MSA for Varicose Veins: A Minimally Invasive Treatment Explained
Varicose Veins Treatment
If you’re suffering from varicose veins, you may be wondering whether there’s a way to treat it without major surgery.
One technique more patients are asking about is the Micro Surgical Avulsion (MSA) treatment, a minimally invasive procedure offered at the Vascular and Interventional Clinic in Singapore. Our specialists are here to guide you through the options and help determine what’s best for your condition, comfort, and goals.
This guide covers what you need to know about MSA for varicose veins, including how it works, benefits, risks, costs, and how it compares to other treatments.
WHAT is it
What Is the MSA Procedure for Varicose Veins?
MSA combines two techniques – micro sclerotherapy and ambulatory phlebectomy – to treat varicose veins comprehensively. This dual approach allows vascular specialists to address both smaller spider veins and larger varicose veins in a single treatment session, making it an efficient option for many patients.
How Does MSA Treat Varicose Veins?
The MSA procedure involves two distinct but complementary techniques:
- Micro Sclerotherapy targets smaller veins by injecting a sclerosing agent directly into the affected vessels. This medication causes the vein walls to collapse and seal shut, eventually leading to their absorption by the body. The process requires multiple tiny injections using ultra-fine needles.
- Ambulatory Phlebectomy addresses larger varicose veins through small incisions, typically 2-3mm in length. Through these micro-incisions, the surgeon carefully removes the problematic vein segments using specialised hooks and instruments. The incisions are so small they often don’t require stitches.
Both procedures are performed under local anaesthesia in an outpatient setting. The combination approach ensures comprehensive treatment of various vein sizes whilst maintaining the minimally invasive nature of the procedure.
Who Is a Good Candidate for MSA?
You may be suitable for MSA if:
- You have visible, bulging varicose veins
- Your ultrasound shows reflux in superficial veins
- You’re not keen on major surgery
- You’re looking for fast recovery and minimal downtime
Patients with very large varicose veins or underlying venous insufficiency may require different approaches. A thorough vascular assessment determines the most appropriate treatment strategy for each individual case.
PROS & CONS
Benefits & Disadvantages of MSA for Varicose Veins
MSA offers a balanced approach to varicose vein treatment, combining effectiveness with minimal invasiveness. However, like all medical procedures, it comes with both advantages and potential drawbacks that patients should carefully consider.
Pros: Minimally Invasive
Advantages of MSA include:
- Small puncture sites and minimally scarring (no stitches required). The tiny incisions used typically fade to barely visible marks within months. This cosmetic advantage is particularly important for patients concerned about leg appearance.
- Local anaesthesia only. Avoiding general anaesthesia reduces procedural risks and eliminates the nausea and vomiting associated with anaesthesia
. - Performed as day surgery. The entire procedure takes 30-60 minutes and doesn’t require hospital admission. Patients can be discharged home after a brief observation period.
- Quicker return to daily activity (1–2 days). Most patients return to normal activities within 2-3 days, compared to 1-2 weeks for traditional vein stripping surgery. The micro-incisions heal quickly without requiring extensive wound care.
Cons: Potential Nerve Irritation
No treatment is without drawbacks. With MSA, these may include:
- Temporary numbness or tingling from superficial nerve irritation. Some patients experience mild numbness or tingling near treatment sites, though this typically resolves within weeks to months.
- Not suitable for deep vein disease. Patients with severe venous insufficiency or very large varicose veins may require alternative treatments like endovenous ablation or surgical intervention.
Compare
MSA vs. Other Varicose Vein Treatments
Choosing between varicose vein treatments requires understanding how each approach addresses different aspects of venous disease. MSA occupies a unique position in the treatment spectrum, offering advantages in specific situations whilst having limitations in others.
MSA vs. Sclerotherapy: Which Is Better?
Traditional sclerotherapy and MSA share the micro sclerotherapy component but differ in scope and capability.
MSA is better when:
- Veins are over 3mm in size
- You want immediate removal of the vein
- Cosmetic results are a priority
Some patients undergo sclerotherapy after MSA for residual veins.
