Concierge hand surgery · London
Private Dupuytren fasciectomy in London, the definitive open operation for cord and PIP contracture.
The lowest-recurrence Dupuytren treatment — a proper open operation by a consultant hand surgeon, with hand therapy started early and splinting for weeks afterwards.
Why patients choose us
- 01
BSSH-accredited hand surgeons
Every operation is performed by a consultant hand surgeon on the British Society for Surgery of the Hand register — not a generalist with an occasional list.
- 02
Hand therapy from day one
Splinting, scar work and range-of-motion drills begin within days, not weeks. The operation is only half of what makes the fingers straighten and stay straight.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private Dupuytren fasciectomy costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A limited fasciectomy for a single ray in our network: £5,000–£9,000, with hand therapy starting within a few days.
| Fasciectomy type | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Limited fasciectomy (single ray) | £5,000–£9,000 | Half-day | Same-day discharge |
| Limited fasciectomy (multiple rays) | £6,500–£12,000 | Half-day | Same-day discharge |
| Dermofasciectomy + full-thickness skin graft | £7,500–£14,000 | Half-day | 1–2 nights |
| Recurrent-Dupuytren fasciectomy | £8,000–£15,000 | Half-day | Same-day discharge |
| Combined bilateral fasciectomy | £11,000–£22,000 | Full-day | 1 night |
| Consultation only | £200–£400 | 30 min | Same visit |
Prices vary by clinic, by the consultant hand surgeon, by the anaesthetic used, and by whether a skin graft is needed. Recurrent and bilateral surgery cost more because the operating time is longer. We come back with a firm quote within one working day.
The problem
When needle and collagenase run out, fasciectomy is the operation that lasts.
Needle fasciotomy and collagenase are quick, but the cord tends to come back — particularly for PIP-joint contracture and aggressive disease. Open fasciectomy physically removes the cord and gives the most durable correction.
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Frightened of an open operation?
It is a day case in most patients — general anaesthetic or regional block, home the same day, hand therapy within days.
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Worried about recurrence?
Recurrence is real but much lower than after needle or collagenase — dermofasciectomy is the lowest-recurrence option of all.
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Sceptical of a quick fix?
You are right to be. Fasciectomy is not a quick fix — it is a proper operation followed by weeks of hand therapy and splinting. That is what makes it stick.
The journey
From enquiry to hand-therapy plan - what happens, in order.
One consultant hand surgeon from first message to review — with the hand-therapy team alongside.
Phase 1 · Before your operation
Concierge, off-stage for you
Phase 2 · On the day
Half-day at the hospital
Phase 3 · After
Hand therapy + review
- 01
Before
You tell us how the hand behaves
A short, confidential form. Which fingers, how long, what you can and can’t do — tabletop test, buttons, gripping a steering wheel.
- 02
Before
We come back with a recommendation
Within one working day: which fasciectomy, which consultant hand surgeon, indicative price. If needle fasciotomy or collagenase would suit you better, we say so.
- 03
Before
We arrange the operation
Usually within two to three weeks. Pre-op assessment, anaesthetic plan, and the hand-therapy pathway are all booked before the day.
- 04
On the day
Admission and anaesthetic
Same-day admission. General anaesthetic or regional block, with a tourniquet applied to keep the surgical field bloodless.
- 05
On the day
The fasciectomy itself
60–120 minutes. The diseased cord is dissected out under loupe magnification, digital nerves and arteries protected, and the wound closed — with a skin graft if the skin is involved.
- 06
On the day
Recovery and discharge
Most people go home the same day in a bulky bandage. Dermofasciectomy with a skin graft may need one to two nights for graft observation.
- 07
After
Hand therapy, and review
Hand therapy starts within a few days — splint, scar massage, active range of motion. Consultant review at two weeks and six weeks, with a longer-term recurrence check.
Typical end-to-end: 2–3 weeks to operation, then 6–12 weeks of hand therapy before full grip returns.
When it helps
When a Dupuytren fasciectomy is the right next step.
Not every cord needs open surgery. These are the situations where fasciectomy, alongside hand therapy, tends to earn its keep.
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PIP contracture > 30°
Fixed bend at the middle finger joint — the classic threshold where open surgery outperforms needle or collagenase.
