Ingrown Toenail Surgery

Ingrown toenails are a painful and frustrating foot problem that plague many people for years by continuing to grow back. We treat ingrown nails and stop them growing back for good using specialised ingrown nail surgery performed by our Brisbane podiatrists.

An ingrown toenail develops when part of your toenail pierces the skin that surrounds it and starts growing into it. Think of it like a splinter in your skin - and with each step, the movement of the piece of nail around the skin can cause pain, making walking and wearing shoes very uncomfortable. While some causes of ingrown nails are hereditary, like a curved nail shape, others are self-inflicted - like the way that the toenails are trimmed or cramming the feet into tight, narrow footwear that pushes the skin of the toe closely against the nail. This is why many people continue to get ingrown toenails over many years - and where ingrown nail surgery can help them finally get that permanent relief.

Do I Need Surgery For My Ingrown Toenail?

We offer two primary kinds of ingrown toenail treatments: nail surgery and conservative ingrown nail care. Conservative ingrown nail care is best suited for people who don’t have a history of ingrown toenails, and their current ingrown nail was caused by a one-off cause - like a specific pair of tight shoes that they’re not wearing again. In this case, simply removing the ingrown nail edge without surgery will help alleviate the pain and allow the nail to heal.

Ingrown nail surgery is recommended for those who have a history of ingrown toenails, or those whose ingrown nail is likely to recur, like if their involuted nail shape was the likely cause of the problem. It’s not uncommon to see patients who have had ingrown toenails conservatively treated several times before opting for the nail surgery.

Types of Ingrown Toenail Surgery

There are two primary types of ingrown nail surgery that we perform:

Partial Nail Avulsion (PNA)

A PNA is the most common ingrown nail procedure that we perform. It involves removing a small part of the nail edge that has ingrown into the skin. The next step is called a chemical matrixectomy, where a chemical called phenol or sodium hydroxide (NaOH) is applied to destroy the nail-growing cells at the base of the nail, meaning that the small problematic nail edge won’t grow back. The procedure is performed under local anaesthetic so is painless for you. The process takes approximately one hour, with the nail edge removal taking only approximately 20 minutes.

Total Nail Avulsion (TNA)

A TNA involves removing the entire toenail as a way of managing the ingrown nail. This option is usually selected by those who are also unhappy with their toenail. This may be from the nail sustaining damage or becoming deformed, infected, thickened, or if the nail itself is also causing discomfort alongside the ingrown portion of the nail. Once the nail is removed, a new nail will grow and replace it unless you opt for a chemical matrixectomy to prevent regrowth. 

Benefits Of Toenail Surgery

• The procedure is done in one appointment in our clinic - not hospitals or day stays
• It is performed quickly over a one hour appointment, with the nail surgery procedure typically taking around 20 minutes
• The procedure is pain-free under local anaesthetic
• You do not need to take any additional time off work or school following the procedure and can go home immediately
• You do not need any special boots or braces while the toe heals
• We dress your toe, provide you with a take-home dressing pack and re-dressing instructions
• Your procedure is completed by experienced podiatrists who monitor your progress to ensure it is healing well with redressing appointments

How To Decide If Surgery Is Right For You

The best way to decide if ingrown toenail surgery is the right option for you is to book in for an appointment with our podiatrists. We’ll assess your toe, review your history, and discuss both your surgical and non-surgical treatment options so that you have all the information you need to make an informed choice.

Toenail Surgery Procedure

Our nail procedures are performed in a sterile environment, and your health and safety is always put first. For the partial nail avulsion:

• We start by preparing your foot and applying iodine (a disinfecting agent) to the area
  
• We inject the toe with local anaesthetic using a thin needle, and confirm it has numbed the area
  
• We apply a tourniquet to limit any bleeding as we remove the small nail section
  
• We use surgical tools to cut down the side of the nail, and free the small section of nail containing the sharp nail spicule, performing checks to ensure that all of the nail has been removed
  
• We perform the chemical matrixectomy, applying phenol or sodium hydroxide to the base of the nail and then neutralising it
  
• Once the procedure is complete, we dress the toe using antiseptic and sterile dressings

After your procedure, we go over what you can expect at home and teach you how to care for your feet over the coming weeks as your toe heals and recovers. We will see you to redress your toe and check on its progress 2-3 days after your procedure, and again the following week. In between appointments, we will provide you with everything you need to continue to dress your toe at home.

