Foot and ankle surgery · UK
Bunion surgery, the right osteotomy for your foot.
Chevron, SCARF, Lapidus, MICA percutaneous or 1st MTPJ fusion - chosen from your weight-bearing X-rays, joint status and hypermobility, not the surgeon's favourite technique. Done as a day case by a BOFAS foot and ankle consultant, with pedobarography and gait analysis available.
Why patients choose us
- 01
A BOFAS foot and ankle surgeon, not a general orthopod
A named consultant who does bunion correction weekly, in a unit that runs a proper foot and ankle service with pedobarography and gait analysis.
- 02
The right osteotomy for your deformity
Chevron, SCARF, Lapidus, MICA or MTPJ fusion. The choice depends on your hallux valgus angle, IMA, TMT hypermobility and joint cartilage, not on the surgeon's favourite technique.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private bunion surgery costs in the UK.
Indicative ranges across our partner units, all-inclusive of surgeon, anaesthetist, hospital and standard follow-up. Send your X-rays and we quote firm figures across two or three options.
In short
A single-foot bunion correction in our network: £6,500–£11,000, home the same day.
| Procedure | Indicative range | Typical duration | Discharge |
|---|---|---|---|
| Single-foot open osteotomy (Chevron, SCARF-Akin) | £6,500–£9,500 | 60–90 min | Same-day discharge |
| Bilateral open osteotomy (both feet, staged or same sitting) | £9,500–£14,000 | 90–150 min | Same-day discharge |
| MICA percutaneous (minimally invasive Chevron-Akin) | £7,500–£11,000 | 45–75 min | Same-day discharge |
| Lapidus fusion (1st TMT, for hypermobility or severe deformity) | £8,500–£12,500 | 75–120 min | Same-day discharge |
| 1st MTPJ fusion or replacement (concomitant hallux rigidus) | £8,500–£12,500 | 75–120 min | Same-day discharge |
| Second-opinion review of prior notes and X-rays | £250–£450 | 30 min | 48 hours |
Prices vary by hospital, by consultant, by whether MICA or open technique is chosen, and by whether lesser-toe or 1st MTPJ work is done at the same time. We confirm a firm quote within one working day.
The journey
From enquiry to walking in normal shoes.
One team from first message through consultation, surgery, physiotherapy and the six-week X-ray.
- 01
Before
You send us your foot photos and weight-bearing X-rays
A short, confidential form. Standing photos of both feet, any weight-bearing AP, lateral and oblique X-rays you already have, and a note on the shoes and activities that hurt.
- 02
Before
We come back with a recommendation
Within one working day: whether an osteotomy fits, or whether a Lapidus fusion or 1st MTPJ procedure is the better call. Indicative price for two or three options.
- 03
Before
Consultation, imaging and planning
Weight-bearing AP, lateral and oblique X-rays. HVA, IMA, DMAA and sesamoid position are measured. Pedobarography and gait analysis where useful. MRI if osteochondral defect is suspected.
- 04
On the day
Arrival at the hospital
Arrival, consent and a chat with the surgeon and anaesthetist. General anaesthetic with an ankle or popliteal regional block for post-op comfort.
- 05
On the day
The surgery itself
60 to 90 minutes as a day case. Open SCARF-Akin, distal Chevron-Akin, MICA percutaneous or Lapidus fusion, with screw or K-wire fixation and image-intensifier confirmation.
- 06
On the day
Home the same day
A post-op shoe or CAM boot, elevation, ice, written aftercare and home within a few hours. You will need someone to collect you after the anaesthetic.
- 07
After
Recovery and physiotherapy
Weight-bearing in a stiff-soled shoe or CAM boot from day 1 for most modern osteotomies. Wound check at 2 weeks, physiotherapy from week 2, X-ray at 6 weeks, driving at 6 to 8 weeks for right-foot surgery.
Typical timeline: 2–3 weeks to surgery. CAM boot or post-op shoe: 6–8 weeks. Return to sport: 12–16 weeks.
When it helps
When bunion surgery is the right step - and when it is not.
The patterns we see most, and the ones where a simple osteotomy is the wrong answer.
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Painful medial bump in normal shoes
The prominent 1st metatarsal head rubs on shoes, forms a bursa and becomes tender - the classic reason patients come forward.
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Progressive hallux valgus with rotation
Great toe drifting laterally, often with valgus rotation of the nail plate - a family history and hypermobility of the 1st TMT joint are common.
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Overlapping second toe or lesser deformity
A hallux pushing the second toe up or under, causing hammer-toe, callosities or metatarsalgia across the lesser rays.
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Sesamoid pain and transfer metatarsalgia
Uncovering of the sesamoids on X-ray with pain under the 1st MTPJ, plus overload pain under the 2nd and 3rd metatarsal heads.
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Recurrent bunion after previous surgery
Recurrence from inadequate initial correction, uncorrected TMT hypermobility or unaddressed DMAA. Revision to Lapidus is often the answer.
