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Ambulatory Phlebectomy for Varicose Veins

Remove visible, bulging varicose veins through tiny incisions smaller than a grain of rice—delivering immediate cosmetic improvement with minimal scarring and same-day recovery.
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Ambulatory Phlebectomy for Varicose Veins
Understanding Microphlebectomy

What Is Ambulatory Phlebectomy?

Ambulatory phlebectomy, also called microphlebectomy, is a minimally invasive surgical technique designed to remove bulging surface varicose veins through tiny punctures or micro-incisions. Using specialized hooks and instruments, the physician carefully extracts diseased vein segments through openings no larger than 2-3mm—small enough to eliminate the need for stitches. This targeted approach allows for immediate removal of visible veins that cannot be treated with thermal ablation alone.

As a complementary procedure to endovenous ablation, ambulatory phlebectomy addresses the cosmetic concerns of prominent varicose veins while improving circulation and reducing symptoms. The technique has been refined over decades and remains the gold standard for removing larger surface veins that protrude from the skin. Because the procedure is performed under local anesthesia in an office setting, patients walk out immediately and resume normal activities within days, with minimal visible scarring.

  • Immediate Removal: Visible varicose veins extracted during single session
  • Tiny Incisions: Entry points 2-3mm, no stitches required
  • Minimal Scarring: Incisions heal to barely visible marks
  • Office-Based: Performed under local anesthesia, walk out same day
  • Rapid Recovery: Return to normal activities within 2-3 days

What Conditions Does Ambulatory Phlebectomy Treat?

Ambulatory Phlebectomy specifically targets bulging surface varicose veins that protrude from the skin and cannot be adequately treated with endovenous thermal ablation or sclerotherapy alone. This technique is ideal for removing cosmetically concerning veins while addressing underlying venous insufficiency.

  • Bulging Varicose Veins:
    Large surface veins that protrude from the skin, creating visible bumps and rope-like clusters. Ambulatory phlebectomy allows immediate physical removal of these veins, providing instant cosmetic improvement and symptom relief from aching and heaviness.
  • Residual Varicosities:
    Remaining surface veins after endovenous ablation of the saphenous trunk vein. These branch veins, no longer receiving reflux from the main vein, are removed through micro-incisions for complete treatment and optimal aesthetic results.
The Ambulatory Phlebectomy Process

How Ambulatory Phlebectomy Works

While every ambulatory phlebectomy follows standardized surgical principles, Dr. Verebelyi customizes each procedure to your unique vein anatomy, aesthetic goals, and symptom profile.
Ambulatory Phlebectomy for Varicose Veins
  1. Pre-Procedure Mapping: With you standing, Dr. Verebelyi uses a surgical marking pen to trace the exact path of bulging varicose veins on your skin. This vein mapping ensures precise targeting and optimal incision placement for minimal scarring.
  2. Local Anesthesia: Tumescent anesthesia—a dilute numbing solution—is injected along the vein path, providing complete comfort during the procedure while also minimizing bleeding and bruising.
  3. Micro-Incision Creation: Using a specialized blade or needle, Dr. Verebelyi creates tiny entry points (2-3mm) along the vein path. These punctures are strategically placed to allow complete vein removal while optimizing cosmetic outcomes.
  4. Vein Extraction: Through each micro-incision, a specialized phlebectomy hook grasps and gently pulls the vein segment to the surface. The vein is carefully removed in sections, with multiple small incisions allowing complete extraction of the entire diseased vein.
  5. Incision Closure: The micro-incisions are so small that stitches are typically unnecessary. Surgical tape or adhesive strips hold the skin edges together, promoting optimal healing and minimal scarring.
  6. Compression Application: A compression bandage or stocking is applied to the treated leg, minimizing bruising and supporting healing while you walk out of the office immediately after the procedure.
The Treatment Process

What to Expect

Our comprehensive approach ensures optimal results and patient comfort throughout your sclerotherapy journey, from initial evaluation through final vein clearance.
before laser hair removal

Before Treatment

Your consultation includes detailed vein mapping and ultrasound evaluation to determine candidacy and plan optimal incision placement for minimal scarring.

  • Ultrasound Evaluation: Comprehensive vein assessment
  • Vein Mapping: Standing evaluation of bulging veins
  • Pre-Procedure Instructions: Medication and clothing guidelines
  • Consultation Duration: 45-60 minutes

During Treatment

Local anesthesia provides complete comfort while Dr. Verebelyi systematically removes each marked vein segment through strategically placed micro-incisions.

  • Tumescent Anesthesia: Small injections for complete numbness
  • Vein Extraction: Systematic removal through tiny punctures
  • Patient Comfort: Awake, no pain during procedure
  • Procedure Duration: 30-60 minutes

After Treatment

Compression dressing supports healing while you walk out and resume light activities immediately. Most patients return to work within 1-2 days.

