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Treatment · Medical Vein Care

Micro-Phlebectomy

The cleanest way to remove visible bulging varicose veins — small punctures, local anesthesia, in-office.

Micro-phlebectomy physically removes bulging varicose veins through tiny incisions barely larger than a needle stick. Performed in our Lake Charles office under local anesthesia, often combined with EVLT in the same visit. Minimal scarring, same-day recovery, and the visible result is immediate — the bulging vein is gone.

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Visible varicose veins, physically removed.

Some of the most bothersome varicose veins are the visible ropy ones that bulge above the skin — particularly on the inner thigh and back of the calf. Closing the upstream trunk vein with EVLT or Varithena reduces the pressure that drives these bulges, and many shrink on their own over the following weeks. But the larger, longer-standing bulges often need a more direct fix.

Micro-phlebectomy does exactly that. Through 1–2 mm punctures along the affected vein, specialized hooks gently grasp the vein wall and lift the diseased segment out. Because the incisions are so small, no stitches are needed — Steri-strips hold the skin together while the punctures heal in about a week. The visible bulge disappears immediately.

What happens at your visit.

Before treatment

Like every vein procedure at LAVC, micro-phlebectomy is preceded by a venous reflux ultrasound. The ultrasound determines whether there's an underlying refluxing trunk vein that also needs treatment. In most cases, we'll treat the trunk vein first or in the same visit — otherwise the same varicosities tend to come back.

The procedure itself

Performed in our Lake Charles office. Local anesthesia only — no IV sedation, no general anesthesia, no hospital stay.

  • The treatment areas are marked while you're standing, so the veins are easy to see.
  • Local anesthetic is infused along the path of each vein.
  • Tiny punctures (1–2 mm) are made above the vein.
  • Specialized hooks gently extract the vein segment.
  • Steri-strips close the punctures — no stitches.
  • Compression is applied.
  • Total time: 30 to 60 minutes per leg, depending on the number of veins.

After the procedure

  • Compression stocking on during waking hours for one to two weeks.
  • Walk frequently the first few days — short walks throughout the day.
  • Most patients return to a desk job within 1–2 days.
  • No heavy lifting (over 25 lb) or strenuous exercise for 1 week.
  • Steri-strips fall off on their own at about a week — don't pull them.
  • Light bruising is expected and fades over 2–4 weeks.

Often combined with EVLT in the same visit.

In many patients, the most efficient treatment plan is EVLT and micro-phlebectomy together — EVLT closes the underlying refluxing trunk vein, and micro-phlebectomy removes the visible bulging tributaries that have already developed. Doing both in one session means:

  • One round of compression stockings, not two
  • One week of activity restrictions, not two
  • One follow-up ultrasound, not two
  • Faster cosmetic result — the bulges are gone immediately, and the deeper structural fix is done at the same time

Whether to combine is anatomy-dependent. Some patients benefit from a staged approach — EVLT first, then micro-phlebectomy a few weeks later once we see which varicosities have resolved on their own. Your surgeon will walk you through the trade-offs at your consultation.

Call (337) 425-9300 to schedule a venous reflux ultrasound and consultation.

Why Lake Area Vein Center

Vein care from a surgical group.

01

Board-certified surgeons

Drs. Devin Seale, Stephen Castleberry, and Matthew Ayo perform every procedure. Same surgeons who operate at the local hospital.

02

In-office diagnostic ultrasound

Venous reflux ultrasound by a vascular technologist in our Lake Charles office. Surgeon reviews findings at a clinic visit about a week later.

03

50 years caring for SW Louisiana

The dedicated vein program of Sulphur Surgical Clinic — locally owned, family-run, serving Calcasieu, Beauregard, Allen, and Cameron parishes.

Frequently asked

Questions patients ask about this treatment.

What is a micro-phlebectomy?

Micro-phlebectomy is the removal of bulging surface varicose veins through tiny incisions — barely larger than a needle stick — using specialized hook-like instruments. It's the gold-standard treatment for visible ropy varicosities, especially the larger tributaries that sit just under the skin.

How is it different from EVLT or Varithena?

EVLT and Varithena close diseased veins from the inside (laser heat or foam) and let the body absorb them gradually over weeks. Micro-phlebectomy physically removes the vein in the same visit — which is faster cosmetically for surface varicosities but better suited to the visible bulging veins than the deeper trunk veins. We often combine micro-phlebectomy with EVLT in the same session: EVLT closes the source trunk vein, micro-phlebectomy removes the visible varicose tributaries.

Does it hurt?

Local anesthesia is used along each treatment site, similar to what you'd get at the dentist. You'll feel small pinches as the numbing medication goes in. After that, the area is fully numb. Most patients describe the recovery as mild soreness and bruising for a week or two, easily managed with ibuprofen.

Are there scars?

The incisions are so small — about 1–2 millimeters — that they typically heal as faint marks that fade over months and become barely visible. Some patients can't find their incision sites a year later. Patients who scar easily (keloids, hyperpigmentation) should mention this at consultation.

How long is the procedure?

Usually 30 to 60 minutes per leg, depending on the number and size of veins being removed. Performed in our Lake Charles office under local anesthesia — no IV sedation or hospital stay required.

What's the recovery like?

Walk out the same day. Compression stocking for one to two weeks during waking hours. Most patients return to a desk job within one to two days. No heavy lifting or strenuous exercise for one week. Mild bruising for two to four weeks is normal. Steri-strips fall off on their own in about a week.

Will insurance cover micro-phlebectomy?

Yes in most cases, when the varicose veins are symptomatic (aching, heaviness, swelling) and there's documented venous insufficiency on ultrasound. Cosmetic-only removal of small surface varicosities without underlying disease is usually not covered. Our billing team verifies your specific plan before scheduling.

Can it be done at the same time as EVLT or Varithena?

Yes, and we often do. Treating the underlying source vein (EVLT) and removing the visible tributaries (micro-phlebectomy) in the same session means fewer total visits and a faster cosmetic result. Whether to combine procedures depends on your anatomy and treatment plan, which we determine after the venous reflux ultrasound.

From the Journal

Read more from our team.

Ready to schedule?

Most patients are seen within two weeks.

An in-office vein ultrasound is the first step. Our front desk verifies your insurance and walks you through scheduling.

Lake Charles · (337) 425-9300 Sulphur · (337) 527-6363