Vein Ablation vs. MSA – Pros & Cons
Generally, ablation deals with the deeper issues, while MSA takes care of the visible veins. They are often used together.
| Feature | MSA | Vein Ablation |
|---|---|---|
|
Method |
Physically removes vein |
Closes vein with heat/glue |
|
Use case |
Removes bulging surface veins |
Treats deeper truncal veins |
|
Recovery Time |
1-2 days |
1-2 days |
When Is Surgery (Phlebectomy) Necessary?
Traditional surgical phlebectomy becomes necessary when:
- Varicose veins are too large for minimally invasive techniques
- Extensive vein networks require complete removal
- Previous minimally invasive treatments have failed
- Complications like bleeding or ulceration are present
MSA serves as an intermediate option between sclerotherapy and surgery, suitable for moderately sized varicose veins that are too large for sclerotherapy alone but don’t require full surgical intervention.
What to expect
What to Expect During & After MSA Treatment
If you’re considering MSA, here’s a step-by-step walkthrough of the procedure and recovery timeline.
How Long Does the MSA Procedure Take?
- The entire treatment usually takes 30–60 minutes.
- Most patients return home the same day.
- It’s done in a clinical setting—not an operating theatre
Recovery Timeline & Compression Stockings
MSA recovery follows a predictable timeline with specific milestones:
Recovery milestones:
- First 24-48 Hours: Mild bruising and swelling are normal. Patients should avoid strenuous activities but can walk normally. Compression stockings must be worn continuously during this period.
- Days 3-7: Most discomfort subsides, and normal activities can resume. Compression stockings should be worn during waking hours. Light exercise like walking is encouraged.
- Weeks 2-4: Bruising fades, and micro-incisions heal. Compression stocking use may be reduced based on healing progress. More vigorous exercise can gradually resume.
- Months 1-3: Final cosmetic results become apparent as treated veins are absorbed by the body. Follow-up appointments assess healing and determine if additional treatments are needed.
RISKS
Risks & Downsides of MSA for Varicose Veins
Like all medical procedures, MSA carries potential risks and complications that patients should understand before treatment. While serious complications are rare, being aware of possible side effects helps patients make educated choices and recognise when to seek medical attention.
Possible Side Effects & Complications
Common and minor side effects include:
- Bruising and Swelling: Expected after treatment, typically resolving within 1-2 weeks. More extensive bruising may occur in patients taking blood-thinning medications.
- Temporary Nerve Sensitivity: Mild numbness, tingling, or altered sensation near treatment sites. This usually resolves within 2-6 months as nerves heal.
- Skin Discolouration: Brown or red marks along treated vein paths, generally fading over several months. Darker skin tones may be more prone to pigmentation changes.
- Phlebitis: Inflammation of treated veins causing tenderness and redness. This responds well to anti-inflammatory medications and compression therapy.
Rare but more serious complications include:
- Deep Vein Thrombosis: Blood clots in deeper veins, requiring immediate medical attention. Risk factors include prolonged immobility and certain medical conditions.
- Infection: Uncommon due to sterile technique, but possible at incision sites. Signs include increasing redness, warmth, and discharge.
- Allergic Reactions: Rare responses to sclerosing agents, ranging from mild skin reactions to severe systemic responses.
How to Minimise Risks Post-Treatment
Following post-procedure instructions reduces complication risks:
- Wear Compression Stockings: As prescribed to promote healing and prevent blood pooling
- Stay Active: Regular walking prevents blood clots whilst avoiding excessive strain
- Avoid Heat: Hot baths, saunas, and direct sun exposure for the first week
- Monitor Symptoms: Watch for signs of infection or blood clots
- Attend Follow-ups: Regular check-ups ensure proper healing and early problem detection
Patients should contact their vascular specialist immediately if they experience severe pain, signs of infection, or symptoms suggesting blood clots.
Signs of Blood Clots After MSA
Although rare, contact your doctor immediately if you notice:
- Severe leg pain or cramping, especially in the calf
- Significant swelling in the treated leg
- Warmth and redness extending beyond the treatment area
- Shortness of breath or chest pain
While blood clots after MSA are uncommon, early recognition and treatment are crucial for preventing serious complications like pulmonary embolism.
