Nail Surgery: Procedures, Recovery, and Risks
Dr. Janani Sree C M
July 11, 2025
Dealing with stubborn nail problems, chronic ingrown nails, recurring infections, or uncomfortable deformities can be frustrating and impact daily activities. When home care and common treatments fail to ease the pain, living with these issues can feel never-ending. We understand how discouraging it can be to struggle with persistent nail issues that affect your comfort and confidence, especially when quick fixes don't help.
For many, nail surgery becomes a safe, medically recommended step to address the underlying cause and bring lasting relief. It's not just about appearance; it's a precise, minor procedure performed under local anaesthesia to restore comfort and function.
This overview explains when nail surgery is considered, what to expect during the procedure, and how recovery works. Understanding each step can help anyone struggling with persistent nail conditions make informed choices and look forward to healthier, pain-free nails.
Nail surgery is a precise, medically recommended procedure that directly addresses persistent nail issues, providing a more permanent solution than topical treatments, which often only offer temporary relief.
Once the underlying condition is evaluated correctly, the procedure may include techniques such as partial or complete nail removal, taking a small tissue sample (biopsy) to diagnose unusual lesions, or surgically altering the nail's structure to restore normal growth and comfort. By addressing the root cause, nail surgery provides a lasting solution for chronic or complex nail disorders.
Chennai residents often seek nail surgery after experiencing recurring problems despite their consistent efforts at self-care. The procedure addresses structural issues that conservative treatments cannot resolve, providing definitive solutions for chronic conditions.
Several nail conditions warrant surgical intervention when conservative treatments prove insufficient. The following conditions commonly require nail surgery for effective resolution:
At Velantis Dermatology in Chennai, we follow proven methods and maintain a clean, safe environment to make sure you get the best possible results.
Nail surgery involves carefully removing affected nail tissue and treating the nail matrix based on the specific condition to resolve issues while reducing risks effectively.
The choice of procedure depends on factors like nail thickness, infection severity, previous treatment failures, and patient-specific considerations. Complications can be minimised by implementing preventive measures, such as careful patient selection, sterile technique, and gentle treatment of the nail matrix.
Partial nail avulsion carefully removes the problematic nail strip while preserving healthy tissue, followed by treatment of the nail matrix with chemicals such as phenol or cautery to prevent regrowth. This approach offers high success rates and long-term relief with minimal recovery time.
Bilateral partial nail avulsion removes narrow wedge-shaped sections from both sides of the nail for double-sided ingrown toenails. It preserves the healthy central part and maintains a natural appearance, while treating both nail matrices to prevent regrowth and provide long-term relief without the need for multiple surgeries.
Total nail avulsion involves complete removal of the entire nail plate in cases of severe infection, deformity, or damage, exposing the nail bed for comprehensive treatment and cleaning, combined with matrix treatment using chemical or surgical methods to prevent regrowth.
Studies show that total nail avulsion with matrix management can be safely performed in a standard dermatology clinic with minimal specialised equipment, ensuring this comprehensive treatment remains accessible and practical for patients who need complete resolution of stubborn nail conditions.
Chemical matricectomy involves using an 88% phenol solution or electrocautery to permanently destroy nail matrix cells in targeted areas, effectively preventing nail regrowth.
Dermatologists apply this chemical treatment after partial or total nail surgery to ensure definitive results. Clinical studies demonstrate that phenol cauterisation offers excellent outcomes with minimal recurrence rates when performed correctly.
Diagnostic nail surgery involves collecting small tissue samples from the nail bed or matrix under local anaesthesia. This procedure diagnoses suspicious nail lesions, including melanoma, psoriasis, tumours, and other nail diseases.
The biopsy may require partial nail removal for proper access to underlying tissues. Medical literature emphasises that nail organ avulsion is essential for identifying malignant diseases, drug side effects, and bacterial infections beyond common onychomycosis.
