Toenail Removal Surgery Melbourne
Fix your problematic toenail with nail removal surgery
Nail removal surgery, also known as a total nail avulsion, is a nail surgery procedure offered at our Melbourne podiatry clinic where the whole toenail is removed. This simple “walk in and walk out” procedure is performed by our highly trained Melbourne podiatrists and takes just 1 – 1.5 hours.
This surgery is mostly performed so that the nail does not regrow again but there are some instances where we perform this surgery so that a new nail does regrow. A total nail avulsion can be a permanent solution to treat painful toenails, thickened toenails, fungal nails and retronychia.
NB. Any surgical or invasive procedure, including nail surgery performed under a local anaesthetic, carries risk. Before proceeding with nail surgery we always advise patients to seek opinion and consultation with one of our qualified podiatrists first.
Total nail avulsion using phenol
A total nail avulsion using phenol is a nail surgery procedure where the whole toenail is removed and phenol is applied to the nail bed. This surgery is designed to prevent a nail growing back. Phenol is a chemical which destroys the nail bed and therefore stops the nail from returning.
This surgery is useful to treat painful and problematic toenails, such as thickened nails or strange growing nails. Quite often these nails are difficult to cut and cause issues with shoe fit, leading to pressure and pain on the nail complex. We can also perform this surgery to treat an isolated chronic fungal nail where the final cosmetic result of no nail is preferred by the patient to the appearance of a fungal nail.
Total nail avulsion with phenol in covered by our 100% cure nail surgery guarantee.
Total nail avulsion without phenol
A total nail avulsion without phenol is a nail surgery procedure where the whole toenail is removed and the nail bed is left intact. This surgery is designed to help remove a problematic nail, whilst still allowing for a new nail to grow back. This surgery is primarily performed by our podiatrists to help treat retronychia but it can also be useful where nail removal is indicated but the use of phenol is not, for example during pregnancy.
It is important to note that with this type of surgery one of the risks is that it can result in a thickened or damaged nail when the new nail returns, which may affect cosmetic appearance. Nails are very slow growing and it can often take up to 18 months for a new nail to fully regrow. Therefore the final cosmetic result should not be judged until after this time. Despite this risk the surgery will generally still produce a better nail and may go a long way to fixing the original problem. Either way thorough assessment by one of our Melbourne podiatrists is essential before any nail surgery and they can provide you with a more accurate prognosis.
Total nail avulsion to treat retronychia
What is retronychia?
Retronychia is a nail condition where the proximal section of toenail (base of the nail) is ingrown into the proximal nail fold. It is characterised by redness and swelling at the proximal nail fold. It is a condition that often gets misdiagnosed by practitioners.
What causes retronychia?
Retronychia is generally caused by some form of trauma affecting the proximal section of the toenail. This can be due to acute trauma like stubbing your toe or dropping a heavy object on your toe. It can also be caused by repetitive trauma such as a pair of shoes that are too small or actions that place repetitive trauma on the end of the toenail. For this reason retronychia can often affect the toes of dancers and runners.
Due to the trauma with retronychia you often get a new nail growing underneath the old nail and this pushes the old nail up into the proximal nail fold, causing redness and inflammation. Because of the trauma the underlying nail matrix is often damaged so a new nail does not grow out. Hence a tell tale sign of retronychia is when the nail is not growing.
What is the treatment for retronyhcia?
Retronychia is often misdiagnosed as an isolated infection of the proximal nail fold. Antibiotics will help settle any associated infection but it will not fix the problem as it is not addressing the cause. To successfully treat retronychia you need to see one of our Melbourne podiatrists and have the damaged toenail removed.
At Melbourne Podiatrists & Orthotics our podiatrists can perform a total nail avulsion without phenol to successfully treat retronychia. After toenail removal the inflammation at the proximal nail fold quickly resolves allowing a new nail to regrow normally. Toenails are slow growing and a new nail can take up to 18 months to fully regrow. New nail growth should be closely monitored by the podiatrist to prevent complications.
Toenail removal surgery procedure at Melbourne podiatrists
Initial appointment
An initial assessment is essential before any toenail removal surgery can be scheduled. At this appointment the podiatrist will diagnose your problematic toenail and take a detailed medical history to find out if you are suitable for toenail removal surgery. They will then explain the procedure in depth, quote you on associated costs and schedule your toenail removal surgery appointment if you choose to proceed.
At Melbourne Podiatrists & Orthotics our podiatrists understand the urgency involved with toenail removal surgery so they will always make sure you can get a nail surgery appointment at fairly short notice.
