Ambulatory Micro-Phlebectomy
When bulging varicose veins create visible rope-like patterns beneath your skin, they signal more than just cosmetic concerns. They are a sign of an underlying vein condition called venous insufficiency. These enlarged vessels slowly progress over time. Varicose veins can be accompanied by other symptoms of venous insufficiency, such as leg pain and aching, heaviness and tiredness, swelling, itching and skin changes. Occasionally, a blood clot can develop in dilated varicose veins.
At Prevosti Vein Center, Dr. Louis Prevosti offers a multitude of options for treating varicose veins and venous insufficiency.
One method is called ambulatory micro-phlebectomy, a precise surgical technique performed using local anesthesia that removes problematic veins through tiny access sites. This procedure provides immediate visual improvement and symptom relief.
Drawing from his extensive background as a heart surgeon, Dr. Prevosti has refined his micro-phlebectomy technique through tens of thousands of procedures. His experience working with delicate cardiac vessels translates into exceptional precision when removing varicose veins.
What Is Ambulatory Micro-Phlebectomy?
Ambulatory micro-phlebectomy is a minimally invasive procedure that removes varicose veins through tiny access sites measuring just 2 to 3 millimeters. Unlike treatments that seal veins from within, this technique removes the diseased vein segments, providing immediate elimination of bulging vessels. The term “ambulatory” in the procedure name means it is done in the office and the patient walks out immediately afterward. “Micro” refers to the very small incisions, and “phlebectomy” is the medical term for vein removal.
This specialized technique requires significant surgical skill and experience to perform correctly. Many vein clinics do not offer ambulatory micro-phlebectomy because of the expertise and time required. Dr. Prevosti's decades of cardiovascular surgery experience and exclusive focus on vein care make him particularly skilled at this delicate procedure. Dr. Prevosti is known for his meticulous attention to detail, gentle hands, patient comfort and good outcomes.
How Does Ambulatory Micro-Phlebectomy Work?
The procedure begins with careful mapping of the varicose veins to identify optimal access points. Dr. Prevosti uses tumescent anesthesia, a specialized form of local anesthetic that numbs the treatment area.
Through tiny, strategically placed access sites, Dr. Prevosti uses specialized phlebectomy instruments to carefully grasp and remove vein segments. Some of the instruments are fine surgical hooks, allowing for the gentle extraction of twisted or tortuous veins. Each access site is positioned to maximize vein removal. Dr. Prevosti’s method strives for complete removal of the varicose vein. Many other clinics either do not offer phlebectomies or use a technique of partial removal and interruption rather than complete removal.
The tiny access sites heal quickly and fade over time. Because the problematic veins are physically removed rather than just sealed, patients see immediate improvement in both appearance and symptoms. Ambulatory micro-phlebectomy has the additional advantage over other treatment methods in that there is less chance of hyperpigmentation or staining of the skin.
Who Is a Good Candidate for Ambulatory Micro-Phlebectomy?
Ideal candidates for this procedure have noticeable dilated veins close to the skin surface. These veins may appear twisted, rope-like or protruding from the leg. They may have a blue or purple color. Patients may experience symptoms from these veins and from deeper veins with venous insufficiency, including aching, throbbing, heaviness or skin irritation. This technique offers relief of symptoms as well as a cosmetic benefit because it eliminates the unsightly veins.
Dr. Prevosti frequently recommends this technique for:
- Large varicose veins that bulge prominently from the skin
- Tortuous veins with multiple twists and turns
- Tender lumps or knots under the skin
- Residual varicose veins after previous treatments
- Veins causing significant symptoms or skin changes
- Patients seeking immediate visual improvement
What to Expect From the Treatment Process
Comprehensive Evaluation
During your comprehensive evaluation, Dr. Prevosti and his team will use a diagnostic venous duplex ultrasound to assess your complete venous system. Dr. Prevosti's extensive vascular experience and specialized expertise in venous disorders enable him to precisely interpret this imaging, identifying subtle patterns and complex vein configurations that guide accurate diagnosis and optimal treatment recommendations. Based on this imaging, a thorough review of your medical history, and a physical examination, he can determine whether micro-phlebectomy alone will address your concerns or if combining it with other treatments would provide the best results.
