• Dr. Jennifer Nicole Falk

What to Expect from Ingrown Toenail Surgery


The exact cause of developing an ingrown toenail is still unknown. In my experience, though, it often seems related to trauma, improper trimming of the nail, and tight shoe gear. When an ingrown toenail develops, it can sometimes be managed conservatively, but often it requires surgical removal of part, or all, of the nail.


REMOVAL TREATMENT OPTIONS

When it comes to removing an ingrown toenail, there is not just one surgical treatment option. Below is a list of the different procedures for the removal of an ingrown toenail.


1. Slant Back Procedure


This procedure involves removing the distal wedge of the ingrown nail, the part that is digging into the skin and causing pain. The removal usually does not involve the use of anesthesia but is also often only a temporary solution. As the nail grows out, it will grow in the same direction, so there is likelihood that recurrence of the ingrown toenail will occur.


2. Partial Nail Avulsion

A nail avulsion procedure requires numbing the toe first. Then, using sterile instrumentation, the involved portion of the nail is freed from its surrounding soft tissue structures and then cut and removed. The toe is cleaned and covered with topical medication and dry dressings.


Aftercare instructions are given for at-home care. Usually, you can return to work the next day, and activities can be resumed when you feel comfortable, which may depend on the shoe gear worn. Any associated pain and/or drainage usually resolves within 3-5 days after the procedure. The nail will grow back out again so there is a chance of recurrence of the ingrown toenail.


3. Total Nail Avulsion


The total nail avulsion procedure is similar to the partial nail avulsion procedure, except the entire toenail is removed. Indications for having the entire nail removed may include a severe ingrown toenail with both sides of the nail involved, a fungal toenail with significant deformity, and a loosened toenail.

Aftercare for a total nail avulsion is the same as the partial nail avulsion procedure.


4. Nail Matrixectomy

A matrixectomy procedure involves using a chemical to burn the root of the nail, which prevents it from growing back out again. There is still a small chance of the nail growing back out, or having a nail spicule develop, but the success rate of the procedure is about 85%. A matrixectomy procedure is more often performed with a partial nail avulsion procedure. Because a matrixectomy procedure is considered permanent, it is usually saved for recurring ingrown toenails. It should not be performed in the presence of an infection.


Aftercare for a matrixectomy procedure is similar to a regular nail avulsion procedure; however, the recovery period is longer. Because of the chemical burn, the surrounding skin can become more irritated, causing mild, localized redness and swelling to the toe, which may last up to two weeks after the procedure.


DISCLAIMER: The above information is meant for educational purposes only and should not be construed as medical advice. Please consult the doctor, or your own healthcare professional, should you have questions or concerns related to your health.


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