Nail removal surgery appointment
Toenail removal surgery is a simple “walk in walk out” procedure performed by our podiatrists under sterile conditions at our Melbourne foot clinic. You will need to bring in some open toed sandals or thongs for this appointment as you will have a bulky dressing on the toe post surgery. Please also feel free to bring in music, headphones or anything else that helps you relax.
Toenail removal surgery consists of the following simple 4-step procedure:
An injection of local anaesthetic is administered to the toe.
The whole nail is removed from the nail bed.
In cases where we don’t want a nail returning, phenol is applied to the nail bed to chemically destroy the nail matrix and prevent future regrowth. In cases where we want a nail to regrow the nail bed is left alone.
The toe is cleaned and appropriately dressed with antiseptic to minimise post-op infection.
Redressing appointments following toenail removal
Your podiatrist will schedule a redressing appointment 1 week following toenail removal surgery. At this appointment the podiatrist will check the healing progress of your toe whilst making sure there is no nail left behind or infection.
In cases where phenol has been used on the nail bed a second redressing appointment is usually scheduled 3 – 4 weeks post surgery. A second redressing is not required for toenail removal without phenol as the healing time is quicker.
Redressing appointments are included in the cost of nail surgery. It is vital that you attend these appointments with your podiatrist to minimise infection and to ensure a successful outcome. Failure to attend redressing appointments may void any associated nail surgery guarantee.
Post surgery reviews
A 1-3 month post surgery review (time frame will depend on the type of nail removal surgery) will be scheduled by the podiatrist. All nail surgery reviews are charged at our standard consultation rates. Toenails are very slow growing so this review is essential to ensure your toenail removal surgery is 100% successful. In cases where phenol has been used the podiatrist needs to ensure there is no nail regrowth. In nail removal surgery cases without phenol, the toenail will return and the podiatrist needs to closely monitor the new nail to ensure it grows back without complications.
NB. This review is compulsory for patients to meet the terms and conditions under our Nail Surgery Guarantee.
Healing
Toenail removal surgery at our Melbourne podiatry clinic is “walk in and walk out” so there is literally no time off your feet. Post nail surgery you will have a big bulky dressing on your toe which you are required to keep dry for 2 days and to wear open toed sandals or thongs. Following removal of this dressing you can get back into normal footwear and resume normal daily living activities.
Toenail removal surgery using phenol – most patients find they can resume most sporting activities after 2 weeks, whilst full healing of the toe takes approximately 6 – 8 weeks.
Toenail removal surgery without phenol – patients can resume sporting activities once the initial dressing is removed and they feel capable. With this surgery the toe usually heals fast providing there are no complications. Full healing can take anywhere from a few days to 1 week from the time of the surgery. In some instances it may be longer depending on trauma.
Toenails are very slow growing (a toenail can take up to 18 months to regrow) therefore you may not see the final cosmetic result until after this period. Good fitting footwear and avoiding nail trauma will ensure the best result.
Regrowth
Nail surgery removal using phenol at Melbourne Podiatrists & Orthotics is a very effective procedure. With this procedure we estimate cases of nail regrowth at less than 1%. In the unlikely scenario there is nail regrowth causing further issue or the original problem returns then you will be covered under our nail surgery guarantee. In these cases our podiatrists will happily perform a second toenail removal surgery procedure at no extra charge to fix the original problem.
Why choose Melbourne Podiatrists & Orthotics for toenail removal surgery
At Melbourne Podiatrists & Orthotics we take toenail removal surgery very seriously and our podiatrists take extra care to ensure your surgery is 100% successful. When choosing a podiatrist for toenail removal surgery it is important that you base your decision on all factors that the surgery entails and not solely on price.
Our podiatrists are experienced in toenail removal surgery and trained to diagnose and treat retronychia. We perform toenail removal surgery regularly on children and adults.
We allow a minimum of 1.5 hours for toenail removal surgery on one toe and 3 hours for two toes. This extra time ensures a professional job, allows for any potential complications that may arise, and ensures that toenail removal surgery is not rushed. Other clinics may only allow 1 hour, which can put the podiatrist under stress if complications arise.
We use a pain numbing device to help reduce the pain associated with local anaesthetic injections. We also have other devices and strategies to help anxious patients both young and old cope with injections and toenail surgery.
Toenail removal surgery with phenol includes the follow up redressing appointments to minimise infection, post surgery complications and ensure healing. Toenail removal surgery with no phenol includes the first redressing appointment (usually only one is required when phenol is not used).
