Concierge foot & ankle surgery · UK
Day-case foot surgery for painful toes, by a BOFAS-aligned surgeon.
Bunions, hallux rigidus, hammer toes, bunionette, Morton’s neuroma — the right operation for the right toe, in a proper theatre, with an ankle block, sedation, spinal or GA as it suits you.
Why patients choose us
- 01
A foot & ankle surgeon, in theatre
A named BOFAS-aligned consultant foot & ankle surgeon or Royal College of Podiatry podiatric surgeon — not a general list, not a training slot.
- 02
The right operation for the right toe
Bunion, hammer toe, bunionette, Morton’s neuroma — each has several options. We match the operation to your imaging and your foot, not to a menu.
- 03
Independent, and free
We’re paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private foot surgery for a toe problem costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A unilateral bunion in our network: £4,000–£7,000, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Bunion correction (unilateral) — scarf/Akin or MICA | £4,000–£7,000 | 60–90 min | Same visit |
| Bilateral bunion correction | £7,000–£11,000 | 90–120 min | Same visit |
| Hallux rigidus — cheilectomy | £3,500–£5,500 | 45–60 min | Same visit |
| Hallux rigidus — 1st MTP fusion | £5,500–£8,500 | 60–90 min | Same visit |
| Hammer / claw / mallet toe (per toe) | £2,000–£4,000 | 30–45 min | Same visit |
| Bunionette (Tailor’s bunion) osteotomy | £3,500–£5,500 | 45–60 min | Same visit |
| Morton’s neuroma excision | £3,000–£5,000 | 45 min | Same visit |
| Ingrown toenail — partial avulsion + phenolisation | £450–£900 | 30 min LA | Same visit |
| Consultation only | £200–£400 | 30 min | Same visit |
Prices vary by clinic, by which surgeon does the case, by the anaesthetic chosen, and by whether extra work (a Weil osteotomy, a second toe, hardware upgrade) is added on the day. We come back with a firm quote within one working day.
The problem
The right surgeon, the right technique, the right toe.
Forefoot surgery is a menu of very different operations sold under one word — “bunion surgery”, “hammer toe”. Picking the wrong one is how patients end up disappointed. We match the operation to your imaging and your foot.
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Not sure it’s needed?
Wider shoes, orthotics, an injection or a toe strap sometimes get you where you need to be. We say so before recommending surgery.
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Worried about recovery?
Flat post-op shoe or boot, driving windows, time off work — we set expectations honestly before you book.
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Want it done properly?
A BOFAS-aligned foot & ankle surgeon or a Royal College of Podiatry podiatric surgeon, weight-bearing X-rays reviewed, MICA where it fits.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to review — including the wound check, the six-week X-ray and the three-month follow-up.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what’s going on
A short, confidential form. Which toe, how long, whether shoes hurt, and any prior injections or orthotics.
- 02
Before
We come back with a recommendation
Within one working day: the right operation (or conservative alternative), the right anaesthetic, and an indicative price. We say if surgery isn’t the right step.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Weight-bearing X-rays reviewed, blood-thinners planned with the team, and pre-op instructions confirmed.
- 04
On the day
Arrival at the clinic
Consent, marking the toe, and a chat with the surgeon and anaesthetist. Ankle block ± sedation, or spinal/GA for larger reconstructions.
- 05
On the day
The procedure itself
30 minutes to two hours in a proper theatre, depending on the operation. Osteotomies fixed with screws or wires, dissolvable sutures where possible.
- 06
On the day
Home the same day
Day-case standard. Flat post-op shoe or heel-relief shoe, crutches if needed, written aftercare, and a lift home arranged if you’ve had sedation or GA.
- 07
After
Recovery and review
Swelling for six to twelve weeks, back to normal shoes at six to twelve. A wound check at two weeks, X-ray review at six, and a final review at three months.
Typical end-to-end: 2–3 weeks from enquiry to procedure. Full healing: 3–6 months.
When it helps
The toe problems that respond to surgery.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Bunion (hallux valgus)
A painful, deviating big toe with a prominent bump — shoes rub, the joint hurts, conservative measures aren’t working.
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Hallux rigidus (stiff big toe)
Arthritis of the 1st MTP joint — pain on push-off, loss of dorsiflexion, dorsal osteophyte you can feel.
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Hammer, claw or mallet toe
A lesser toe fixed in a bent position, with painful corns on the knuckle or tip that don’t settle in wider shoes.
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Overlapping or underlapping 5th toe
A little toe that lies over or under its neighbour — painful in shoes, sometimes a lifelong deformity in adults.
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Bunionette (Tailor’s bunion)
A painful bump on the outer edge of the foot at the base of the little toe — the mirror image of a bunion.