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Concomitant hallux rigidus
Stiff, arthritic 1st MTPJ alongside the valgus - an osteotomy alone will fail. 1st MTPJ fusion or a well-selected replacement is the safer call.
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Pes planus and hypermobile 1st ray
A flat, pronating foot with a hypermobile first ray drives recurrence after distal osteotomy - Lapidus fusion addresses the root cause.
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Red flag: cosmetic-only request
Bunion surgery is done for pain and function, not appearance. A painless, non-progressive bunion is generally best left alone - the risks outweigh the gain.
Procedure options
Bunion surgery is a family of operations, matched to the deformity.
Classification runs mild (HVA under 20, IMA under 13), moderate (HVA 20 to 40, IMA 13 to 20) and severe (HVA over 40, IMA over 20). The right operation is the one that matches your angles, your joint and your first-ray hypermobility.
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Distal osteotomy (Chevron, Mitchell)
V-shaped cut through the 1st metatarsal head, translated laterally and fixed with a screw. Best for mild deformity: HVA under 20 degrees, IMA under 13 degrees.
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SCARF osteotomy (mid-shaft)
A Z-shaped mid-shaft cut - the workhorse. Allows large lateral translation, rotation and DMAA correction for moderate deformity: HVA 20 to 40 degrees, IMA 13 to 20 degrees.
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Proximal or basal osteotomy
Crescentic or closing-wedge cut at the base of the 1st metatarsal for severe deformity: HVA over 40 degrees, IMA over 20 degrees. Powerful correction but a longer lever means longer recovery.
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Lapidus (1st TMT fusion)
Fusion of the 1st tarsometatarsal joint. The answer for hypermobile first ray, severe deformity, arthritic TMT joint or recurrent bunion after previous osteotomy.
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MICA percutaneous
Minimally invasive Chevron-Akin through 3 to 4 mm incisions, fluoroscopic-guided burr, screw fixation. Similar outcomes to open with less soft-tissue trauma and faster recovery in the right hands.
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1st MTPJ fusion
For severe concomitant hallux rigidus. Reliable pain relief and a stable, plantigrade foot. Trade-off is loss of great-toe motion and difficulty with high heels.
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1st MTPJ replacement (Cartiva, hemi)
A joint-preserving option for hallux rigidus with mild-to-moderate valgus. Preserves motion but is less predictable than fusion and less suitable for severe deformity.
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Akin osteotomy (proximal phalanx)
A small medial closing-wedge cut in the proximal phalanx, added to a metatarsal osteotomy to correct residual hallux interphalangeus and improve alignment.
Our vetted UK network
A small panel of foot and ankle surgeons, we picked them.
BOFAS-member consultants at Fortius Clinic Foot & Ankle, London Foot & Ankle Centre, HCA The Wellington Foot & Ankle, Cromwell BUPA, London Bridge Hospital Orthopaedics and Chelsea and Westminster Private Orthopaedics. Introductions are made privately once we understand your case.
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BOFAS-member consultant foot and ankle surgeons, not general orthopaedic lists
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Units with pedobarography, gait analysis and modern image intensifiers on site
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MICA percutaneous capability available where the deformity suits it
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Anaesthetist-delivered regional blocks (ankle or popliteal) for post-op comfort
Safety and recovery
Outcomes and risks - honestly.
Patient-reported satisfaction sits around 85 to 90 percent when the operation is matched to the deformity. Recurrence is 10 to 15 percent - usually a marker of under-correction or unaddressed hypermobility, not bad luck.
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General anaesthetic with a regional block
A GA with an ankle or popliteal block is standard. The block gives 12 to 24 hours of pain relief and reduces the need for opioids at home.
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Recurrence, 10 to 15 percent
The commonest late complication. Usually related to inadequate initial correction or unaddressed hypermobility of the 1st ray - a reason to choose the right procedure, not the smallest one.
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Undercorrection or overcorrection
Undercorrection leaves symptoms; overcorrection produces hallux varus with medial drift. Both are minimised by careful pre-op planning of HVA, IMA and DMAA.
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Avascular necrosis of the metatarsal head
A rare (under 1 percent) risk after distal osteotomy, driven by soft-tissue stripping. Modern minimal-dissection techniques and MICA reduce this further.
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Transfer metatarsalgia
Pain shifting to the 2nd and 3rd metatarsal heads if the 1st ray is shortened or elevated. Addressed by correct osteotomy geometry and, if needed, a Weil osteotomy of the lesser rays.
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Hardware irritation, infection, nonunion
Screw prominence occasionally needs removal at 6 to 12 months. Deep infection is under 1 percent. Nonunion is uncommon after osteotomy, a little higher after Lapidus fusion.
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Weight-bearing in a post-op shoe or boot
For most modern osteotomies you weight-bear on the heel in a stiff-soled shoe or CAM boot from day 1. Lapidus fusion is often non-weight-bearing or heel-only for 2 to 6 weeks.
