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Varicose veins are a common problem, affecting up to 1 in 3 adults in their lifetime. They are usually a sign of an underlying venous insufficiency.
Thread veins can appear anywhere on the body but are mostly evidenced on the legs and face. They are more common than varicose veins, affecting up to 80% of adults.
Leg ulcers appear as broken skin in the lower leg or feet. We have been successfully treating venous leg ulcers for over 20 years.
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Avulsions, also referred to as phlebectomies, are used as an alternative to foam sclerotherapy, for the treatment of any varicose veins that remain after endovenous laser ablation (EVLA) has treated the cause.
The below content has been medically reviewed and approved by Consultant Interventional Radiologist Dr. Mark Bratby (MBBS, MRCP, FRCR), Medical Director and Head of the Medical Advisory Committee at Veincentre.
Last reviewed 2nd May 2025.
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Avulsions, also known as Phlebectomies, are a technique used to remove varicose veins through tiny incisions in the skin. This differs from foam sclerotherapy, which works by gently sealing the veins using a medicated foam that your body then naturally absorbs over time.
In many cases, avulsions can be carried out at the same time as your EVLA treatment. However, because they require a higher amount of local anaesthetic, your consultant will carefully assess whether it is better to perform them during the same appointment or arrange a second visit. This ensures you remain completely comfortable and that the procedure is carried out safely. Your consultant will explain everything in detail during your consultation and guide you through the most suitable plan based on your individual needs.
Your journey begins with a consultation with one of our experienced consultants. During this appointment, we will talk through your symptoms, carry out a detailed scan, and discuss the best treatment options for you. If avulsions are recommended, your dedicated consultant will explain how the procedure works and answer any questions you might have. You will be fully informed and reassured before moving forward with your personalised treatment plan.
Before the procedure starts, your consultant will carefully mark the positions of the varicose veins on your skin while you are standing. Once you are lying down, your leg will be gently cleaned and covered with sterile drapes to maintain a safe environment.
A diluted local anaesthetic is injected into the tissues over the marked veins to make the procedure as comfortable as possible. Tiny incisions, just a few millimetres wide, are then made along the path of the vein using a very fine needle or small scalpel blade.
Through these small openings, a delicate surgical hook is used to gently tease the vein out. Small sections of the vein are carefully removed using fine instruments. This process is repeated along the leg, allowing longer segments of vein to be removed with minimal impact on the surrounding tissue.
Once all the targeted veins have been removed, small adhesive dressings are placed over each incision to protect the area. A supportive bandage is then applied to help reduce swelling and minimise bleeding, followed by a compression stocking to aid your healing.
Before you leave, your nurse will provide full aftercare instructions and explain how to look after your leg in the days ahead. We recommend staying active with gentle walking while also giving your body the time it needs to recover. If you ever have any concerns or questions after your procedure, our friendly team is always just a phone call away. We are here to support you at every step of your recovery.
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We understand that cost is an important factor when considering varicose vein treatment, and it is natural to want clear, honest information about what is included. At Veincentre, we are proud to offer avulsions at a fixed, transparent price. There are no hidden extras or unexpected fees. The full cost will be confirmed after your consultation, once your consultant has assessed your individual needs and discussed your treatment plan with you.
Avulsions are a safe and effective option for physically removing prominent varicose veins, particularly those close to the surface of the skin. While it may involve a slightly longer recovery than foam sclerotherapy, avulsions can offer excellent cosmetic and symptomatic results. It is often used alongside EVLA, or occasionally as a follow-up treatment to address any remaining visible veins.
If avulsions are recommended as part of your treatment, you can feel confident knowing that you will be looked after by an experienced consultant and supported every step of the way. We are here to make the process simple, supportive and fully tailored to your needs.
Both avulsions and foam sclerotherapy are effective ways to treat varicose veins, but they work in very different ways. The most suitable option for you will depend on the size and location of your veins, your scan results and your personal preferences, all of which will be discussed in detail during your consultation.
