Skip to main content


Schedule an Appointment with the best Vein doctors, Drs Kavic MD and Giraldo MD at the Advanced Vein Center Pittsburgh area

The latest advancements in vein care are offered by our Board-certified Doctors. Schedule an appointment to get a thorough evaluation of your veins and your concerns. 

vein institute of pittsburgh
Varicose veins on legs. The structure of normal and varicose veins

Microphlebectomy –  is the minimally-invasive removal of unsightly varicose veins.

Have a varicose vein that you just can’t stand? In most cases simply removing it is the best option. This is known as a Microphlebectomy (“Micro” = small, “phleb” = vein, and “ectomy” = removal). This may sound severe, but in reality it’s exactly what’s needed to make the leg look and feel better.

Remember that varicose veins aren’t working properly. Mid to large-sized varicose veins actually do more harm than good. The valves within them aren’t working, which allows blood to flow back down the legs. This is why varicose veins sufferers often complain of heavy, aching legs.

1 Hour Office Procedure for Beautiful legs!

terry krysinski md

This procedure takes about 1 hour and is usually done right in your doctor’s office. This is primarily because it’s so safe. The main reason for this is that being “put under” with general anesthesia isn’t necessary. This also means no overnight stay, or even observation time in most cases.

Local anesthetics similar to those used in a dentist’s office are used instead. Most patients report feelings of pressure put no pain. If patient anxiety is an issue, then medications can be prescribed to be taken before the procedure. Most describe the process as quick and easy when asked about it afterwards. They then usually go on to mention how great their legs look and feel.

Microphlebectomy – Little Risk!

A Microphlebectomy is minimally invasive, and carries almost no risk. Minor bruising is common, which will subside normally. There will likely be some temporary swelling and discomfort at the incision sites as well. This is short-lived and can be managed with over-the-counter medications such as Tylenol (acetaminophen) if needed. The chances of even minor complications such as infections is very low. In virtually all cases, the benefits of receiving this procedure outweigh the negligible risk.

Schedule Microphlebectomy

Commonly referred to as ambulatory phlebectomy, this surgical procedure is the removal of varicose veins that are too painful and superficial to be treated via ELVA. This occurs by local anesthesia to the area and then removing the varicose veins via needle punctures in the skin. This is often combined with EVLA, and has a high rate of effectiveness because it completely removes the varicose vein. It is performed under local anesthesia and does not require stitches or sutures. 

Schedule an Appointment with Dr. Giraldo MD or Dr Kavic MD at the Advanced Vein Center

The latest advancements in vein care are offered by our Board-certified Doctor. Schedule an appointment to get a thorough evaluation of your veins and your concerns. 


Commonly referred to as ambulatory phlebectomy, this surgical procedure is the removal of varicose veins that are too painful and superficial to be treated via ELVA. This occurs by local anesthesia to the area and then removing the varicose veins via needle punctures in the skin. This method of treatment is prefered over previous treatments mentioned because of the long recovery time needed. 

Microphlebectomy is performed in an in-office setting. It is often combined with endovenous laser ablation therapy. 

Before Microphlebectomy

Before the procedure, your doctor will conduct an ultrasound exam of the treatment site to identify which veins will be removed. A skin marking pen will be used to identify the sites on the patient’s leg. 

The Microphlebectomy Procedure

For more varicose vein before and after images click here to visit our gallery.

Microphlebectomy will remove the diseased portions of veins. It is a procedure that is typically following an EVLA. The varicose veins will be pulled out through the needle puncture sites under local anesthesia. 

The punctures will be covered with steri-strips following surgery. Sutures and staples are not necessary. Bandages and stocking will be applied to the problem area. Your health care team will have you walk on the treadmill before being discharged to drive yourself home. A follow-up visit will be needed to re-examine the treatment site. 

Microphlebectomy Alternatives

The Microphlebectomy is generally regarded as a “good” procedure by surgeons. Related vein procedures such as RF ablation and the more recent “Vein Glue” treatment are, as well. So what makes a treatment “good” in the mind of a surgeon? It does exactly what it’s supposed to do with little or no collateral damage.These minimally-invasive procedures are in stark contrast to Vein Stripping. Most surgeons regard this procedure as potentially doing more harm than good. It is now rarely performed because it’s an outdated procedure.

Vein Stripping – Old Technology

Wexford Vein Dr Doctor
Varicose Vein Stripping , or Ligation and Surgery

Vein Stripping accomplishes somewhat different goals than the Microphlebectomy procedure. The safety of such modern, minimally-invasive treatments is best discussed in relation to Vein Stripping, however. Serious risks include infection and the formation of potentially life-threatening blood clots. Damage to surrounding blood vessels, nerves, and other structures is also possible. A lengthy hospital stay is usually required after the procedure, often 7 days or longer. Periods of downtime ranged from weeks to months. Today, tens of thousands of patients have extensive scarring from Vein Stripping procedures performed years or even decades ago.

