realize how much discomfort they had accepted as normal. Pain caused by venous insufficiency is often improved by walking or by elevating the legs. The pain of arterial insufficiency, conversely, is worse with ambulation and elevation. Pain and other symptoms of venous disease may worsen with the menstrual cycle, with pregnancy, and in response to exogenous hormonal therapy (eg, oral contraceptives).