Foam sclerotherapy is the more commonly used treatment at Veincentre. It is a quick, walk-in, walk-out procedure that involves injecting a medicated foam into the affected veins, causing them to gently close. Your body then naturally absorbs the treated veins over time. Most patients find this treatment straightforward, with minimal downtime and little to no discomfort afterwards.
Avulsions, on the other hand, involve physically removing the vein through tiny incisions in the skin. This technique can be helpful for larger or more prominent varicose veins, particularly those that are close to the skin’s surface. While avulsions are still a minimally invasive procedure, they do involve slightly more recovery time and may lead to a bit more bruising or tenderness in the days following treatment.
At Veincentre, we always aim to recommend the most effective and comfortable approach for you. In many cases, foam sclerotherapy is all that is needed to achieve great results. If avulsions are the better option based on your scan and symptoms, your consultant will explain everything clearly and guide you through what to expect. Whichever treatment you need, you will be in experienced hands and fully supported throughout your journey.
Avulsions, also known as phlebectomies, can sometimes be offered on the NHS, but access to this type of treatment is often limited. Whether or not it is available to you usually depends on the severity of your symptoms and local NHS funding criteria. In many areas, treatments for varicose veins are only provided if the condition is causing significant discomfort or complications. Even when treatment is available, traditional surgical options are more commonly offered, which can involve longer recovery times and may not be as minimally invasive as the techniques used at Veincentre.
At Veincentre, we offer avulsions as a walk-in, walk-out procedure performed under local anaesthetic. It is often used alongside EVLA or as a follow-up to address any remaining visible veins. The treatment is carried out by an experienced consultant and designed to be as safe and comfortable as possible.
If you have been waiting for treatment on the NHS or have been told that your only option is surgery, we are here to offer a different approach. Our goal is to provide you with modern, effective treatment tailored to your individual needs, so you can feel confident and supported at every stage.
Avulsions are a safe and commonly performed treatment for removing varicose veins. Like all medical procedures, there are a few risks to be aware of, but most people experience a smooth recovery with only mild side effects.
It is normal to have some bruising, tenderness or mild swelling in the treated area. These symptoms usually settle within a few days and are part of the body’s natural healing process. Small scars may develop at the site of the incisions, although these tend to fade with time and are usually barely visible.
In a small number of cases, there may be minor bleeding, temporary numbness or a patch of firmness under the skin. These effects are typically short-lived and improve as your body heals. Infections are rare but possible with any minor skin procedure, which is why we take great care to maintain a clean, safe environment and provide full aftercare guidance.
Your dedicated consultant will explain everything in detail during your consultation, so you know exactly what to expect. We are here to make sure you feel fully informed, supported and comfortable before, during and after your procedure. If you have any questions along the way, our friendly team is always here to help.
Looking after your legs following avulsions is an important part of your recovery, and we will make sure you feel supported every step of the way. After your procedure, small adhesive dressings will be placed over the tiny incisions, followed by a bandage to reduce swelling. You will then be fitted with a class II compression stocking to wear for the next 7 days. This helps to support healing, improve circulation and minimise bruising.
Most people are up and walking shortly after the procedure. We encourage gentle movement, including a daily 20-minute walk, as it helps aid your circulation and recovery. You can usually return to everyday activities within a day or two, although we do recommend avoiding strenuous exercise, hot baths and swimming for at least a week.
Some bruising and tenderness around the treated areas is completely normal, and you might notice small patches of firmness under the skin. These usually settle within a few weeks. The tiny incisions are typically closed without stitches and heal well, often leaving little to no visible scarring.
Before you leave the clinic, your nurse will give you clear aftercare instructions and explain what to expect as you heal. If you ever feel unsure about anything or have any concerns during your recovery, our team is always just a phone call away. We are here to make sure your experience is as smooth, safe and comfortable as possible.