Dr. Prevosti personally performs all evaluations, taking his time to explain your condition and the treatment modalities recommended. He gives you time to ask questions and takes the time to answer them all. His compassionate approach helps patients feel comfortable and informed about their treatment options.
Treatment Day
Wear comfortable, loose-fitting clothing on your lower body. You can bring shorts or change into ones we provide you before your procedure. While the actual vein removal takes 30 to 60 minutes, depending on the extent of varicose veins, plan for approximately two hours total time in the office. You can drive yourself to and from the appointment. You do not need to bring someone with you, although you're welcome to bring someone if you wish.
After administering tumescent (local) anesthesia, Dr. Prevosti begins the meticulous process of vein removal. Most patients feel minimal sensation during the procedure. His gentle technique, refined through years of delicate cardiac surgery, minimizes tissue trauma and promotes rapid healing.
Immediate Aftercare
Following the procedure, a compression wrap is applied to the treated areas. Dr. Prevosti and his staff provide detailed verbal and written post-procedure instructions. Patients can walk and drive immediately after the procedure.
Recovery and Post-Treatment Care
Recovery from ambulatory micro-phlebectomy is remarkably swift compared to traditional vein stripping. You can walk, drive and perform light daily activities immediately after treatment. The compression wrap stays on overnight, then you'll transition to wearing compression stockings for three days or as directed by Dr. Prevosti.
Most patients do not need to take any medications for post-op discomfort. Mild discomfort can be handled with over-the-counter medications like ibuprofen or acetaminophen. The tiny access sites heal quickly, typically leaving minimal scarring that fades significantly over several months.
Activity guidelines include:
- Immediate return to light walking, driving and light daily activities
- Office work and work from home can resume the same day or the next day
- Physically demanding jobs may require two to three days off
- Low-intensity exercise, like yoga or brisk walking, can resume in two days
- Strenuous exercise, such as tennis and running, can resume after one week
Dr. Prevosti schedules follow-up appointments within one week and again at six weeks to monitor healing and address any questions. His thorough approach to post-procedure care promotes optimal results and patient satisfaction.
Why Choose Dr. Prevosti for Ambulatory Micro-Phlebectomy
Dr. Prevosti's unique qualifications make him exceptionally skilled at performing micro-phlebectomy:
- Cardiovascular surgical background: His years as a heart surgeon working with fragile cardiac arteries and veins provide unmatched precision in vein removal techniques
- Exclusive vein focus: Unlike practices that divide attention between different specialties, Dr. Prevosti dedicates 100% of his practice to treating vein disorders
- Extensive experience: Having performed tens of thousands of vein procedures, he has developed techniques that maximize results while minimizing discomfort
- Comprehensive certification: Board-certified in Thoracic and Cardiovascular Surgery, diplomat of the American Board of Venous and Lymphatic Medicine, and RPVI (registered physician vascular interpreter) and RPhS (registered phlebology sonographer) status
- Patient-centered care: All evaluations, treatments and follow-ups are personally performed by Dr. Prevosti in one convenient Canton location
Combining Treatments for Optimal Results
While ambulatory micro-phlebectomy effectively removes visible varicose veins, addressing underlying venous insufficiency often requires a comprehensive approach. Dr. Prevosti frequently combines micro-phlebectomy with other minimally invasive treatments to provide complete resolution of venous disorders.
Radiofrequency ablation, endovenous laser ablation and Venaseal glue may treat deeper vein insufficiency feeding the surface varicose veins. Varithena foam and ultrasound-guided foam sclerotherapy can address smaller tributary veins. This multi-modal approach, tailored to each patient's unique anatomy, helps maximize results and minimize recurrence.
Experience the Prevosti Difference
At Prevosti Vein Center, ambulatory micro-phlebectomy is performed with the precision and care that only comes from decades of specialized vascular experience. Dr. Prevosti's meticulous technique, gentle hands and compassionate approach help patients achieve freedom from the physical and emotional burden of varicose veins.
If bulging varicose veins affect your comfort and confidence, contact Prevosti Vein Center today to schedule your consultation. Discover how Dr. Prevosti's expertise in ambulatory micro-phlebectomy can provide the immediate, visible results you seek.