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Advanced MCP + PIP contracture
Combined knuckle and middle-joint contracture where full correction needs the cord physically removed.
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Recurrence after PNF / collagenase
Cord has re-formed after a less invasive treatment and the finger is bending again.
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Skin involvement (dermofasciectomy candidate)
Diseased skin adherent to the cord — the skin comes out with the disease and is replaced with a full-thickness graft.
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Multiple rays affected
Two or more fingers involved, where a single operation can address the whole hand.
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Aggressive Dupuytren’s diathesis
Early-onset, bilateral, family history, Ledderhose or Peyronie’s — the phenotype that recurs, where a definitive operation buys more time.
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Post-PNF short-lived correction
Needle fasciotomy released the cord but it came back quickly — fasciectomy is the next logical step.
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Red flag: post-op ischaemic finger
A cold, dusky, pulseless finger after surgery is an emergency — same-day return to theatre.
Fasciectomy types
Not all fasciectomies are the same.
What each option on your consent form is actually for.
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Limited fasciectomy single ray
The diseased cord in one finger is dissected out, with digital nerves and arteries carefully preserved.
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Limited fasciectomy multiple rays
Two or more rays addressed in a single anaesthetic — longer operation, one recovery.
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Dermofasciectomy + graft
The involved skin is excised with the cord and replaced with a full-thickness skin graft — the lowest-recurrence option.
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Recurrent fasciectomy
Redo surgery after previous fasciectomy, PNF or collagenase — technically demanding, longer operating time.
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Bilateral fasciectomy
Both hands operated on together in selected cases, with a coordinated therapy plan.
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Segmental aponeurotomy (specialist)
Selective removal of short cord segments — reserved for specific patterns and specialist judgment.
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Post-op review only
Consultant review of a fasciectomy performed elsewhere, with a therapy plan alongside.
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Consultation
Clinic assessment with a consultant hand surgeon to confirm whether fasciectomy is the right operation.
Our vetted London network
A small panel of hand surgeons, we picked them.
Consultant hand surgeons across central, north, west and south London, working with dedicated hand-therapy teams. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every hand surgeon in our network.
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BSSH-accredited consultant hand surgeons performing the operation
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In-house hand-therapy team, working alongside the surgeon
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Escalation to plastic surgery available for skin grafting
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Dedicated post-op rehab pathway — splinting, scar work, range-of-motion drills
Safety and eligibility
A proper operation, with honest odds.
Fasciectomy is a well-established operation with a good safety profile in experienced hands. The things worth planning are the anaesthetic, the hand-therapy pathway, and the honest conversation about recurrence.
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Anaesthetic
General anaesthetic or regional block (brachial plexus or axillary), chosen with the anaesthetist on the day.
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Usually day-case
Most people go home the same day. Dermofasciectomy with a skin graft may need one to two nights for graft observation.
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Nerve or artery injury
Digital nerve and artery injury is real but small in experienced hands — loupe magnification and careful dissection reduce the risk.
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Complex regional pain syndrome
CRPS is an uncommon but recognised complication — early hand therapy and mobilisation are the best preventive step.
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Skin necrosis at the incision
Wound-edge necrosis can occur, particularly in dermofasciectomy — usually managed with dressings, occasionally revision.
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Hand therapy is essential
Splinting, scar massage and active range-of-motion drills within days of surgery — the outcome depends on it as much as on the operation.
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Splinting for weeks
A night splint is usually worn for at least three months to hold the correction while scar tissue matures.
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Driving
Typically 2–4 weeks after surgery, once you can grip the wheel safely and perform an emergency stop.
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Recurrence
Recurrence is lower than after needle fasciotomy or collagenase — but Dupuytren’s is a biological process and can return over years.
Reading your report
An operative note is short. Read the last part first.
Whichever fasciectomy was performed, the report keeps to the same four parts.
A quiet reminder
The operation is only half of it — the hand therapy is what makes the fingers straighten and stay straight.
If you would like us to talk you through it before your hand therapy starts, just ask.
- 01 Header
Contracture severity and diathesis features
The MCP and PIP contracture angles, the rays involved, and any features of aggressive Dupuytren’s diathesis (early onset, bilateral, family history, Ledderhose).
