Micro-Incision Phlebectomy (Removal of Varicose Veins)

Prior to the introduction of micro-incision phlebectomy, the removal of clusters of varicose veins was performed through incisions that left unsightly scars. Today, specialized surgical hooks are placed through incisions one or two millimeters ( less than one tenth of an inch) in length. As a consequence of the use of such small incisions for phlebectomy (vein removal) a cosmetically improved result is achieved.

The advantages of micro-incision phlebectomy are:

1) The small incisions usually do not require suture closure.

2) A cosmetically acceptable surgical alternative to the laborious treatment methods employed in the injection treatment of small clusters varicose veins.

3) The avoidance of possibility of hyper-pigmentation (brown discoloration) or skin ulceration as a result of the injection treatment of veins would otherwise be employed.

4) Local anesthesia is sufficient in many cases.

5) The small incisions eventually mature into barely visible scars the size of a small dot.

The disadvantages of micro-incision phlebectomy when compared to sclerotherapy are:

1) An anesthetic is required and the procedure may need to be performed in a operating room. Click here to view instructions for patients having procedures or operations performed under general anesthesia, region anesthesia, or local anesthesia with intravenous sedation.

2) Since small hooks are used to extract the veins through the micro-incisions, it is possible that a small sensory nerve could be damaged during vein removal. However, such an injury rarely occurs.

Post Operative Varicose Vein Surgery instructions following Micro-Incision Phlebectomy and/or Vein Stripping

• For the first postoperative day, your leg(s) will be wrapped from toe to groin in an elastic bandage. On the day after surgery, you can remove the dressing yourself or return to your surgeon’s office to have it removed. You will be allowed to shower and resume normal activities at this time. The leg(s) will need to be rewrapped with elastic bandages, and possibly sterile gauze, daily. The gauze should be used over any draining skin wounds until the drainage has stopped. Use elastic bandages until you are comfortable putting on your prescription compression stockings, usually 10-12 days after surgery. It is not necessary to use tight compression at night, but we recommend loose wrapping with an elastic bandage to protect your incisions while you sleep. Compression of the treated leg(s) will be necessary for two to three weeks.

• During the immediate postoperative period, avoid prolonged sitting or standing. We encourage you to walk and when lying down to keep your legs elevated.

• If the outer dressing is constricting, causing numbness or pain, you may remove and rewrap it. If you notice active bleeding from your incisions when you unwrap the dressing, apply pressure and elevate the leg for a few minutes before rewrapping your leg. If bleeding occurs through the wrap, place gauze and tape or an ace wrap over the outer dressing to reinforce it.

• You will be bruised and have areas beneath your incisions that are lumpy/bumpy, and you may experience numbness, tingling, burning or intermittent sharp shooting pains. These will typically resolve over a period of a few weeks to months. It is unusual, but possible, to have small areas of permanent numbness. Wear your compression stockings for 12 hours a day while you are up and about.

• Walking and exercise will help you to recover more quickly from your surgery. Try to elevate your legs over the level of your heart for 15 minutes at least twice a day. Avoid sitting or standing in one place for long periods of time.

• Do not drive or drink alcohol while taking prescription pain medication.

• Do not take aspirin or aspirin-containing medications for two weeks after your operation.

• If you have any questions or problems, your surgeon and nurses are available to speak with you at any time.

Content reviewed and updated on August 3, 2013.