Varicose Vein Surgery or Microphlebectomy is a procedure performed to address bulging, twisting varicose veins that cannot be treated with endovenous laser treatments. It is often combined with endovenous laser treatment and sclerotherapy of spider veins. After marking the bulging veins, a local anesthetic is used and a small micro-incision is made, allowing a small hook like instrument to be inserted just below the surface of the skin and remove the diseased vein segment by segment, as it extends down the leg. Typically no sutures are required and the incisions heal within 1-2 weeks during which time compression stockings are worn. When treated, these ropy veins are permanently gone. However, if you have a family history you could form new ropy veins.