Quick Read: If your legs keep swelling, puffy ankles by evening, one leg heavier than the other, skin that feels tight or looks discoloured — this blog is worth reading before your next appointment. Leg swelling is often dismissed as tiredness or ageing, but when it keeps coming back, it may signal a circulation or vein problem that will not improve on its own. In this blog, Dr Chen Min Qi, a vascular and endovascular surgeon practising in Singapore, explains what is really happening inside your veins, when you need to act, what modern minimally invasive treatment looks like, and what to expect in terms of cost if you are considering care in Singapore.
Dr Chen Min Qi, MBBS, MRC, FRCS, FAMS
When Leg Swelling Is More Than Just Tiredness
Most people assume swollen legs mean they have been on their feet too long, had too much salt, or are simply getting older. Sometimes that is true. But when swelling keeps returning, especially when it is worse in one leg, comes with aching or a heavy feeling, or starts leaving marks on your skin, your veins may be struggling to do their job.
Inside your legs, a network of veins works against gravity to push blood back up to your heart. When the valves inside these veins weaken or fail, blood pools in the lower leg. Fluid leaks into the surrounding tissue. The leg swells, sometimes slowly over months, sometimes suddenly.
This is called chronic venous insufficiency (CVI) — and it is far more common than most people realise. Dr Chen Min Qi sees this pattern often in his vascular practice: patients who have been managing with compression stockings for months, or moving between different doctors, without anyone looking carefully at what is happening inside the veins.
Other vascular-related causes of persistent leg swelling include:
- Deep vein thrombosis (DVT) — a blood clot in the deep veins. DVT causes sudden, often painful swelling in one leg and requires urgent medical attention. This is not a condition to monitor at home or delay seeking care for.
- Pelvic vein compression (May-Thurner syndrome) — the left iliac vein gets compressed between the spine and an artery, restricting blood return from the left leg. This is frequently missed on standard scans and is one of the conditions Dr Chen specifically looks for when the left leg swells disproportionately.
- Lymphedema — swelling caused by impaired lymphatic drainage, often following cancer treatment, infection, or injury. This requires a different management approach from vein disease.
An important clinical point: these conditions can look similar on the surface but require very different treatments. A proper duplex ultrasound — not just a physical examination — is how you tell them apart. This is the starting point for any meaningful vascular assessment.
What Happens If You Leave It Too Long
Persistent venous swelling is not just uncomfortable. Left unmanaged, it causes progressive damage to the skin and deeper tissue — changes that become increasingly difficult to reverse.
Here is what that progression looks like:
- Skin around the ankle becomes dark, hardened, and leathery, a condition called lipodermatosclerosis, which signals significant venous pressure buildup.
- Venous eczema develops — the skin becomes itchy, inflamed, and fragile, and can break down with minimal trauma.
- Venous leg ulcers form — open wounds around the lower leg or ankle that are slow to heal and highly prone to infection. These are painful, disabling, and costly to treat once they develop.
- In undetected DVT, a clot can dislodge and travel to the lungs, causing a pulmonary embolism — a life-threatening emergency. This is why sudden one-sided leg swelling should never be dismissed.
Compression stockings can slow the progression, but they do not treat the underlying vein problem. For many patients, the window for the most straightforward treatment is earlier, before the skin and tissue changes become permanent.
What Modern Vascular Treatment Actually Looks Like
Treatment starts with an accurate diagnosis. At Dr Chen’s clinic, this means a clinical assessment combined with a detailed duplex ultrasound of the leg veins and, where relevant, the pelvic veins — to map exactly where the problem is and how severe it is. This step shapes everything that follows.
Depending on what is found, treatment options include:
- Endovenous thermal ablation (laser or radiofrequency) — a thin catheter is guided into the diseased vein under ultrasound, and heat is used to seal it shut. No large incisions, no general anaesthesia in most cases. The procedure takes around 45–60 minutes, and most patients walk out the same day.
- Venoplasty and stenting — for pelvic vein compression (May-Thurner syndrome), a balloon opens the narrowed vein and a stent keeps it open. This is a treatment that is not routinely offered at most vascular centres in the region.
- Sclerotherapy — injection of a solution to close smaller varicose veins and spider veins. Often used alongside ablation for more comprehensive treatment.
