Treatments
How microphlebectomy removes bulging varicose veins through tiny punctures,
when it is used alone or with other treatments, and what results look like immediately.
Microphlebectomy, also called ambulatory phlebectomy, is a precise in-office
technique for physically removing the largest, most bulging surface varicose
veins. These are typically veins measuring 1 centimeter or more in diameter
that are too large and prominent for sclerotherapy or foam injection to
address effectively. At The Vein Clinic of Dallas, every microphlebectomy is
personally performed by Dr. Husein Poonawala , a Harvard-trained vascular and interventional radiologist with double board certification in venous and
lymphatic medicine.
Microphlebectomy is a minimally invasive in-office procedure that removes
bulging varicose veins from the surface of the leg through tiny 2 to 3mm
access punctures rather than surgical incisions. No stitches are placed, and
the treated sites typically heal without visible scarring.
The veins removed through microphlebectomy are the larger, rope-like surface
varicosities that develop as venous pressure builds due to insufficiency . These veins can cause aching, heaviness, throbbing, and localized tenderness in addition to their visible appearance, and at a certain size and degree of tortuosity, injection-based treatments cannot reach or collapse them reliably. Microphlebectomy removes them directly. It is almost always performed as part of a sequenced treatment plan alongside sclerotherapy , ensuring complete correction without leaving residual vessels behind.
30–60 minutes
Trial typically required before procedures
Immediate visible removal
Same day or next day
Covered by most plans
Microphlebectomy is recommended when a diagnostic duplex ultrasound confirms
bulging surface varicose veins causing symptoms or significant cosmetic concern, and
when the clinical picture supports physical removal as the most appropriate intervention.
Large, rope-like surface varicose veins that are too bulging or tortuous for sclerotherapy or foam injection alone to address effectively
Veins that remain visibly prominent after a refluxing source vein has been treated with RFA, VenaSeal, or Varithena
Situations where no underlying saphenous reflux is present and the surface veins themselves are the primary clinical finding
Patients who want immediate visible correction of bulging varicose veins confirmed to be causing symptoms or meaningful cosmetic concern
Microphlebectomy is performed under local anesthesia from start to finish, with no
hospital stay and ano general anesthesia required.
Local anesthetic numbs the skin over the treatment area along the course of the varicose vein, ensuring complete comfort throughout the procedure.
A series of tiny 2 to 3mm punctures are made at precise intervals along the vein using a needle or small blade. No surgical incision is required.
A specialized micro hook is introduced through each puncture to grasp and remove the varicose vein in carefully extracted segments.
No stitches are placed. Small adhesive strips are applied to help the punctures close cleanly and heal without scarring.
A compression stocking is applied after the procedure to support healing and minimize bruising in the treated area.
The puncture sites typically become invisible over one to two weeks, leaving no visible evidence of the access points.
Visible relief, the same day.
Bulging surface varicose veins are physically removed during the procedure itself, producing immediate flattening and elimination of the treated veins
Aching, heaviness, throbbing, and localized tenderness associated with the removed veins typically resolve promptly as venous pressure is eliminated
Tiny access punctures heal without stitches, and scarring is minimal to none in the vast majority of patients
Most patients return to light normal daily activities the same day or the day following treatment with minimal disruption
When microphlebectomy is used to treat symptomatic varicose veins
caused by chronic venous insufficiency with confirmed venous reflux, it is typically covered by insurance. Our team verifies your specific coverage and manages all prior authorization submissions on your behalf before any treatment is scheduled. Some plans require a conservative management trial before approving definitive treatment. We will tell you exactly what your plan requires upfront.
Plans accepted include BCBS, Anthem, Medicare, Aetna, Cigna, United
Healthcare and more.
Microphlebectomy has a long and well-established safety record and is performed under local anesthesia with a very low complication rate. Mild bruising and tenderness resolve within one to two weeks. Infection and significant bleeding are rare, and our post-procedure protocol minimizes the very small DVT risk associated with any vein procedure.
Dr. Poonawala personally performs every microphlebectomy using meticulous technique guided by a thorough understanding of your venous anatomy.
Microphlebectomy is performed at the right stage of your treatment plan, after source vein treatment when underlying reflux is present, or as a standalone procedure when evaluation confirms it is appropriate. The sequence matters as much as the technique.
Bulging veins are physically removed during the procedure itself, making this one of the few treatments that produces visible improvement on the day of treatment rather than over weeks.
Your microphlebectomy is part of an ongoing care relationship. Annual follow-up evaluations allow us to monitor vein health over time and protect your results for the long term.
If your legs have developed bulging varicose veins that ache, feel heavy, or create
cosmetic concern, microphlebectomy offers immediate physical removal with no stitches,
no surgical incision, and no downtime.
Schedule your consultation with The Vein Clinic of Dallas, serving Flower Mound, Lewisville, Coppell, Southlake, Irving and the greater DFW area.