Ambulatory Phlebectomy

For veins that are large and close to the surface, ambulatory phlebectomy is often the best approach. The visible veins protruding under your skin are actually branches from a deeper (superficial) vein. Even though the deeper vein, such as the Great Saphenous Vein (GSV) or Small Saphenous Vein (SSV) is closed, these visible veins still remain. This is because the vein has been weakened beyond the point where it can contract to normal size. In this case, a phlebectomy offers the best cosmetic result for removing these veins.

A phlebectomy is the removal of a vein through a very small incision under a local anesthetic. A small hook is passed through this incision to elevate and hook the vein. This may be done in conjunction with the primary procedure or done at a later date. In this procedure, a skin incision of about 1 mm is made through which the veins are extracted. Ambulatory phlebectomy is done under local anesthesia. Patients generally wear compression bandages for 2-3 weeks afterwards to facilitate healing.  This minimizes swelling and discomfort and allows for proper healing. 



The benefits to ambulatory phlebectomy include:

      * Office procedure~walk-in, walk-out treatment

      * Minimally invasive (micro-incisions or pinholes only)

      * Local anesthesia

      * No stitches or scars

      * No downtime

      * Excellent cosmetic results



After the varicose vein is removed, your leg is wrapped with an ace bandage and you’re asked to walk around the doctor’s office before going home. Once the ace bandage is removed it will be replaced with a compression stocking that you’ll need to wear for 2 weeks.

Most patients experience little to no discomfort and generally don’t even need pain medication. In fact, you are encouraged to walk after the treatment, then return to work the next day. Strenuous activity is limited for 2 weeks, however. The results of this procedure have been excellent, both from a cosmetic and patient satisfaction point-of-view.

Frequently Asked Questions

How does the procedure actually work?
Skin incisions or needle punctures as small as 1mm in diameter are used to access and extract the varicose vein with a phlebectomy hook. The hook is inserted into a micro-incision in the leg, and a section of the vein is hooked, then removed, through the incision. After the procedure, a compression bandage is placed, then you will wear compression stockings for 2 weeks. This minimizes swelling and discomfort and allows for proper healing.

What is the recovery and post-operative care like after an ambulatory phlebectomy?
You can go back to work and return to normal daily activity 24 hours after treatment ~ walking is very much encouraged! You’ll need to wear a support stocking for 2-3 weeks following the procedure.  The wounds will take an entire year to completely remodel, but you can minimize the chance of scarring if you wear sunscreen whenever you’re exposed to the sun.  

What are the side effects of ambulatory phlebectomy?
Compared to traditional vein stripping, this technique leaves virtually no scarring and has no side effects. Also, because it’s an in-office, minimally invasive procedure performed under local anesthesia, you’ll experience very little downtime. Skin pigmentation at the site of the treated varicose vein may occur but is usually temporary.

How successful is ambulatory phlebectomy?
The long-term results of ambulatory phlebectomy are excellent when the procedure is performed for the appropriate medical reasons.

Before & After