Microphlebectomy

What is microphlebectomy?

Microphlebectomy (also called ambulatory phlebectomy) physically removes bulging varicose veins through nicks in the skin so small — typically 1–2 mm — that they usually need no stitches. A fine hook lifts the vein out segment by segment under local anaesthesia. It deals directly with the rope-like surface veins that ablation techniques do not remove.

Who it may suit

Microphlebectomy suits prominent, tortuous surface varicosities — the veins patients can see and feel. It is very often combined with treatment of the underlying leaking vein in the same sitting: endovenous ablation or VenaSeal closes the source, and microphlebectomy clears the visible branches. Removing the surface veins without fixing the source leak tends to give a short-lived result, so the ultrasound assessment decides the sequence.

What the procedure involves

• Performed under local anaesthesia, usually as a day procedure
• The vein segments are removed through multiple tiny nicks along the vein
• The nicks are closed with adhesive strips rather than stitches
• You walk immediately afterwards; most patients return to desk work within a day or two

What to expect afterwards

Bruising along the treated track is expected and settles over one to two weeks. The tiny nicks generally heal to marks that are hard to find after a few months, though any skin cut can scar, and pigmentation changes are possible. Temporary numb patches near a treated segment can occur where small skin nerves run close to the vein; these usually recover. Compression stockings are typically worn for a short period afterwards.

Is it right for me?

If bulging veins are the main complaint, the question is what is feeding them. At consultation your veins are scanned, and I go through whether microphlebectomy alone is enough or whether the truncal vein should be treated at the same time — one anaesthetic, one recovery, rather than two separate procedures.