Zadek's procedure represents the most comprehensive approach to nail surgery, involving the complete removal of the nail with total matrix excision. This aggressive treatment addresses severe recurrent cases or situations where multiple previous therapies have failed.
Complete matrix removal ensures permanent resolution of chronic nail problems.
The minor nail procedures usually consist of:
Before nail surgery, a few critical preparations ensure a safe and smooth experience. These steps align with Velantis Dermatology's commitment to evidence-based, doctor-led care, ensuring predictable outcomes rather than quick fixes.
Quitting smoking is essential as it delays wound healing and increases complications; additionally, optimising diabetes control and blood thinner levels promotes faster healing and smoother recovery.
During the consultation, your dermatologist will explain the exact method—partial nail avulsion, total removal, or chemical matrixectomy—and set realistic expectations. A digital nerve block is standard for nail surgery, providing effective numbing with minimal trauma. Controlling bleeding effectively during surgery helps prevent complications and promotes a cleaner, faster healing process.
Choose open-toed or loose shoes to protect the surgical site and avoid tight footwear. Arrange for someone to drive you home, as driving right after isn't recommended. Rest at home, keep the foot elevated, and leave the initial dressing intact.
Begin by addressing nail issues with conservative methods such as proper trimming, topical antifungal treatments, or oral medications. Surgical treatment is recommended if these symptoms do not resolve or persistently cause pain, infection, or nail deformity. Nail surgery involves a careful process: confirming the diagnosis, selecting the most appropriate surgical approach, and performing the procedure in a sterile environment to minimise risks and promote proper healing.
The pre-operative phase consists of :
This part of the procedure involves :
Local Anaesthetic Administration: Before a nail surgery begins, a local anaesthetic is used to numb only the surgical site while the patient remains fully awake. Regional anaesthesia involves carefully injecting a numbing medicine, usually lidocaine, near the base of the affected toe or finger. This digital block prevents pain signals, ensuring a painless procedure. Typically, numbness develops within 5–10 minutes and lasts 2–3 hours after surgery, covering the entire treatment comfortably in about 95% of cases.
This phase involves meticulous surgical steps, including maintaining a sterile environment, carefully removing the affected nail portions, and treating the nail matrix to prevent regrowth.
Nail Matrix Treatment: Applying phenol for 30-60 seconds chemically destroys the nail matrix cells responsible for nail growth, effectively preventing regrowth in most cases and reducing the chances of the problem recurring.
Immediate Post-Operative Steps are as follows:
Recovery after nail surgery requires careful wound care and adherence to activity restrictions. Understanding the recovery timeline and proper protocols helps patients set realistic expectations and minimise the risks of complications, promoting optimal healing.
Following nail surgery, patients can typically walk immediately or the next day, but should limit movement and rest with foot elevation for 1-2 days. Complete healing takes 4-6 weeks, with regular dressing changes and prescribed pain management, excluding aspirin unless otherwise advised.
Keep the initial bandage in place for 24-48 hours after the procedure, ensuring it remains completely dry. After removing the bulky dressing, begin daily dressing changes using sterile bandages. Clean the wound gently with mild soap and water, pat dry, and apply fresh dressing materials as instructed. Change dressings every 2 days, keeping the wound dry on alternate days to promote healing.
Avoid getting the surgical site wet for the first 48 hours after nail surgery. Once initial dressings are removed, you can shower while protecting the wound area. Allow controlled water exposure during dressing changes, but avoid prolonged soaking until the wound has progressed significantly.
Walking is generally allowed right after the procedure, but activity should be kept minimal during the first two days to support healing. High-impact movements, such as running, gym workouts, or wearing tight footwear, should be strictly avoided for at least 1–2 weeks post-surgery. During this period, opt for open sandals or spacious shoes that place no pressure on the treated area. After 2–3 weeks, you can gradually shift to loose-fitting, closed-toe shoes, depending on your comfort and the progress of your healing.
However, in cases of total nail avulsion, longer recovery is necessary—patients may need to limit activity and avoid enclosed footwear for up to 4–6 weeks to allow the nail bed to heal fully.