- Lymphedema management — a structured programme combining compression therapy, manual lymphatic drainage, and patient education for patients where lymphatic drainage is impaired. Surgical procedures may be considered for more advanced cases to alleviate some of the symptoms.
Most of these are performed as day procedures. Recovery is typically short, and many patients return to light activity the next day.
Why Patients Choose Singapore — and What It Costs
For Indonesian patients considering where to seek vascular care, Singapore stands apart not just for its medical infrastructure, but for the depth of subspecialty expertise available in a single centre.
Singapore’s healthcare system operates under rigorous national standards, and vascular specialists here are trained and credentialled to international benchmarks. For complex or difficult-to-diagnose conditions, pelvic vein obstruction, May-Thurner syndrome, or leg swelling that has not responded to standard treatment — access to the full range of diagnostic tools and interventional capabilities in one place matters far more than geography.
Treatment in Singapore involves a higher cost than in Indonesia, and that is worth planning for honestly. Here is a realistic cost guide:
- Initial specialist consultation: SGD 218 (approximately IDR 3 million)
- Duplex ultrasound: SGD 400–700 (IDR 4.6–8 million)
- Endovenous ablation: SGD 4,000–8,000 (IDR 46–92 million), depending on the extent of disease
- Venoplasty/stenting for pelvic vein obstruction: SGD 8,000–15,000+ (IDR 92–170 million+), depending on complexity
What this reflects is access to a vascular surgeon with dedicated subspecialty fellowship training, a clinic equipped with a hybrid operating theatre for complex procedures, and the full range of minimally invasive options under one roof.
Conditions like May-Thurner syndrome are frequently missed in routine vascular workups, not because the technology does not exist, but because diagnosing them requires a surgeon who specifically looks for them. For patients who have spent months without a clear answer, getting an accurate diagnosis and the right procedure done once is what ultimately matters — in outcomes, in recovery, and in total cost over time.
Dr Chen’s clinic at the Vascular & Interventional Centre also provides Bahasa Indonesia-speaking support and can assist with appointment coordination for patients travelling from Indonesia.
About Dr Chen Min Qi — Vascular & Endovascular Surgeon, Singapore
With over 2,000 endovascular procedures to his name, Dr Chen Min Qi brings a depth of hands-on experience in minimally invasive vascular care that is rare in the region.
His training path reflects a commitment to subspecialty excellence:
- Medical degree from the Yong Loo Lin School of Medicine, National University of Singapore (NUS)
- Advanced vascular subspecialty fellowship at St Mary’s Hospital, London — one of the world’s leading vascular centres — funded by the Singapore Ministry of Health’s Health Manpower Development Plan (HMDP) scholarship, awarded to a select few surgeons each year
- Former Head of Vascular Service at Woodlands Health, where he led multidisciplinary teams managing complex vascular conditions, diabetic limb disease, and surgical service development
- Clinical tutor at both NUS and NTU medical schools, and peer reviewer for the International Wound Journal
- Specialist in procedures not routinely offered at most vascular centres in the region, including pelvic vein stenting (May-Thurner syndrome), prostate artery embolisation (PAE), and vascular treatments for erectile dysfunction
His clinic, the Vascular & Interventional Centre, is equipped with a dedicated hybrid operating theatre that supports complex endovascular work — the kind of setup that allows procedures like pelvic vein stenting to be planned and performed with precision imaging on-site.
FAQs
Mild occasional swelling, after a long flight or a day on your feet, often improves with rest and elevation. But swelling that keeps returning, worsens over time, or affects one leg more than the other is unlikely to resolve without finding and treating the underlying cause.
Vein-related swelling typically comes with heaviness or aching in the legs, ankle swelling that is worse by evening, visible varicose veins, skin darkening around the ankle, or a history of blood clots. A duplex ultrasound is the most reliable way to confirm this. A physical examination alone is not enough.
DVT is a blood clot in the deep veins. It typically causes sudden, painful swelling in one leg and requires urgent assessment. Chronic venous insufficiency (CVI) is a long-term condition where vein valves fail gradually, causing progressive swelling, heaviness, and skin changes over months or years. Both need different treatment approaches.
Taking the Next Step Toward Healthier Legs
If you are considering minimally invasive vein treatment in Singapore, you may contact the clinic team via WhatsApp for consultation arrangements and care coordination with Dr Chen Min Qi.
