When you have a varicose vein near the surface of the skin that is too large to treat with sclerotherapy and too small for laser ablation, ambulatory phlebectomy is a great solution to remove the unwanted vein. Also known as microphlebectomy or stab phlebectomy, this procedure is very effective at removing the vein, yet requires only miniscule incisions and minimal recovery.
What is ambulatory phlebectomy?
This procedure uses small, slit-like incisions in the skin to remove varicose veins and larger spider veins. This procedure takes the place of what was formerly known as vein stripping, which required long incisions and difficult recoveries. In contrast, phlebectomy removes varicose veins through tiny incisions piece by piece. Ambulatory phlebectomy is minimally invasive and doesn’t require sutures or general anesthesia.
Who is a good candidate for an ambulatory phlebectomy?
Phlebectomy may not be the best option for all varicose veins. The veins need to be near the surface of the skin. This is a good procedure for bulging surface veins. Deeper veins are better treated with laser ablation. Pregnant women and those with an active skin infection cannot have phlebectomy. If you’ve had problems with blood clots, you may not be a candidate.
How is an ambulatory phlebectomy performed?
This is an outpatient procedure at our L.A. Vein Center offices on Van Nuys Boulevard in Sherman Oaks. The procedure takes from 45 to 60 minutes. Here’s what’s involved.
Dr. Lee begins the procedure by marking the targeted veins. Next, the treatment area is injected with a local anesthetic, ensuring there isn’t any discomfort during the procedure.
Dr. Lee then makes tiny incisions (only about the size of the tip of a ballpoint pen, 2-3mm) over the targeted vein. Through these incisions she inserts a surgical hook to extract the damaged vein section by section. This may seem impossible, but because veins collapse, the pieces are easily removed through these minimal holes. The incisions don’t require sutures, just small bandages. After your procedure, we apply compression bandages over the treated areas. You will wear these for one week to help minimize swelling and discomfort.
Is there recovery after having a phlebectomy?
Our patients from across L.A. are amazed these procedures don’t make for a difficult recovery. It’s normal for patients to have some bruising, swelling, and minor discomfort where the veins have been removed. Diligent wearing of your compression bandages and then compression stockings can minimize these effects. You’ll wear these for one week. Over-the-counter pain medications are usually all that is needed for any discomfort. Patients can walk and get back to normal activities immediately, although exercise and heavy lifting need to be put off for a couple of weeks. Patients can return to work the next day.
How soon will I see results from ambulatory phlebectomy?
Your minor incisions won’t require sutures; they will be barely visible in 6-12 months. You’ll have some swelling and bruising, and there can be mild skin pigmentation changes over the treated area, but this clears in a short time in most cases. Because your vein is removed, the visual issues and raised skin of your varicose vein will be gone. These results are permanent, although you can still develop other varicose veins.
What are the potential complications of ambulatory phlebectomy?
Ambulatory phlebectomy with Dr. Lee is a safe, effective procedure. There are some potential risks, but they are rare:
- A nerve injury to the skin, though these usually resolve with time
- Severe bleeding or swelling
- Numbness or pain in the feet
- Thrombophlebitis (inflammation causing a blood clot)
Is ambulatory phlebectomy painful?
When Dr. Lee describes the procedure during your consultation, many patients tell us it sounds quite painful. It’s not. Prior to working on any vein, Dr. Lee injects the area with local anesthetic. This numbs the skin across the vein and keeps you from feeling the small incisions or the insertion of the hook to grab the poorly functioning vein. While our blood vessels don’t have any nerves, the surrounding skin certainly does. But the local anesthetic keeps you comfortable.
Afterwards, you may have some soreness, but it’s easily handled with over-the-counter pain medication. The lack of pain or any noticeable recovery is far different from the old method of surgically removing varicose veins, vein stripping.
How do I prepare for my ambulatory phlebectomy?
There really isn’t any preparation necessary for these procedures at L.A. Vein Center. You’ll need to wear compression stockings afterwards for one week, so you’ll want to purchase these beforehand. We’ll prescribe a muscle relaxant that you’ll need to take before your procedure. Since only local anesthesia is necessary, you don’t have to worry about fasting prior to your treatment. Because you had a muscle relaxant, you’ll need someone to drive you home from your treatment.