Microphlebectomy Benefits

The Microphlebectomy offers many benefits to almost all patients, yet shares none of the drawbacks of older procedures. It’s almost all upside, in fact. The recovery period is limited to the time it takes for the small ¼ in access incisions to heal. Stitches aren’t required, so there’s no need for a return visit to have them removed. Patients can resume most normal, day-to-day activities like office work and driving immediately. Strenuous exercise like running and lifting weights can be started again in about 2 weeks.

The cosmetic results of a Microphlebectomy are immediate visible after any swelling and bruising have subsided. The relief of symptoms such as achiness can be felt at this point as well. Remember that the varicose vein(s) in question has been removed. It’s possible for patients to develop other vein problems later, but this isn’t a guarantee. The results of a Microphlebectomy are permanent, for all practical purposes.

Does the Microphlebectomy procedure work? 


Yes. The microphlebectomy procedure is extremely effective when performed on the right patients. The cosmetic results are almost always excellent and achiness is reduced or eliminated. It’s also a permanent solution.

This procedure works well on the vast majority of patients with larger problem veins. Smaller veins can (and should) be treated with injection-based Sclerotherapy instead. The choice is simple, since Sclerotherapy is even less invasive than a microphlebectomy and accomplishes the same goal. Both get rid of unwanted veins for good.

In other cases, deeper veins which aren’t visible on the surface are the underlying cause of the problem. These can be treated effectively as well using other minimally-invasive techniques. If present, it’s best to treat these first. All of these procedures will likely be offered by the same facility, i.e. a vein or vascular center.

Total removal of the faulty vein – best solution

This will improve the surrounding circulation as blood is re-routed to nearby healthy veins. There’s no risk of “running out of veins,” either. Each leg has literally miles of small to mid-sized veins which return blood back up the leg towards the heart.

Fortunately, this can be done quite easily by a vein specialist surgeon. The Microphlebectomy is a safe and minimally invasive way to remove these unwanted veins. Tiny incisions are all that’s needed to access the vein—these are typically less than ¼ in long. They rarely require stitches, and instead are dressed using special bandages called Steri-Strips or another type of “butterfly bandage.” These incredibly useful dressings hold the edges of the wounds together as they heal.

Restore Your Legs Appearance

Pittsburgh Vein Institute

The goal of a Microphlebectomy is restoring the leg to its original appearance. The only result should be the absence of the ugly, bulging, and often painful varicose vein. Most importantly, visible scarring is usually absent.

Experienced surgeons are trained to make such micro-incisions so that the edges align perfectly and scarring doesn’t occur. Often the necessary incisions can be hidden using lines and other pre-existing marks on the skin. This is one of many reasons why it’s essential to select a surgeon with lots of experience. If any minimal scarring that does occur it tends to fade with time, often completely.

Is the procedure painful?

In general, patients report very little discomfort. Many compare the feeling of the initial injection of the local anesthetic as a pinch or similar to a bee sting. In the vast majority of cases, patients don’t feel anything after that except for maybe a little pressure. The veins are not very deep in the leg and therefore far from any major nerves. While technically a surgical procedure, microphlebectomy is considered minimally invasive. It is not normally painful nor is there any reason to be frightened. We take great pride in putting our patient’s comfort first.

Are stitches required?

Since the needle holes are so tiny, sutures or staples are not required after microphlebectomy. The possibility of scarring is minimal. If you carefully use sunscreen and other techniques to limit sun exposure to the treated area in the months following the procedure, the marks will fade even faster.

How successful are microphlebectomies?

The results of a microphlebectomy are overwhelmingly positive. Patients report a high level of satisfaction with very few instances of side-effects. By virtue of being a minimally invasive procedure that requires only local anesthesia many of the possible pitfalls are avoided. Additionally, the puncture holes are so small, that the infection risk is greatly reduced. Adding to microphlebectomies’ incredible success rate is the addition of an EVLA. After the damaged feeder vein is sealed off with a specialised laser, the varicose veins coming from it can more effectively be removed. When used together, microphlebectomy and EVLA offer a one two knockout punch to the varicose veins.

Does insurance cover the cost of microphlebectomies?

vein institute of pittsburgh
Clinic receptionist, medical team 

Those of us who suffer from varicose veins realize that they are not always simply a cosmetic worry. There are medical issues associated with them as well. For this reason health insurance may be able to help with treatment costs. Call the office today to set up your risk-free varicose vein evaluation at the Advanced Vein Center. Our dedicated healthcare insurance specialists, Nicole and Melissa, can check your benefits and preauthorize your procedure so you knowyou are covered- and there are no surprise bills! With our help, you can get ready to show off your legs next summer.

Phlebectomy FAQ:

Sclerotherapy vs. Microphlebectomy — How Are They Different?

Which Is the Better Procedure?


How long does it take to recover from a Phlebectomy?

Tylenol the next day is usually all that is needed following a microphlebectomy. During the procedure the Vein Dr lightly numbs the area so you do not feel it.

Phlebectomy side effects

Most side effects, if you have any at all are transient. Bruising in the area, occassionally short term numbness are possible but usually fade quickly. 

