Nail Surgery
What is nail surgery?
Nail surgery involves the removal of infected and damaged toenails through surgery under local anaesthetic.
Why would I need this procedure?
The most common reason for toenail surgery is if a toenail has ingrown i.e. the toenail has caused a break in the skin of the toe leading to pain and possible infection. Sometimes the toenail might not have broken the skin, but it can still cause pain due to it, for example, being thickened or curled at the edges.
Prices
£50 non refundable deposit
One toe £350
Two toes £450
Procedure
Nail surgery is a straightforward procedure
First, I assess you, and receive your written consent to go ahead with the procedure
You will have an injection of a local anaesthetic into the affected area, this makes sure the surgery will be pain-free
The appointment lasts around 45 minutes, but the procedure takes about 20 minutes
The two main procedures carried out are:
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Partial nail avulsion (removal): the side or sides of a nail only are removed
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Total nail avulsion (removal): the whole nail is removed
After this, I will apply a chemical called Phenol to limit the chance of the nail re-growing
A sterile dressing is then applied
What are the expected benefits of treatment?
Once fully healed the benefits can include:
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No more pain in the toe
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No more risk of infection in the toe
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No more need for antibiotics
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Footwear more comfortable
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Able to resume sports activities
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Work, school or college no longer disrupted by the problem
Checklist of things to remember for the day of your toenail surgery.
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Bring a current prescription or list of medications
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Continue to take medication unless advised otherwise
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Bring any medication you may need on the day e.g. Inhalers, Insulin etc.
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Bring a pair of open-toed shoes e.g. sandals
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Arrange for a lift home or taxi to take you home after the procedure (do not drive home after surgery and do not use public transport)
Feel free to bring a friend or family member to accompany you during the procedure, but please limit this to one person due to limited space in the clinics.
Under 16s must be accompanied by a person with parental or legal responsibility for them.
Continue to eat and drink as normal (you do not need to fast)
You may wish to bring a book to read or music to listen to etc.
Please remove nail varnish or toe jewellery from the toe to be operated on.
What are the potential risks and side effects?
Pain following the procedure once the local anaesthetic has worn off. This varies from patient to patient.
The pain usually starts to ease within 24 hours. Paracetamol (taken as per manufacturer’s guidelines) is the recommended form of pain-relief if required.
Use of open toed footwear to reduce pressure on the toe is also advisable.
Excessive bleeding may occur. To help reduce the risk of this happening it is important to rest for the remainder of the day with the foot raised when possible.
Infection - Precautions are taken to reduce the risk of infection, but the post-operative wound usually takes some weeks to fully heal meaning there is the risk of infection occurring. Infection can delay the healing process.
Nail regrowth can occur in approximately 5% of cases (when phenol is used). Regrowth does not always cause a problem, but if it does the procedure may need repeating.
Cracking of the toenail - After partial removal of a toenail, sometimes the remaining part can develop a crack. This usually grows out, but can take some months to do so.
Nerve/Bone trauma - This rarely occurs, but can be caused by the injections or pressure applied to the toe during the procedure. This can result in discomfort which might take up to two to three months to resolve.
Phenol burns - Occasionally the chemical (phenol), used to prevent regrowth of the nail, can spread to the skin surrounding the nail. Once the anaesthetic has worn off, this would be painful; therefore great care is taken to try to prevent this from happening.
Anaphylactic shock - This is a serious (sometimes life-threatening) adverse reaction to a substance e.g. local anaesthetic. Fortunately it is extremely rare, but I am trained for such an event and it would be treated as a medical emergency.
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