This is a micro-surgery, in which small (1cm) incisions are made and the varicose veins are directly removed from under the skin surface with local anesthesia.  These twisted, bulgy veins are easily seen and are the result of faulty valves in the saphenous veins. Once removed, we close the incision with absorbable suture.  Removing the vein in small sections minimizes the occurrence of blood clots and makes for a faster healing time.  In many cases, this procedure takes approximately 30 minutes in our office procedural suite. After the procedure, you can resume all your normal activities within 24 hours.   Ambulatory phlebectomy is often used in conjunction with EVLT laser or RFA technologies for the treatment of varicose veins. Both treatments will close the saphenous vein(s) that are the cause of the varicose veins, and the ambulatory phlebectomy will treat the varicose veins themselves.