Phlebectomy cost

Microphlebectomies can cost, if out of pocket, $500-$2,500 a leg depending on where you live, how bad your legs are, the amount of veins you want to treat… Luckily, phlebectomies are usually covered by insurance! As long as you meet medical necessity requirements phlebectomies are a covered service. Varicose veins are often painful and limit the activities of your day. If it affects your quality of life, we can help.

Phlebectomy recovery time

There is little to no recovery time needed. the little bandaids or steristrips leave in place a few days until they fall off.  Wear your stockings as recommended by your Vein Doctor, usually about 2-3 weeks during the day. During this time limit lifting heavy loads or straining.

What can I expect after microphlebectomy?

You can usually return to your normal activities with in 24 hours. However don’t lift heavy weights for two weeks and you will need to wear 20-30 mm hg thigh high compression stockings for 2-3 weeks while avoiding strenuous exercise.

Will veins reappear after a phlebectomy?

The actual damaged veins are taken out, so that particular vein cannot return! We usually recommend treating veins in a stepwise fashion. This would include ablating the larger veins first. This way the incompetent valves that caused the vein damage are removed prior to the phlebectomy, so it cannot make new ones.

Phlebectomy risks

There is always a 1-2% risk of infection any time you break the surface of the skin. Sometimes, if you are prone to scars or hyperpigmentation, the skin may remain discolored for a while in a 2mm area. Rarely you could have a usually transient area of numbness and tingling, which usually lessens in several months.  Bruising under the skin or bleeding from the small poke hole can also occur.

Remove Problem Varicose Veins for Good Using Microphlebectomy!

The offending vein is removed! It is gone for good. When you remove the bandage the next day you will be amazed at the difference in the way your legs will look and feel.

Why choose Advanced Vein Center, Bridgeville Pa. for microphlebectomy?

If you live in the South Hills of Pittsburgh, our vein Dr is near you. He is well trained with many years of Vein experience. Appointments are usually available within a day or two and easily scheduled around your work schedule. We have a certified Vascular Lab as well as well trained certified RVT’s-Registered Vascular Technicians who perform the doppler Ultrasound exam.

Our Locations for a vein doctor near me:

Phlebectomy before and after photos:

Treatment of varicose before and after. Varicose veins on the legs.

What to expect after varicose vein surgery?

You will remain in the recovery room until you are alert and your vital signs remain consistent. A sore throat may be common due to the tube used during surgery.It is common that patients walk and go home the same day as surgery if all recovery procedures are met. One day of hospital stay may be needed in other cases. Compression stockings may be needed to stabilize the veins and promote the healing process. 

Recovery time following surgery is a process that varies in length. This is dependent upon the procedure type, type of anesthesia, your health, age, etc. It may be days or even weeks to achieve a full recovery. 

Pain management is very important to the recovery process. Discomfort will most likely be present following surgery. Your doctor will treat your pain to provide comfort and the ability to rest. Inform your doctor if your pin levels increase or change in any way. 

Keeping follow-up appointments following surgery for varicose veins is important.

Contact your doctor right away or seek medical attention if you are experiencing the following:

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing
  • Change in alertness such as passing out, dizziness, unresponsiveness, or confusion
  • Fever. A low-grade fever (lower than 101 degrees) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. 
  • Leg pain, redness or swelling, especially in the calf region, which may indicate a blood clot
  • Pain that is not controlled by your medication
  • Unexpected drainage or pus coming out of an incision 

Is the microphlebectomy procedure comfortable?

Patients often experience little discomfort with this procedure and only feel a small pinch sensation from the anesthesia. This is not usually a painful or intimidating procedure. Our doctor performs this procedure with fantastic care with his patients’ health in mind.

Will You Require Stitches?

Since the incisions are very small, microphlebectomy does not require sutures or staples. Minimal scarring is possible. Careful sun protection in the following weeks and months will aid in the marks fading quicker. 

What results can you expect?

Microphlebectomy has a very high success rate and is often done in conjunction with an EVLA. The refluxing vein trunk will be sealed with a laser, and the varicose veins will be removed.Combined with EVLA, microphlebectomy offers great success in improvement of pain, fatigue, and leg appearance.

Varicose veins are a medical issue in addition to being a cosmetic concern. Health insurance often helps with the cost of treatment. Call today to schedule an evaluation by our doctor at the Vein Institute of Pittsburgh.

Symptoms of Spider Veins

Individuals with spider veins often experience swelling, throbbing, burning, cramp sensations, and leg fatigue. The level of symptoms varies from person to person. Many who do not experience any symptoms still choose to get the spider veins treated.

Seeking treatment of spider veins can greatly reduce the following symptoms:

  • Heavy and achy feelings in the legs
  • Burning, throbbing, or muscle cramping
  • Swelling of the lower legs
  • Itchiness in the associated area

Multiple procedures are often combined. A typical example is a patient who first receives RF ablation to clear underlying vein disease. A Microphlebectomy will then be performed to remove remaining surface veins. Sclerotherapy or surface laser therapy may then be used to remove very small surface veins (spider veins).