COSTS
MSA Cost & Value: Is It Worth the Investment?
Cost is a key consideration. Here’s what goes into MSA pricing in Singapore and how it compares to other vein treatments.
MSA Procedure Cost Breakdown
The cost of MSA for varicose veins in Singapore can vary depending on the severity of your vein condition.
According to the Ministry of Health’s fee benchmarks, the surgeon’s fee for such a procedure typically ranges from $2,600 to $4,300.
Treatment costs in Singapore vary based on the procedure type, clinic setting, and extent of treatment required. To give a sense of cost, the table below outlines how MSA compares to other common vein treatments in terms of estimated surgeon’s fees.
Other fees to consider include:
- Consultation and duplex ultrasound scan
- Facility cost
- Compression stockings and medications
- Post-op review
Insurance & Medisave Coverage for MSA
Medisave coverage for the MSA procedure is available when the treatment is deemed medically necessary. Conditions like painful varicose veins with documented symptoms may qualify for partial coverage.
Private insurance coverage varies widely between policies and providers. Some comprehensive health insurance plans cover medically necessary vein treatments, whilst others exclude these procedures entirely or have specific limitations.
To qualify for insurance coverage, you typically need documentation of symptoms like pain, swelling, skin changes, or functional impairment rather than purely cosmetic concerns.
Pre-approval from insurance providers is recommended before proceeding with treatment to understand your coverage.
DID YOU KNOW?
The Vascular and Interventional Centre is the only private vascular centre in Singapore with its own in-house operating theatre.
This allows us to offer you greater convenience, reduced facility and equipment-related fees, and minimised waiting times for your procedure.
FAQs about MSA for Varicose Veins
How Many Sessions Are Needed?
In most cases, only one session per leg is sufficient. Larger vein clusters may require a follow-up or adjunctive treatments like sclerotherapy.
When Is MSA the Best Treatment Choice?
You may want to consider MSA when you have:
- Mixed Vein Sizes: When patients have both small and moderately large varicose veins, MSA treats them comprehensively in fewer sessions than other approaches.
- Lifestyle Considerations: Patients requiring minimal downtime benefit from MSA’s quick recovery compared to surgical options.
- Previous Treatment Experience: Those who’ve had partial success with sclerotherapy alone may benefit from MSA’s enhanced capability.
A vascular ultrasound helps assess whether MSA or another treatment is better suited.
Does MSA Provide Permanent Results?
MSA effectively eliminates treated veins permanently – once removed or closed, these specific vessels won’t return. However, the underlying tendency to develop varicose veins may persist, potentially leading to new vein formation over time.
The permanence of results largely depends on addressing underlying venous insufficiency and following post-treatment care instructions diligently. Follow-up scans and periodic reviews help detect early recurrence and guide further management.
CONTENTS
YOUR Preferred Health Partner
Why Choose the Vascular & Interventional Centre
We Own Our Own Hybrid Operating Theatre
Unlike many other clinics, the Vascular & Interventional Centre owns and operates our own fully equipped day surgery theatre (angiosuite). This gives you a significant advantage:
- Lower facility and equipment fees – as we do not rely on third-party hospitals.
- Faster scheduling – skip the hospital queues, your procedure can be done promptly and at your convenience.
- Seamless care – from consultation to surgery and follow-up, all under one roof.
This integrated setup allows us to offer greater cost transparency, shorter waiting times, and a smoother overall experience for patients seeking varicose veins treatment.
Highly Experienced Team with Transparent Pricing
Our team brings years of specialised experience in varicose veins treatment, having successfully treated thousands of patients with various venous conditions.
We believe in transparent pricing without hidden costs or unexpected charges. Before beginning treatment, you’ll receive a detailed cost breakdown including all anticipated expenses, helping you plan accordingly and avoid financial surprises during your treatment journey.
Our commitment to transparency extends to treatment expectations, potential risks, and realistic timelines for results. We want you to feel confident and well-informed.
