Besides closing the vein responsible for the varices, many times we might recommend a procedure called a phlebectomy. The visible veins protruding under your skin are actually branches from a deeper (superficial) vein. Even though the deeper vein, such as the GSV or SSV is removed or closed, these visible veins might 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 clinical and cosmetic result for removing these veins. .
The procedure is performed in the office under a local anesthetic. Initially the bulging veins are drawn over with a permanent marker as they tend to flatten out and not be apparent when the patient is lying on the table. Using the marked trajectory as a guide the local anesthesia is applied and using small incisions of 2-3 mm the vein is accessed by means of a special hook ( a crochet needle like device ). Once the vein is hooked and exposed, using a gentle tugging motion it is segmentally removed.
The picture to the right shows a segment of a vein that has been removed and placed above the mark that was priorly made. The incision as noted is very small.
The final result is excellent as there is minimal if any scaring at all and the removed veins can not grow back again. The patient walks out of the office after this procedure with minimal if any discomfort and very little downtime.