Is it necessary to have a phlebectomy on feet or ankles or is it just for cosmetic purposes? I have no pain in my feet.

I have already had laser abulation in both legs and chemical ambulation in one. I would rather not have any more procedures. I still have bulging veins in my feet and on my ankles, but I am wondering if he is recommending a phlebotomy for cosmetic purpose or is there any medical need. Thank You!

Doctor Answers 9

Medical vein treatment vs. cosmetic vein treatment

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Varicose veins are one of the multiple signs of venous insufficiency. Without any treatment, those with the disease may experience progressive symptoms like leg swelling, skin damage, and ulcers that can debilitate and impact a great deal the quality of life; however, that outcome is preventable with proper treatment. A vein specialist is able to recommend the best treatment for you according to your ultrasound results for venous insufficiency and physical examination depending also on your specific signs and symptoms. If you are concern see a specialist for second opinion or ask for clarification for a better understanding. Thank you for your question. 

Varicose veins without symptoms

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Thank you for your question. Procedures for venous disease are patient driven and if you don't have symptoms, they can be left alone. Make sure you read about venous disease and the consequences of untreated problems (see book in link below) and also take a venotropic agent like Varicosamin to keep your veins healthy gling forward. 

H Karamanoukian MD FACS

certified vein specialist and double board certified surgeon

Feet varicose veins

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In general, there is minimal indication to treat varicose veins which do not cause any symptoms. Varicose veins carry a 1% lifetime risk of 'clotting'; usually seen in large twisty leg and thigh varicose veins. A good physical examination and review of your current symptoms should guide your doctor as to what the next step is. 

Maraya Altuwaijri, MD, FACS
Laguna Hills Vascular Surgeon

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Treating varicose veins in Los Angeles

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Once root veins are addressed, it is important to treat smaller tributary veins. A combination of laser, sclerotherapy, and surgery can help address the smaller veins. 

Best, 

Dr. Karamanoukian

Los Angeles vein expert

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Ankle varices

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Once the venous insufficiency is closed off in the legs and the source of the problem is corrected, the veins in the feet and ankles should improve with time.  That being said, if these veins are large and bulging, they do not need to be treated if they are not symptomatic.  If your feet swell, ache, throb or bother you, then I would recommend removal. If they are asymptomatic, then leave them alone.  I would give it several months to see if they improve.  It is not abnormal to have the veins improve over several months. 

Susan Fox, DO
Hollywood Phlebologist
5.0 out of 5 stars 8 reviews

Varicose Veins on the feet

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If you have had the underlying "feeder vein" taken care of (which it sounds like you have), then these will likely shrink. It is not absolutely necessary to have these removed. They will shrink over time. Remember, they didn't show up overnight...they will take time to become smaller. They may never get back to their "normal size". However, they should become less noticeable. 

Manu B. Aggarwal, MD
Lima Phlebologist

Foot veins

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I think you answered your own question.  With no symptoms and only appearance it would be for cosmetic reasons. Ambulatiry phlebrctomy is a great choice but keep in mind there is a chance of potential nerve injury especially around the ankle and top of foot. Foam sclerotherapy is another option but may require several treatment sessions to get the results you would like 

Foot veins

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If these veins are not causing you any discomfort or contributing to swelling in your ankles or feet, I would suggest leaving them alone.

Lisa Perez, MD
Atlanta Physician

Foot veins

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Foot vein treatment is usually a cosmetic procedure.  If there are clots in the foot veins then evacuating them may be considered not cosmetic but this would be a rare occurrence .

John Landi, MD
Naples General Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.