- 02 Technique
Rays and fasciectomy type
Which rays were operated on, the type of fasciectomy (limited, dermofasciectomy, segmental), skin graft if used, and tourniquet time.
- 03 Findings
Correction achieved intra-op
The correction achieved on the table — full or partial extension, any residual PIP contracture, and any intra-operative complications.
- 04 Impression
Rehab plan, splinting, recurrence risk
Read this first. The hand-therapy plan, splinting regime, expected recovery milestones, and the honest conversation about recurrence risk.
Recognised by major UK insurers
Most policies cover Dupuytren fasciectomy when clinically indicated; we confirm cover and pre-authorisation before booking.
Frequently asked
Everything we get asked about Dupuytren fasciectomy.
Quick answers on recovery, driving, scarring, recurrence and cost.
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What does a Dupuytren fasciectomy involve?
A fasciectomy is an open operation in which the diseased Dupuytren’s cord is physically dissected out of the palm and fingers, with the digital nerves and arteries carefully preserved. It is done under general anaesthetic or a regional block, usually as a day case, and is followed by weeks of hand therapy and splinting.
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Fasciectomy vs needle fasciotomy — what is the difference?
Needle fasciotomy (PNF) uses a needle to cut the cord through the skin — quick, minimally invasive, but with a higher recurrence rate. Fasciectomy removes the cord through an open incision — a bigger operation, longer recovery, but a much lower recurrence rate and better for advanced or PIP-joint contractures.
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Fasciectomy vs collagenase — which is better?
Collagenase injection dissolves the cord chemically and is useful for straightforward MCP-joint cords in early disease. For PIP contracture greater than 30°, multiple rays, recurrence, or skin involvement, open fasciectomy gives the most durable correction.
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How long is the recovery after Dupuytren fasciectomy?
The bandage comes off within a week, hand therapy starts almost immediately, and most people are back to desk work in 2–3 weeks. Full grip strength and comfortable heavy manual work take 6–12 weeks. Night splinting continues for around three months.
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When can I drive after a fasciectomy?
Typically 2–4 weeks after surgery, once the wound is settled and you can grip the wheel and perform an emergency stop comfortably. Your surgeon and insurer will confirm — driving before you are fit to control the car invalidates cover.
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Will I have a scar? What about the skin graft?
Yes — the incisions are zig-zag or Bruner-type across the palm and fingers to avoid straight-line scars that could contract. If a dermofasciectomy is performed, a full-thickness skin graft (usually from the inner arm or groin crease) is used to replace the diseased skin, and the graft site heals as a thin linear scar.
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What is the recurrence rate after fasciectomy?
Recurrence depends on the type of operation, the disease pattern and the patient’s diathesis. Limited fasciectomy has a recurrence rate typically quoted in the 20–40% range over several years; dermofasciectomy is the lowest-recurrence option, often below 10% in the operated finger.
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How important is hand therapy afterwards?
Essential. Splinting, scar massage and active range-of-motion drills within days of surgery are what convert a good operation into a straight, functional finger. Skipping the therapy is the single fastest route to a poor outcome.
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How much does a private Dupuytren fasciectomy cost in London?
A limited fasciectomy for a single ray is typically £5,000–£9,000. Multiple rays £6,500–£12,000, dermofasciectomy with skin graft £7,500–£14,000, recurrent surgery £8,000–£15,000, bilateral £11,000–£22,000. We confirm a firm figure within one working day.
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When should I see a hand surgeon urgently?
A cold, dusky or pulseless finger after surgery, a rapidly enlarging wound infection, or sudden loss of sensation in a finger are all reasons to contact the surgical team the same day. In pre-operative disease, urgency is rare — but rapidly progressing contracture is worth an early opinion.
Related
Looking for something else?
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Dupuytren’s contracture
The underlying condition — how the cord forms and when to treat it.
Learn more -
Needle fasciotomy
The minimally invasive alternative — quick, but higher recurrence.
Learn more -
Collagenase injection
Chemical dissolution of the cord for selected patterns.
Learn more -
All tests
Browse the full menu of tests and procedures we arrange.
Learn more