Nail Surgery
Many people mistakenly believe toenail surgery is a complicated procedure requiring a hospital visit. However, this is often not the case. It’s a fairly routine procedure that our expert team of podiatrists can perform at any of our clinics.
We perform two types of surgery: a partial nail avulsion, where we remove one or both sides of the affected nail, or a total nail avulsion, where the entire nail is removed.
​
Why might you need nail surgery?
The most common problem requiring minor toenail surgery is an ingrowing toenail, where the side of your nail cuts into the surrounding skin. Mostly affecting the big toe, the skin can become inflamed and infected which can be very painful.
If this is the first time, you experience an issue with this nail and your condition is not too severe, a podiatrist can try to help the nail by offering a conservative approach to the ingrown toenail. Unfortunately, if it has been left untreated, got infected, or is too embedded in the skin and/or keeps recurring, toenail surgery might be your solution.
There are many different causes for ingrown toenails, including poor nail cutting technique, narrow fitting shoes, or injury. Sometimes it’s simply a case of genetics if you have nails with naturally curved edges.
Other situations requiring toenail surgery are fungal nail infections or thickened toenails that press on your nail bed causing painful corns to form under the nail
What does the procedure involve?
There are three stages to the operation:
-
Firstly you will be given an injection of local anaesthetic which will make your toe numb.
-
Once the toe is numb, the podiatrist will carefully remove either all or part of the nail, and will use a chemical called phenol to kill the cells of the exposed nail bed. This normally ensures that the nail will not regrow in this section.
-
A dressing will then be applied to the toe. You are advised not to drive whilst the toe is numb, our advice is to get a taxi or a lift home and avoid excessive walking for the first 24 hours.
Will it be painful afterwards?
It is advisable to bring loose fitting or open toed footwear with you on the day of the procedure as a large dressing is applied to the toe. Some patients may experience slight discomfort when the anaesthetic wears off, but this does not normally last very long. If there is a discomfort it is advised to take a painkiller (something you would usually take for a headache).
​
Dressings and follow up
We advise that you attend the clinic to have the toe re-dressed within a few days of the operation being carried out. Another follow-up will be scheduled 14 days after the initial redressing but the dressing will probably require changing daily for 6/8 weeks. We will provide a list of specific dressings to purchase and instructions on how to do this. Last but not least we will do a final review towards 4 weeks post-op.
​
Are there any risks and complications?
As with all surgery, there are minor risks.
• Infection;
• Recurrence and regrowth of the nail (under 10%);
• Delayed healing;
• Adverse reaction to Phenol / Local anaesthesia;
• A thickened nail plate;
• Altered nail shape (every effort is made to provide a cosmetic appearance. Sometimes due to a large involuted plate condition/infection, a large section needs to be removed);
• Nail cyst.
​
Can anyone receive this treatment?
Although treatment is available to most patients with painful ingrowing toenails, we will need to assess if there are any medical or surgical reasons why such a procedure should not be undertaken, this includes taking a vascular and Should you wish to discuss Nail Surgery further, or should you have any questions about the information provided, please do not hesitate to contact us.