Permanent toenail removal surgery with phenol includes our nail surgery guarantee which guarantees success. We are unaware of any Melbourne podiatry clinic that offers the same level of service and guarantee when it comes to nail surgery.
FAQ toenail removal surgery?
Yes, but it does depend on the severity and what is causing the infection. If the toenail is causing the infection because it is ingrown, such as in cases of retronychia, then the nail will need to be removed for the infection to clear. The main issue with infection is it can affect the workings of the local anaesthetic so severe infections will require antibiotics before toenail removal surgery. Our podiatrists will always thoroughly assess your toenail before and after nail removal surgery and will let you know if antibiotics are required at any stage.
Yes. Whilst toenail removal surgery is a very safe procedure there are still some contraindications. It is vital that you discuss with the podiatrist prior to booking toenail removal surgery if you:
- Have a needle phobia or suffer from anxiety
- Are pregnant
- Are breastfeeding
- Have allergies to local anaesthetics such as lidocaine
- Have allergies to medicaments, primarily iodine and phenol
- Are allergic to certain dressings or bandages, primarily bactigras
- Are on blood thinners
- Have an underlying health condition that may affect surgery
- Are on any other medication that may affect surgery
Our podiatrist will discuss these with you to work out if you are still suitable for toenail removal surgery.
Please inform the podiatrist prior to booking toenail removal surgery if you have a needle phobia or suffer from anxiety with injections. In some cases your GP may need to prescribe you with oral sedation for use prior to toenail removal surgery. If indicated our podiatrists will be happy to discuss these options with you and your GP.
This will mostly depend on whether phenol is to be used during the toenail removal surgery. Currently we advise that toenail removal surgery with the use of phenol is best avoided during pregnancy and conservative treatment options should be explored.
Whilst local anaesthetics like lidocaine are generally considered safe after the first trimester (12 weeks) the evidence for the use of phenol (which is toxic to humans) is limited during pregnancy, therefore it is best avoided.
If you are pregnant we advise seeing one of our podiatrists to discuss your toenail removal options. In some cases, after the first trimester, we may be able to remove a problematic nail under local anaesthesia without the use of phenol and this may provide a short term solution.
For urgent nail surgery during pregnancy our podiatrists may decide to refer you to a podiatric or orthopaedic surgeon for a different nail surgery technique without the use of chemicals.
With breastfeeding our podiatrists will always take a conservative approach. Therefore we advise it is best to delay toenail removal surgery until after breastfeeding. For urgent toenail removal surgery (with or without phenol) where the benefits outweigh the risks we advise consultation and approval from your obstetrician prior to surgery.
Whilst research has shown that the use of a local anaesthetic such as lidocaine during breastfeeding is safe, there is limited evidence on the use of phenol. Whilst the quantity of phenol applied to the nail bed during nail surgery is unlikely to affect the breastfed baby, it has not been extensively studied and therefore it is best avoided.
Yes. Our podiatrists can perform up to 2 toenail removals on the one day. When doing two toes our podiatrists allow approximately 2.5 – 3 hours for the nail removal surgery, although most procedures are finished in 2 hours.
Yes. Because the local anaesthetic only affects the toe you can safely drive home following toenail removal surgery. Please bear in mind that you will have a big dressing on the toe, so please drive in appropriate footwear or barefoot. We advise elderly patients or those patients not confident in driving to arrange alternative transport home.
Post toenail removal surgery you will have a big bulky dressing on your toe for the first 2 days so you will need to wear open toed sandals or thongs. Following removal of this dressing after 2 days you can get back into closed toe footwear, providing the shoes are a good fit and appropriate. Tight shoes are to be avoided as they place pressure on surrounding tissue which can delay healing.
This will depend on the type of toenail removal surgery, healing and the sport. Toenail removal surgery without phenol can heal quickly meaning patients can return to sport as soon as the initial dressing is removed (after 2 days) and they feel capable. Toenail removal surgery with phenol takes longer to heal. We find with this nail surgery most patients can resume sport after 2 weeks, whilst full healing of the toe takes approximately 6 – 8 weeks.
Podiatrists are highly trained in toenail removal surgery. Toenail removal surgery using phenol compared to some other nail surgeries is minimally invasive, yet highly effective. This results in a high rate of success, minimal post-op pain and faster recovery times.
Do you have a problematic toenail that needs to be removed?
Our podiatrists are experts in toenail problems and can perform toenail removal surgery at our Melbourne foot clinic to help cure problematic toenails.
So if you have a problematic or painful toenail that requires removal, book an assessment with one of our friendly Melbourne podiatrists today!