Ambulatory Microphlebectomy

An Improvement on a Traditional Vein Treatment.

A Solution to
Diseased Veins

Ambulatory Microphlebectomy in New Braunfels, Texas

Ambulatory Microphlebectomy is a useful procedure when there are persistent, superficial varicose veins after treating the main vein trunks (the greater saphenous vein and the short saphenous vein). This can occur because there is still a reason for elevated pressures in that vein.

Ambulatory Microphlebectomy is an improvement on the older Phlebectomy procedure in that only a small semicircular incision is made and a modified crochet hook is inserted through that small puncture to pull the vein out. No sutures are necessary.

What it Treats

Large superficial Varicose veins that persist after treatment of the major venous trunks, or the rarer Varicose veins in patients that do not have significant venous insufficiency of the main venous trunks.

Procedure Time

30-60 minutes, depending on the number of veins that need to be removed.

Recovery Time & Side Effects

There is minimal recovery time. There may be some discomfort, and a compression stocking must be worn for a week after the procedure. Most people can drive themselves home and return to work or their usual activities the next day.

Is the Procedure Painful?

Tumescence or dilute local anesthesia is used during the procedure. The installation of this anesthesia is uncomfortable but very quickly the area becomes numb. There is little post-procedural pain in most cases. Usually, local anesthesia is all that is necessary. However, if you are averse to needles, we can offer our nitrous oxide inhalational anesthetic (ProNox) for a small fee, which reduces the anxiety and the discomfort of the needle sticks and the procedure.

The Treatment Process


Step 1

First, the veins will be marked with a skin marker to ensure accuracy. The patient will be in a standing position. This allows these varicose veins to become obvious. Then the patient lies down and the skin is prepped. For your comfort, we apply anesthesia.


Apply the Anesthetic

Step 2

A dilute anesthetic or tumescence anesthetic is used to numb the area. A tiny curved incision is made immediately next to the varicose vein to be removed. A modified crochet hook is used to tease the vein out of the subcutaneous tissue.

Remove the Vein

Step 3

Another tiny incision is made about one inch further along the vein, and the vein can be progressively pulled out either in continuity or in pieces along the entire course of the vein. This process is repeated until the desired extent of vein is removed.


A Better Look for Your Veins

Step 4

The incisions made during the procedure are so small that they do not need a suture. The cosmetic result is improved because of a curved incision.

About ProNox

ProNox is device that mixes oxygen and nitrous oxide to a safe 50:50 ratio that can be inhaled to provide relief from anxiety and pain. Nitrous oxide is a very old compound and has been used as an anesthetic gas since the 1880s. It is frequently used by dentists. Our device can be controlled by the patient so that the appropriate amount of anesthesia can be provided in a safe fashion. Nitrous oxide does not last long and its effects are completely gone after 5 minutes. You would be safe to drive yourself home after a brief period of time of observation in the office. This is not a covered expense by insurance, so a small fee is charged. If you’re interested, simply ask about it when you schedule your procedure.

Request a consultation

If you’re suffering from a vein condition, or just achy, painful legs, request a consultation with our professional team at Hill Country Med Spa.



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