  • Immediate Walking: 10-15 minutes before discharge
  • Compression: 48-72 hours continuous, then daytime 1-2 weeks
  • Activity Limits: No strenuous exercise 7-10 days
  • Visible Results: Immediate removal, final result 2-3 months

Ambulatory Phlebectomy Results & Recovery

While ambulatory phlebectomy delivers consistent outcomes, individual results depend on the extent of vein disease, number of veins removed, skin healing characteristics, and adherence to post-procedure instructions.

Immediate & Short-Term Recovery

  • Same-Day Mobility: Walk immediately after procedure, driving permitted next day
  • Compression Requirements: Continuous 48-72 hours, then daytime only 1-2 weeks
  • Common Side Effects: Bruising, mild tenderness, tightness along treated areas (2-4 weeks)
  • Activity Restrictions: Avoid strenuous exercise, heavy lifting, prolonged standing 7-10 days
  • Return to Work: Next day for desk jobs, 2-3 days for physical occupations
  • Incision Healing: Surgical tape removed after 5-7 days, incisions close within 2 weeks
  • Visible Improvement: Immediate vein removal, final cosmetic result develops over 2-3 months

Long-Term Outcomes

  • Cosmetic Results: Bulging veins eliminated, incisions fade within 6-12 months
  • Symptom Resolution: Pain, heaviness, aching resolve within 2-4 weeks
  • Scarring: Micro-incisions heal to small, flat marks that continue fading over time
  • Permanence: Removed veins do not return; new varicosities may develop from genetic predisposition
  • Patient Satisfaction: High satisfaction rates due to immediate visible improvement
  • Combination Treatment: Often performed with endovenous ablation for comprehensive results
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Our Team

20+ Years of Vascular Excellence

Laser Vein Treatments

The team at Colorado Skin & Vein, led by David Verebelyi, MD, RVT, and Christina Jordan, FNP, CANS, has been treating vein conditions for over two decades, earning a reputation as leaders in advanced vascular and laser medicine.

Dr. David Verebelyi serves as Chief of Laser Surgery at Colorado Skin & Vein, bringing over 20 years of specialized experience in venous care and minimally invasive vein treatments.

  • Double board-certified physician
  • Registered Vascular Technician with advanced diagnostic imaging expertise
  • Fellow & Instructor, American Society for Laser Medicine and Surgery
  • Personally performs all vein procedures using state-of-the-art technology
  • Holds honors MD and B.S. in Science & Psychology
Common Questions

Ambulatory Phlebectomy Frequently Asked Questions

Is ambulatory phlebectomy painful?
The procedure is performed under local anesthesia, eliminating pain during vein removal. You may feel slight tugging or pressure, but no sharp pain. Post-procedure discomfort is typically mild—similar to muscle soreness—and managed with over-the-counter pain relievers.

Treatment duration depends on the number and size of veins being removed. Most procedures take 30-60 minutes. Including preparation and post-procedure instructions, expect to spend approximately 90 minutes at our office.

The micro-incisions (2-3mm) are designed to minimize scarring. No stitches are needed, and incisions heal to small, flat marks that fade significantly over 6-12 months. Most patients find scars barely visible once fully healed.

Most patients return to work the next day. Desk jobs present no issues. If your work involves prolonged standing, heavy lifting, or strenuous physical activity, plan for 2-3 days of modified duty.

Light walking is encouraged immediately. Avoid strenuous exercise, running, heavy lifting, and high-impact activities for 7-10 days. After 10 days, gradually resume your normal fitness routine as tolerated.

Yes. Compression is essential for optimal healing and minimal bruising. Wear compression continuously for 48-72 hours, then during waking hours only for an additional 1-2 weeks as directed.

When performed to treat symptomatic varicose veins causing pain, swelling, or other functional impairment, ambulatory phlebectomy is typically covered by insurance. Coverage requires documentation of symptoms and medical necessity. We verify benefits and obtain authorization before treatment.

Ambulatory phlebectomy physically removes bulging varicose veins through micro-incisions. Sclerotherapy injects a solution to collapse veins, but is typically used for smaller spider veins and cannot effectively treat large, bulging varicosities. Phlebectomy provides immediate removal of prominent veins.

The specific veins removed will not return. However, genetic predisposition to varicose veins means new veins may develop over time in different locations. Maintaining a healthy weight, staying active, and managing risk factors help prevent new vein formation.

Denver's Trust Vein Experts

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Danielle Killingsworth, NCMA, Aesthetics Coordinator at Colorado Skin & Vein in Denver

Danielle Killingsworth

NCMA, Aesthetics Coordinator

Danielle is a Colorado native who brings more than 22 years of experience in the medical field. Throughout her career she has developed a diverse clinical background across infectious disease, general surgery, and pain management — giving her a well-rounded understanding of patient care and of what it takes to create a safe, comfortable, and personalized experience.

