Nail Surgery
Ingrown toenail that you just can't get rid of?
Ingrown toenails are really common; around 20% of people attending their GP surgery for a foot problem have an ingrown nail and we see A LOT of them at Your Feet First.
Not all ingrown toenails are created equal and so the treatment approach will be dependent on you and your nail.
For some people, ingrown nails are a one off problem, caused by trauma or incorrect nail cutting, and can be addressed in one visit without the need for surgery, although some choose to have a local anaesthetic if their toe is particularly painful.
If your ingrown toenail has been a long term problem, keeps recurring or where conservative treatments have been unsuccessful surgical removal of the nail, or the side(s) of the nail, may be a better option for you to avoid continued discomfort and pain.
Types of Nail Surgery
“Nail Surgery” is commonly used to describe a variety of different minor surgical procedures involving removal of a toenail (or fingernail, less frequently). The type of nail surgery that would be best for you will depend on your nail and the reason for your surgery. While partial nail avulsions are the most frequently performed type of nail surgery, there are times when a total removal will be more appropriate, such as where the whole nail is damaged beyond repair.
Partial Nail Avulson
Where only one side of the nail is causing you problems, we remove that section of the nail. In most cases, we’ll be able to leave enough nail that, once healed, people won’t notice you’ve had surgery.
Bilateral Partial Nail Avulsion
Where both sides of your nail are problematic, or where we think that removing one side will cause an inbalance, we may advise removal of sections either side of your nail.
Total Nail Avulsion
In some cases, we may suggest the removal of your entire nail either permanently or temporarily. This may be a preferred option for people where the entire nail is damaged beyond repair, or where we don’t believe a partial avulsion will be successful.
What is phenolisation?
Phenolisation is the process of applying phenol, an acid, as part of your surgical procedure to destroy the cells in your nail matrix which grow new nail.
Phenolisation is safe and effective, stopping regrowth in more than 98% of surgical cases.
Phenolisation is safe for most patients. While evidence of increased risk is limited, we do not routinely advise phenolisation for patients who are pregnant or breastfeeding.
What should I expect during my surgery?
Your nail surgery will be carried out under local anesthetic and will usually take under an hour. We’re keen for you to be as comfortable as possible during your procedure, so your Podiatrist will take you through the procedure and answer any questions you might have before beginning.
We’ll go through some final checks and consent forms with you to make sure that your surgery is the right choice for you.
Your Podiatrist will answer any questions that you have and make sure you’re nice and comfortable.
We’ll clean your toe/foot thoroughly and then administer a local anesthetic.
While we wait for your toe to go numb, we’ll make sure we have everything set up and get ready to start your procedure.
Once you’re completely numb, we’ll apply a tourniquet to limit blood flow to the end of your toe.
We’ll then use our instruments to ease your nail away from your skin, and then remove it. While we’re there we’ll take away any nail fragments and excess tissue.
If you’ve opted for a permanent removal with phenolisation, we’ll apply Phenol to the area where we have removed nail to destroy the nail matrix.
We’ll do this 3 times, and then flush the area to remove any remaining acid.
We’ll remove the tourniquet to restore full blood flow to the end of your toe.
Finally, we’ll apply a large, multi-layered dressing.
As your dressing will be bulky, you should bring open toed shoes….but we also have slippers you can wear away, if needed.
TOP TIPS
Ask lots of questions; your Podiatrist’s job is to answer them. There are no silly questions and it’s important that you feel comfortable and confident in your choice.
You should eat and drink as normal before your surgery to maintain your hydration and blood sugar levels. This will help you avoid feeling dizzy or faint during your procedure.
Some people feel more comfortable with a friend or family member present. Feel free to bring someone with you to hold your hand, for a chat, or just to watch what happens!
Relax!
Bring a book, listen to your favourite music, or watch something funny on your phone if it helps you stay calm during your procedure. We won’t be offended if you don’t want to chat!
What should I expect after my surgery?
At Your Feet First, we provide nail surgery as a package of treatment which means we’re with your until you are fully healed. We’ll provide you will full after care advice, your post-op dressing pack and follow up appointments during the healing process. Every person’s post-op experience will be slightly different, but we expect most patient’s will heal completely within 12 weeks with appropriate at home after care.
You’ll have a large dressing on your toe which must not be removed and must be kept dry. This will be changed within 48 hours of your surgery.
You may experience slight discomfort once your anaesthetic wears off, but may feel nothing at all.
We’ll provide you with everything you need to take care of your toe in between appointments.
You’ll need keep your toe clean, dry and change your dressing every 2 days.
During weeks 1-3, you’ll have a check up to ensure you are healing as planned.
You’ll notice a reduction in swelling and redness, and the wound should be healing. Pain is uncommon and would usually be caused by tight footwear or activity that irritates the wound.
You’ll need to keep your toe clean, dry and dressed while ever you have an open wound.
Healing times will vary from person to person, depending on your procedure, health and after care. We expect most patients to be fully healed within 4-12 weeks.
At around 8 weeks post-op, we’ll see you for a discharge check up to ensure everything is healed or healing, as planned.
Frequently Asked Questions
No. As a private clinic, we can assess and carry out your surgery without the need for a referral.
The whole procedure takes around an hour. It may take longer if multiple nails are being removed.
We would advise against driving until your local anaesthetic has worn off and full feeling returns to your toe. Driving while anaesthetised may invalidate your insurance.
For the first 24-48 hours after surgery, you will have a large dressing on your toe. You will need to wear open toed shoes or shoes which can comfortably accommodate the dressing. We’ll redress your toe within 48 hours of your surgery and you should then be fine to wear most sensible shoes, but should avoid tight fitting shoes until your wound is fully healed.
Yes, please discuss this with your Podiatrist.
You can use Clearpay’s “Pay in 3” plan in clinic.
If you have had a procedure which includes phenolisation, there is less than 2% chance of regrowth. It is so unlikely, that if you are unfortunate enough to have regrowth, we’ll carry out a surgical revision or redo your surgery free of charge.
When surgeries are carried out without phenolisation, regrowth is expected and a review and management plan will be discussed with you at your appointment. Should regrowth become problematic and not respond to conservative management, patients may later opt to have a further nail surgery with phenolisation (fees apply).
As the surgery is carried out under local anaesthetic, it is pain free.
The injection of local anaesthetic can be uncomfortable, but takes effect very quickly.
Most patients remain numb for a few hours after surgery and find that once feeling returns, discomfort is limited and manageable.
This will depend on you, your activity level at work/school and the footwear you may need to wear.
We wouldn’t advise you to return to work/school immediately or on the day of your surgery, as you should rest with your leg(s) elevated where possible.
Get in Touch.
Ashfield Therapy Centre
49-51 Station Street
Kirkby-in-Ashfield
Nottinghamshire
NG17 7AN
01623 723328
info@yourfeetfirst.org
MON 09.00 – 18.00
TUE 09.00 – 18.00
WED 09.00 – 18.00
THUR 09.00 – 20.00
FRI 09.00 – 13.00