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Physiotherapy from week 2
Toe mobilisation, scar management and gait re-education from around 2 weeks reduces stiffness and speeds return to normal shoes.
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Red flags after discharge
Increasing pain out of proportion, calf swelling or tenderness, fever, a hot wound or spreading redness - call the unit or go to A&E the same day.
Non-surgical care
Activity modification, wide toe-box shoes, custom orthotics, night splints and bunion sleeves do not correct the bony deformity, but they can settle symptoms and slow progression. A sensible first step for a mild, non-progressive bunion, and a fair long-term answer for anyone not fit for or not wanting surgery.
Reading your consultation and op note
Your bunion notes in four parts. Read the last one first.
Whichever surgeon you see, the notes and op report keep to the same shape.
A quiet reminder
Angles and technique names read coldly - we translate them for you.
If you would like us to talk you through the plan before your consultation, just ask.
- 01 Assessment
Clinical exam and X-ray angles
The bump, valgus angle at the great toe, rotational deformity of the nail plate, 1st TMT hypermobility, lesser-toe status. Weight-bearing HVA, IMA, DMAA and sesamoid position.
- 02 Plan
Chosen procedure and rationale
Why this osteotomy or fusion for your deformity - mild, moderate or severe by HVA and IMA - and whether the 1st TMT joint, MTPJ arthritis or lesser rays need addressing at the same time.
- 03 Op note
What was done, and fixation used
Approach (open or MICA), osteotomy geometry, degree of translation and rotation, Akin add-on, screw or K-wire fixation, image-intensifier confirmation and any lesser-toe work.
- 04 Recovery
Weight-bearing, follow-up and physio
Read this first: what shoe or boot to wear, when to weight-bear, wound-check and X-ray dates, driving timeline, physiotherapy start and expected return to sport.
Recognised by major UK insurers
Cover for bunion surgery varies by insurer - usually funded when symptomatic. We confirm cover before booking.
Frequently asked
Everything we get asked about bunion surgery.
Quick answers on technique choice, MICA, recovery timelines and cost.
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What actually is a bunion (hallux valgus)?
A bunion is a three-part deformity: the first metatarsal drifts medially, the great toe (hallux) drifts laterally, and the prominent metatarsal head shows as a medial bump. Rotation of the hallux, a flat foot (pes planus), hypermobility of the first tarsometatarsal joint and a family history are all common contributors. It is a deformity of the whole first ray, not just the bump.
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Which bunion operation will I need?
It depends on your hallux valgus angle (HVA), intermetatarsal angle (IMA) and the state of the 1st TMT joint. Mild deformity (HVA under 20, IMA under 13) suits a distal Chevron. Moderate (HVA 20 to 40, IMA 13 to 20) is the classic ground for SCARF or MICA. Severe (HVA over 40, IMA over 20) or a hypermobile first ray needs a Lapidus fusion. Concomitant arthritis of the 1st MTPJ points to fusion or replacement rather than realignment.
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What is MICA and is it better than open surgery?
MICA is minimally invasive Chevron-Akin: 3 to 4 mm incisions, a fluoroscopic-guided burr and percutaneous screws. Published outcomes are similar to open SCARF-Akin for mild to moderate deformity, with less soft-tissue trauma, a smaller scar and often a quicker return to normal shoes. It needs specific training and equipment, and it is not the right answer for every foot.
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When can I walk, drive and get back to sport?
Most modern osteotomies allow heel weight-bearing in a stiff-soled post-op shoe or CAM boot from day 1. You will be in that shoe for 6 to 8 weeks. Driving is usually 6 to 8 weeks for right-foot surgery (sooner for left-foot with an automatic). Return to sport is 12 to 16 weeks for running and impact activity, once bone healing on X-ray is confirmed.
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How much does private bunion surgery cost in the UK?
Roughly £6,500 to £9,500 for a single-foot open osteotomy, £9,500 to £14,000 for bilateral surgery, £7,500 to £11,000 for MICA, and £8,500 to £12,500 for Lapidus fusion or 1st MTPJ fusion or replacement. All-inclusive of surgeon, anaesthetist, hospital, one-night stay if needed and standard follow-up. A firm quote comes back within one working day.
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Do insoles, splints or bunion sleeves correct the deformity?
No. Wide toe-box shoes, custom orthotics, night splints and bunion sleeves can settle symptoms and slow progression, but they cannot correct the bony deformity. They are a sensible first step for mild or non-progressive bunions - and a fair answer for anyone not fit for or not wanting surgery.
Ready when you are
Send your foot photos and X-rays. We come back within one working day.
An honest read on whether an osteotomy, MICA, Lapidus fusion or MTPJ procedure fits your foot - with two or three options and a firm price for each.
Related treatments and conditions
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Hallux valgus (condition)
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Hallux rigidus (condition)
Arthritis of the great-toe joint - assessment and treatment.
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