As Aesthetics Coordinator at Colorado Skin & Vein, Danielle combines that clinical knowledge with a genuine passion for aesthetics. She is dedicated to helping patients feel confident, informed, and supported throughout their aesthetic journey, from the initial consultation through treatment and follow-up care.

She believes one of the most rewarding parts of her career is building meaningful relationships with patients and helping them look and feel their very best.

Outside of work, Danielle enjoys spending time with her family, including her four boys, getting lost in a good book, and working in her garden. Fun fact: she is a dedicated Dallas Cowboys fan.

Nikki Moyta, Operations Director at Colorado Skin & Vein in Denver

Nikki Moyta

Operations Director

For over 26 years, Nikki has dedicated her career to the dermatology and aesthetics industry, building her experience from the ground up — starting in a patient scheduling call center, moving to the front desk, and rising to executive leadership overseeing multiple providers and locations.

Originally from Pittsburgh, she moved to Orlando before starting 10th grade and later attended Seminole State College of Florida. Her career in dermatology began in 2002, scheduling appointments for a multi-location practice. She grew quickly within the organization, moving into front-desk and checkout roles before being promoted to Office Manager in 2008. In 2012, her leadership and operational expertise led the CEO to seek her out for an expanded role overseeing multiple providers and locations — a position she held through 2022.

Outside of her professional career, Nikki is passionate about giving back to the community:

  • Community outreach
  • Voted “Cheerleader of the Practice”
  • 1st Place Winner — Miles for Melanoma

With a career built on leadership, dedication, and a genuine passion for patients and the aesthetics industry, she is excited to bring her experience and enthusiasm to the Colorado community. When she is not in the office, you can find Nikki with her Siberian husky, Compass, somewhere on top of a mountain.

Betina Lacson, RVT at Colorado Skin & Vein in Denver

Betina Lacson

RVT

Betina graduated from the Cardiovascular Technology Program at Grossmont College in California in 2020, and brings more than six years of experience in the duplex world of venous insufficiency. Much of her career has centered on superficial vein mapping and assisting in surgery while providing attentive patient care.

At Colorado Skin & Vein, she assists with venous ablation procedures as well as ultrasound-guided sclerotherapy. She is committed to quality care at every stage — from the initial consultation, through surgery, to post-operative appointments — making sure each patient feels fully supported.

In her free time, Betina loves Kizomba dancing with her Afro-Latin dance community, and can often be found at electronic dance music shows in different cities. If you are feeling generous, she will happily accept a karaoke room or an iced Thai milk tea.

Brooke Owens, PA-C, MPAS at Colorado Skin & Vein in Denver

Brooke Owens

PA-C, MPAS

Brooke Owens, PA-C, MPAS is a compassionate Physician Assistant who brings a strong clinical foundation, exceptional attention to detail, and a patient-centered approach to Colorado Skin & Vein.

Prior to joining the practice, Brooke spent several years in pediatric primary care, caring for patients with a wide range of acute and chronic conditions. She became known for her thorough evaluations, thoughtful clinical decision-making, and ability to build lasting relationships with patients and their families. That experience strengthened her diagnostic expertise while reinforcing the importance of listening carefully, educating patients, and creating individualized treatment plans.

Drawn to the unique blend of medicine, procedures, and patient transformation, Brooke was excited to move into vascular medicine and aesthetic care. She is passionate about helping patients improve not only their health but also their confidence — whether they are seeking treatment for vein disease, skin concerns, or cosmetic enhancements. By combining broad medical experience with advanced specialty training and a meticulous eye for detail, she delivers safe, effective, and personalized care.

Brooke believes the best outcomes begin with trust. She values taking the time to understand each patient’s goals, answer questions, and ensure they feel informed and comfortable throughout their care.

Angel Croce, Staff Manager at Colorado Skin & Vein in Denver

Angel Croce

Staff Manager

Angel has been in healthcare for more than 20 years. Her journey began in 2004, after her father suddenly passed away from a stroke. Losing him was a life-changing experience, and it inspired her to choose a career where she could help others and give patients and their families the care, compassion, and support they need during difficult times.

Throughout her career she has worked across cardiology, neurology, family practice, and urgent care — each experience helping her grow both personally and professionally. She now works in vascular care and aesthetics, where she enjoys building relationships with her patients, helping them understand their care, and making sure they feel comfortable and supported throughout their journey.

Outside of work, Angel is a proud mom of two. Family is incredibly important to her, and in her spare time she loves being outdoors with her husband and their two dogs — hunting, fishing, and enjoying Colorado.

For Angel, healthcare is more than a career — it is personal. What started as a way to honor her father’s memory has become more than two decades of caring for others, and she is grateful to keep doing something that means so much to her every day.