Toenail Surgery - What's Involved?

At Podiatry & Wellness Clinic, ingrown toenails are one of the most common and potentially painful foot issues we see. Ingrown toenails typically affect the big toe, and occur when the nail grows around the side of the toe. They can cause pain, inflammation and even serious infection if left untreated.

If your ingrown toenail can’t be treated at home, your podiatrist will offer you a medical treatment plan. This could be a non-surgical trim and cut of the toenail to remove the troublesome piece of nail without too much hassle. However, if this is not successful, or your ingrown toenail is too far gone by the time the podiatrist sees it, then nail surgery under a local anaesthetic may be advised, to remove the nail.

Below, we have included some FAQ about toenail surgery.

What is nail surgery?

toenail surgery diagram
Partial Nail Avulsion (above)

Nail surgery involves the removal of either the entire nail or one or both margins of the nail. This is called a total (TNA) or partial nail avulsion (PNA) and is commonly used to remedy ingrowing toe nails where indicated.

The procedure is carried out under local anaesthetic and, in most cases, following removal of the nail itself, a caustic chemical (phenol) is applied to the nail matrix. This part of the procedure is called matrix destruction by phenolisation. The intent of phenolistaion is to prevent the nail from growing back.

If the nail has been damaged, either from a fungal infection or trauma, and the nail is likely to grow back without any problems, no chemical (phenol) will be used to destroy the nail matrix. In these cases, the expected outcome is for the new nail to regrow.

What would I need to do before the surgery?

You will be able to eat and drink normally on the day but will need to avoid taking any Aspirin directly before the procedure. However, if Aspirin has been prescribed by your GP, let the podiatrist know before the day of your surgery. It is also very important not to have a local anaesthetic anywhere else in the 24 hours before the procedure as you may receive a higher dose than what is safe for you.

You may wish to take a bath or shower on the day of surgery as it is strongly advised that you do not bathe or shower for approximately 6 days following the procedure. This is because there is an increased likelihood of infection if the dressing gets and remains wet.

It is preferable for you to wear either loose fitting trousers or a skirt. This enables the podiatrist to maintain a sterile environment throughout the procedure. As there will be a large dressing applied to the area, it is advised to bring some open toed footwear (sandals/flip-flops) with a space big enough for the dressing to fit through, as any enclosed footwear will cause pressure to the area or the dressing will prevent the footwear from fitting.

How long will the surgery take?

You should allow for 1 - 1 ½ hours - this allows time for the preoperative assessments and paperwork, preparation including local anaesthetic, and the surgery to be carried out. If a longer period of time is needed, the podiatrist will discuss this at your initial appointment.

What should I do when I get home?

For the remainder of the day, you will be advised to rest with your foot up above hip level, to reduce bleeding from the site. It is important to keep your circulation flowing by rotating your ankle and stretching and flexing your legs every half hour or so.

How much does the surgery cost?

Our prices start from £300 for toenail surgery, depending on whether you would need a partial nail avulsion or a total nail avulsion.

If you have an ingrown toenail, contact our clinic today to make an appointment with one of our podiatrists.