Initial healing of the nail bed usually occurs within 7-10 days, with full recovery ranging from 3 to 6 months, depending on the procedure. Partial nail removal often leads to regrowth within 3-4 months, whereas complete removal can take up to a year.
Schedule your post-surgery check-up within one week to assess healing progress. Your dermatologist will examine the site for signs of infection, abnormal regrowth, or delayed healing. Contact your clinic immediately if you notice increasing pain, swelling, excessive discharge, or red streaking around the wound.
Partial nail regrowth can occur if some nail matrix tissue remains after surgery; in such cases, a repeat procedure may be required for permanent correction.
Trim nails straight across to prevent future ingrown edges. Choose properly fitted footwear that doesn't compress toes. Perform regular self-examinations for early signs of recurrence and consult your dermatologist promptly if problems arise.
When considering nail surgery, choosing the right medical provider is crucial for both safety and successful outcomes. Velantis Dermatology combines medical expertise with state-of-the-art facilities to deliver comprehensive nail surgery services that patients can trust.
All nail surgery procedures at Velantis Dermatology are performed by qualified dermatologists following strict sterile protocols. Our surgical suite maintains hospital-grade standards with proper sterilisation equipment, sterile instruments, and controlled environments to minimise infection risk. Each procedure follows established medical guidelines, comprehensive pre-operative assessment, and post-operative care instructions.
Our dermatologists have extensive experience managing complex nail conditions, including severe ingrown nails, recurrent infections, nail tumors, and chronic deformities. We assess each case carefully, considering underlying issues such as diabetes or circulation problems that might affect healing. This specialized approach enables us to handle cases needing referral to other specialists.
We use proven surgical techniques, including chemical phenolisation for permanent nail border removal and precise matrix excision procedures. Phenolisation involves applying phenol to destroy nail-producing cells, preventing regrowth of problematic nail segments. Matrix excision offers surgical removal of specific nail matrix areas when conservative treatments have failed. These techniques are chosen based on individual patient anatomy and the severity of their condition.
Our systematic approach to nail surgery consistently achieves positive outcomes with minimal complications. Success is measured by complete symptom resolution, proper healing without infection, and patient satisfaction with functional results. We keep detailed records of treatment outcomes and continuously monitor healing progress through scheduled follow-up appointments.
Modern nail surgery uses effective pain control techniques that minimise discomfort. Explaining what to expect can help reduce common fears and misunderstandings about nail surgery.
Nail surgery is performed under local anaesthesia (like lidocaine or ropivacaine), numbing the area after a brief sting so the procedure is virtually painless; patients remain awake and typically experience mild, manageable post-operative discomfort that can be controlled with over-the-counter pain relievers like paracetamol.
Monitor for these warning signs after nail surgery:
Contact your doctor immediately if you notice heat, swelling, or increasing pain, as these may indicate an infection that requires prompt antibiotic treatment. Velantis offers medically supervised post-surgical follow-up for timely evaluation and appropriate care to ensure safe recovery and early intervention if needed.
Potential risks associated with nail surgery include mild bleeding, swelling, and discomfort. Closely monitoring for infection and following sterile techniques and proper wound care significantly reduce these risks.
Specific complications may include infection, delayed healing, allergic reactions to anaesthetics, or regrowth of the nail if the matrix is incompletely treated. Rare outcomes may consist of minor scarring or nail deformities, making awareness essential for proper aftercare and timely medical consultation.
The following are a few procedure-related risks:
To minimise risks associated with nail surgery, it is essential to use evidence-based surgical techniques, including precise matrix treatment, a strict sterile protocol, and individualised risk assessments for patients with diabetes or those taking blood thinners, to reduce the risk of infection.
Understanding these potential complications and how to mitigate them is vital for anyone considering nail surgery. As we delve deeper into the topic, the next section will explore the cost considerations in Chennai, providing a comprehensive view of what to expect financially when undergoing nail surgery.