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FAQs

Does toenail surgery carry any risk?

All surgeries that break the skin layer carry the risk of infection, and we do everything we can to minimise this risk in our clinic with our safety, sterilisation and hygiene protocols. There is also a risk that even with the chemical matrixectomy, the nail edge may still regrow.

When is toenail surgery not advised?

If you have certain medical conditions such as those that impact your circulation and impair your ability to heal wounds or fight infections, ingrown toenail surgery may not be advised. Additionally, if your ingrown toenail has a significant infection, you may need a course of antibiotics before your nail surgery. 

How long will it take to recover from ingrown toenail surgery?

Recovery times can range between two to six weeks. The recovery time is quicker with sodium hydroxide.

How much does ingrown toenail surgery cost?

Nail Surgery PNA
F546	PNA & matrix sterilisation - single edge. Incl 1 review	$315.00
F548	Each additional edge	$60.00
F985	Post Surgery Pack	$52.00
	Total	$426.25
	NAIL SURGERY PATIENT PACK
	Bag
	RIODINE POVIDONE-IODINE ANTISEPTIC SOLUTION 10% 15ML
	14 FABRIC ISLAND DRESSING 5 x 7cm Dr Remdy Healing Hydration Moisture Treatment Post Surgery Information Flyer

Nail Surgery TNA
F547	TNA and matrix sterilisation. Incl 1 review	$415.00
F548	Each additional nail	$60.00
F985	Post Surgery Pack	$51.00
	Total	$526.25

Will I be able to walk after ingrown toenail surgery?

Yes, you will be able to walk out of your appointment after the surgery. However, if the surgery is performed on your driving foot, we recommend you have someone else drive you home.

Is ingrown toenail surgery painful?

The surgery itself is painless as it is performed under local anaesthetic. You can experience pain and discomfort for a short time following the procedure, particularly after the anaesthetic wears off. In this case, you can use non-steroidal anti-inflammatory drugs to relieve the pain.

Please advise our team if you are sensitive to pain and we will arrange a topical LA prior to the surgery to numb the skin of the toe. Patients still experience discomfort from the pressure of LA but not the sharp pain from the needle. 

What if I am needle-phobic?

Don’t worry, you’re not the only one. Our team is well rehearsed in this and have strategies to help people of all ages through this process. 

How effective is ingrown toenail surgery?

Ingrown toenail surgery is very effective. In our clinic, we estimate our rate of successful treatment, which we define as the nail growth not recurring, to be 98%, which is in line with studies, with one showing a 99.7% success rate from 348 partial nail avulsions performed. Sodium hydroxide has been found to have similar results to phenol, with 100% success rates being found in a study of 156 partial nail avulsions, and may even yield faster healing rates in some cases.

Can an ingrown toenail grow back after surgery?

It is uncommon, but it does occur, and it is outside of our control. 

How long does ingrown toenail surgery last?

Ideally, forever!

Do I need to take time off work for ingrown toenail surgery?

No, you can return to work following your surgery, though if you have a job where you spend all day on your feet, we recommend booking your surgery towards the end of the workday so you can rest afterwards. You should also avoid getting the toe wet for the days following your surgery.

Can my foot get infected after toenail surgery?

Any surgical procedure that breaks the skin poses a risk of infection. We do everything we can to minimise this risk by following safety, sterilisation and hygiene protocols. We also ask that you minimise your risk of infection at home by keeping the toe dressed for the length of time that it takes the wound to heal and close and avoid getting the toe wet.

Does private health insurance cover ingrown toenail surgery

Yes, depending on your plan and level of cover, private health funds can cover or contribute to the cost of ingrown toenail surgery. To confirm your cover, please speak to your private health fund.

Does DVA & Workcover cover IGTN surgery?

Yes they do.

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