Varicose veins may cause cosmetic distress, but they can also cause symptoms related to underlying venous disease. Ambulatory phlebectomy can help remove varicose veins and manage leg discomfort.

Varicose veins are enlarged, bulging veins that often appear on the legs. They’re more common with age.

For some people, varicose veins are a cosmetic concern, as they can be highly visible.

But the visibility of these veins isn’t the only concern. Varicose veins can also cause pain and discomfort. An ambulatory phlebectomy is a procedure that can remove varicose veins and ease any symptoms they cause.

A phlebectomy is a procedure that removes veins just below the skin’s surface. It’s one of a few procedures you can choose to manage varicose veins, but it is usually reserved for for large and thick-walled veins.

Ambulatory procedures are usually done in an outpatient setting, without the need for you to have a multiday stay in a care facility.

It involves making small incisions on opposite sides of a vein and removing it piece by piece.

A surgeon will outline the veins to be removed, placing local anesthetic into the skin. Small openings called “stab incisions” are made every 2 to 3 centimeters with a scalpel or a needle, and sections of the vein are removed with specialized hooks and clamps.

The length of your procedure will depend on how many veins are being removed and whether you’re having other procedures done at the same time, which is common.

Broad compression pads are placed over the incisions afterward and removed the next day.

Before you undergo a varicose vein ambulatory phlebectomy, you may need to complete some diagnostic testing. Underlying health conditions like hypertension can influence varicose veins or may feature complications like blood clots.

Most outpatient procedures with local anesthetics don’t have fasting requirements, but your surgeons will discuss any necessary changes to diet, lifestyle habits, or medications before the phlebectomy.

Recommendations on surgical site preparation will also be given. You may be asked to shave your entire leg or a portion of your groin. You’ll likely also be advised to avoid lotions, creams, or other topical products immediately before the procedure.

Loose-fitting pants will be the most forgiving on your legs post-op. Wearing dark colors may be best if you’re concerned about surgical marker rubbing off on your clothing.

If you already have compression socks, be sure to bring them along.

Before you leave, your care team will let you know how soon you can resume showering or bathing and what pain medications you can take if you’re uncomfortable. However, pain following an ambulatory phlebectomy is usually minimal.

You can get back to nonstrenuous activities almost immediately. In fact, walking after the procedure can help reduce inflammation and promote healing. Note that temporary bruising and swelling is expected.

Many people have concurrent procedures with a phlebectomy, and this can affect your recovery time.

Research indicates that in concurrent surgical situations, many people return to sedentary work 2 to 3 days after treatment. Most are back to work fully within a week after a single-leg phlebectomy and 2 weeks after a double-leg phlebectomy.

You’ll likely be advised to wear compression stockings for at least 10 days following surgery. If you’re very active, your surgeon may recommend taking them off sooner.

An ambulatory phlebectomy is considered to be generally safe with minimal risk of bleeding. But as with any procedure, there’s a risk of complications.

When complications do arise, they’re often related to:

  • inflammation from vein remnants
  • nerve damage that causes skin numbing
  • local anesthetic allergy
  • bruising and swelling

Any time you make an opening in your skin, there’s a risk of wound-related complications, like infection, delayed healing, and hematoma.

These risks may be increased if you live with diabetes, chronic stress, or a high body mass index.

Can varicose veins return after surgery?

There’s a slight chance that removed varicose veins will reappear. In addition, you may develop new varicose veins in the same location, especially if the underlying cause isn’t addressed.

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An ambulatory phlebectomy for varicose veins is an outpatient procedure that uses small incisions to remove varicose veins. It’s a low risk procedure with minimal downtime during recovery.