Nail surgery provides precise treatment for chronic nail problems such as ingrown toenails, with services in Chennai focusing on evidence-based care, transparency, and ethical practises.
In Chennai, nail surgery for ingrown toenails typically costs between ₹2,000 and ₹5,000, though prices can vary depending on the clinic and the complexity of the procedure. When more extensive treatment is necessary like total nail removal, costs can increase to ₹15,000-₹30,000.
Various factors influence the price, including the extent of the surgery, the type of anaesthesia used, postoperative dressings, and the level of follow-up care. Clinics with advanced medical facilities or experienced dermatologists may charge more, reflecting the quality and safety of their care.
For patients seeking trustworthy guidance and transparent, medically supervised treatment, Velantis offers evidence-based nail surgery focused on clinical accuracy and patient-centred care.
Nail surgery is usually an outpatient procedure, not covered by insurance in India, so patients typically pay out of pocket.
This financial clarity empowers Chennai residents to plan nail surgery confidently, addressing chronic pain effectively. We'll break everything down into key conclusions to guide your decision-making process.
When performed by a skilled dermatologist, nail surgery lowers the risk of complications, recurrence, or scarring and helps rebuild confidence and comfort over time. Opting for doctor-led care instead of quick fixes allows patients to manage chronic nail conditions safely and effectively, resulting in better outcomes without false promises or cosmetic hype.
Unlike over-the-counter remedies or unqualified treatments, which often fail and lead to repeated infections or nail deformities, proper nail surgery provides lasting results through structured, evidence-based care.
The key to successful nail surgery lies in choosing an experienced dermatologist who prioritises sterility and ethical practices. Patients benefit from clear explanations of the procedure, including what to expect during recovery and how to manage pain effectively. Recovery timelines vary, but with proper aftercare, most individuals resume normal activities quickly while maintaining healthy nails.
If you're facing repeated nail problems and seek safe, long-lasting solutions, schedule a consultation with Velantis today. Our dermatologists offer personalised, ethical, and evidence-based nail surgery aimed at genuine recovery, not quick fixes.
Q1. Is Nail Surgery Painful?
A1. Nail surgery is performed under local anaesthesia, which causes a quick sting but effectively numbs the area, ensuring the procedure is pain-free. Any mild discomfort afterwards is typically manageable with common pain relievers like paracetamol.
Q2. How Long Is Recovery?
A2. Most patients can walk and perform light activities the day after nail surgery, with rest and foot elevation recommended for 1-2 days; complete healing typically takes 4-6 weeks with regular dressing changes for proper recovery.
Q3. Will My Nail Grow Back?
A3. If only part of the nail is removed, the remaining nail may grow back normally, though the treated edge might not. If the nail matrix is entirely removed, the nail won't regrow. Regrowth occurs in less than 5% of cases.
Q4. Can Home Care Avoid Surgery?
A4. Mild ingrown toenails may improve with warm soaks and proper nail trimming. However, chronic or infected cases often require nail surgery for a permanent solution, as home remedies may only provide temporary relief.
Q5. How Do I Care for My Toe/Finger After Surgery?
A5. Keep the area clean and dry, following your doctor's dressing change instructions. Soak the toe in warm water and apply antibiotic ointment as advised. Avoid tight shoes to prevent irritation during healing.
Q6. Is Nail Surgery Safe for Diabetics?
A6. Nail surgery is generally safe for diabetic patients if blood sugar is well-controlled. Inform your dermatologist about your condition and medications to ensure proper care and minimise infection risks.
Q7. Is It Safe for Children or the Elderly?
A7. Nail surgery can be performed on children with parental consent and careful explanation to reduce anxiety. It's typically safe for older adults, but overall health must be assessed to avoid complications.
Q8. How Can I Prevent Future Nail Issues?
A8. Cut nails straight across, avoid trimming too short, and wear well-fitting shoes. Keep feet dry to prevent skin softening around nails. Regular podiatrist visits can help if you're prone to issues.
