Can a microphlebectomy be performed on these under eye veins even though they're not that big? (Photo)

Question

I have one under my right eye and 2 under my left. They don't buldge but they're still very noticeable. I would like to avoid laser so my question is can a microphlebectomy treat these even though they're not really big?

Raffy Karamanoukian, MD, FACS · Answer

Under eye veins can vary in caliber and length, ranging from bluish varicose veins to light red spider veins. The treatment of larger varicose veins is very specialized and I have demonstrated my technique on the Doctors television show which can be found online. Treatment includes surgical removal with initiation of a skin brightening regimen to optimize skin thickness and collagen content. 
  
Associated dark pigmentation on the lower eyelid skin can be due to melasma, bluish veins, hemosiderin deposits, and hyperpigmentation.  
  
Topical regimens include: 
  
MelaClenz
  Melarase AM
  Melarase PM
  Melapads
  Replenish Retinoid Cream
  Additional therapies for undereye rejuvenation include fractional laser, fractional RF, Covalent peels, and LED microneedling with Replenish serum. The video demonstrates an analysis of varicose veins.
  
Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

John Landi, MD · Answer

The posted veins are too small for microphlebectomies.  They may even be too small for sclerotherapy.  Topical laser or fine needle RF with Ellman Surgitron or Vein Gogh may all work.  See a vein specialist.

Michael Nguyen, MD · Answer

The treatment that we recommend for our patients with veins on your area of concern would be to use laser therapy. Treatment of facial veins requires a highly skilled doctor because arteries and veins run very closely together and there is a risk of complication.
It is very important that you are evaluated first prior to any treatment(s) by a board certified provider to be certain that this is a treatable vein.Thank you for your question!

Gary Nackman, MD, FACS · Answer

The veins shown in your picture are very small, and I would not perform microphlebectomy. Laser with the Nd:YAG would be my first choice. Sclerotherapy is also an option.

Can a microphlebectomy be performed on these under eye veins even though they're not that big? (Photo)

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