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Microphlebectomy for Varicose Veins
Microphlebectomy is a minimally invasive outpatient procedure that removes varicose veins through tiny skin punctures. Learn how it works and whether it's right for you.
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Who Is a Good Candidate for Microphlebectomy?
Microphlebectomy is well-suited for patients with:
- Large or medium-sized varicose veins close to the skin's surface
- Varicose veins that cause symptoms such as aching, heaviness, swelling, or cramping in the legs
- Veins that have not responded to or are not appropriate for compression therapy alone
- Veins that require physical removal rather than ablation
- Those wishing to avoid the risks of skin staining seen with sclerotherapy of large veins.
It is often performed alongside endovenous ablation or echosclerotherapy, which treats the underlying diseased saphenous vein, while microphlebectomy removes the visible tributary branches. Your physician will assess your veins using ultrasound before recommending a treatment plan.
Microphlebectomy may not be appropriate for patients with active skin infections near the treatment area, blood clotting disorders, or certain circulatory conditions. A thorough consultation will determine whether this is the right approach for you.
What is Microphlebectomy?
Microphlebectomy (also called ambulatory phlebectomy) is a minimally invasive surgical procedure that removes varicose veins close to the surface of the skin. Using small punctures rather than incisions, a surgeon extracts the affected vein segments through the skin to remove or interrupt a problem vein.
The procedure is performed under local anesthetic, most patients walk in and walk out on the same day, and results are immediate and visible. For bulging, rope-like varicose veins that cause pain, heaviness, or cosmetic concern, microphlebectomy offers a highly effective and durable solution.
How Microphlebectomy Works
Before the procedure
Your surgeon will mark the varicose veins on your leg while you are standing, as veins are more visible in this position. A duplex ultrasound is typically performed beforehand to map the venous anatomy and confirm the treatment plan.
During the procedure
The skin is cleaned and local anesthetic is injected along the treatment area to numb it thoroughly. The surgeon makes a series of very small punctures (typically 1 to 3 millimetres) along the course of the vein. Using a small phlebectomy hook, or tiny graspers, the vein is gently removed in segments through these openings. The punctures are so small that stitches are often not needed; they are covered with small adhesive strips and a compression bandage.
The procedure typically takes 15-30 minutes depending on the extent of the veins being treated.
After the procedure
You will be asked to wear a compression stocking for a period following the procedure, usually one to two weeks. Walking is encouraged immediately and helps promote healing and circulation. Most patients return to desk work within a day or two and resume more active work or exercise within one to two weeks.
What Results to Expect
The veins removed during microphlebectomy are gone permanently.
Because the vein is physically extracted rather than collapsed in place, there is no residual bruising or tissue reaction from a destroyed vein underneath the skin. The tiny puncture marks heal quickly and typically fade to the point of being barely visible within a few months.
Some bruising and swelling along the treatment area is normal and resolves over one to three weeks. The overall cosmetic outcome is generally excellent.
It is worth noting that microphlebectomy treats existing veins, not the underlying condition that caused them. If untreated venous insufficiency is present, addressing it (usually through ablation of the saphenous vein) is important to reduce the likelihood of new varicose veins developing over time.
Benefits of Microphlebectomy
Microphlebectomy is one of the most effective treatments available for surface varicose veins. Key advantages include:
- Performed under local anesthetic with no general anesthesia required
- Outpatient procedure with same-day discharge
- Immediate removal of the vein, with no waiting for the vein to be gradually reabsorbed
- Very low risk of scarring
- High patient satisfaction and durable results
- Can be combined with other venous treatments in the same session
Risks and Considerations
Microphlebectomy is a safe procedure with a low complication rate, but patients should be aware of the following possibilities:
- Bruising and swelling in the treated area, which resolves over days to weeks
- Temporary numbness or altered sensation near the treatment site
- Small residual skin marks at puncture sites, which typically fade significantly
- Wound infection (rare)
- Recurrence of varicose veins over time if underlying venous insufficiency is not also treated
Your surgeon will discuss your full risk profile during your consultation.
Frequently Asked Questions
What is microphlebectomy?
Is microphlebectomy painful?
How is microphlebectomy different from vein stripping?
How is microphlebectomy different from sclerotherapy or laser treatment?
How long is recovery after microphlebectomy?
Will the varicose veins come back after microphlebectomy?
Does health insurance cover microphlebectomy?
Book a Consultation
If you are living with varicose veins that cause discomfort or affect your confidence, a consultation at Windflower Vein & Vascular is the first step toward understanding your options.
We will assess your veins, answer your questions, and recommend a treatment plan that fits your goals and anatomy.
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