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Morton’s neuroma
Burning pain and numbness in the ball of the foot, worse in tight shoes — considered when injections and orthotics have failed.
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Freiberg’s / sesamoid pain
Persistent pain under a metatarsal head (Freiberg’s infraction) or under the big toe (sesamoiditis / fracture) that hasn’t settled.
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Red flag: infected toe, spreading
A hot, spreading red toe with fever — particularly in diabetes — is not a clinic booking. Same-day GP or A&E.
Procedure options
One toe problem, several operations.
What each option on the table actually involves — and which fits which problem.
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Bunion — scarf/Akin osteotomy
The workhorse for moderate hallux valgus. Cuts and shifts the 1st metatarsal (scarf) with a small wedge in the toe (Akin), fixed with screws.
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Bunion — MICA (minimally invasive)
Percutaneous Chevron-Akin through tiny stab incisions with a burr. Increasing UK adoption; less soft-tissue trauma, similar correction to open surgery in the right foot.
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Bunion — Lapidus (1st TMT fusion)
Fusion of the 1st tarsometatarsal joint for severe deformity or a hypermobile 1st ray. Longer recovery but powerful, durable correction.
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Hallux rigidus — cheilectomy
Removes the dorsal bone spur to restore dorsiflexion in Mann grade 1–2 arthritis. Preserves the joint; quicker recovery than fusion.
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Hallux rigidus — 1st MTP fusion
The gold-standard for grade 3–4 arthritis. Eliminates pain reliably; you lose big-toe bend but keep push-off and can walk, hike and cycle.
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Hammer toe — PIPJ arthroplasty/fusion
Straightens a fixed lesser-toe deformity with a K-wire or intramedullary implant (SmartToe, Nextra, TenFuse). Often combined with a Weil osteotomy or flexor-to-extensor transfer.
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Bunionette / 5th toe correction
Chevron or scarf osteotomy of the 5th metatarsal for a painful Tailor’s bunion, or Butler/Wilson correction for an overlapping little toe.
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Morton’s neuroma, sesamoid, Freiberg’s
Neurectomy for a failed-injection neuroma, partial sesamoidectomy for a chronic sesamoid problem, and debridement or dorsal wedge osteotomy for Freiberg’s.
Our vetted UK network
A small panel of foot & ankle surgeons, we picked them.
BOFAS-aligned consultant foot & ankle surgeons and Royal College of Podiatry podiatric surgeons across London and the major UK cities. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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BOFAS-aligned consultant foot & ankle surgeons, or Royal College of Podiatry podiatric surgeons
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MICA (minimally invasive) available as an option where it fits the foot
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Weight-bearing X-rays reviewed before recommending an operation
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Honest about recurrence, hardware issues and Cartiva implant caveats (NICE IPG738, MHRA post-market signal)
Safety and recovery
What to expect afterwards — honestly.
Forefoot surgery is common and safe as day-case work, but every operation has specific trade-offs — recurrence, hardware, transfer metatarsalgia, driving windows. Here they are, without the sales gloss.
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Recurrence is real, especially bunions
Bunion recurrence sits around 15–25% at ten years across all techniques. The bigger the pre-op deformity, the higher the risk.
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Non-union of an osteotomy or fusion
About 2–5% of osteotomies or fusions fail to unite and may need further surgery. Smoking and poorly controlled diabetes push the number up.
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Hardware pain and hardware removal
5–15% of patients want screws or wires removed later — usually a short day-case a year after healing.
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Transfer metatarsalgia
Over-shortening or over-elevating the 1st ray shifts load onto the 2nd and 3rd metatarsals. Careful planning and good technique keep this uncommon.
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Weil osteotomy: AVN and floating toe
Rare avascular necrosis of the metatarsal head and a “floating” toe (loss of ground contact) are the specific risks patients are counselled about.
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Sensory nerve injury
The dorsal digital nerves sit close to bunion and hammer-toe incisions — a small area of numbness on top of the toe can persist.
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Recovery in a flat / heel-relief shoe
Osteotomies: a flat post-op shoe for four to six weeks. Larger reconstructions: a boot. Normal shoes at six to twelve weeks; swelling for three months.
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Driving
Left-foot surgery in an automatic: usually a week. Right-foot surgery: four to six weeks, once you can perform an emergency stop safely.
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Cartiva synthetic implant — caution
NICE IPG738 accepted use with special arrangements; MHRA post-market data shows a signal for early failure. We flag it before you choose it over fusion.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used — scarf/Akin, MICA, Lapidus, cheilectomy, fusion, hammer toe correction — the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you’d like us to talk you through the note before your review, just ask.
- 01 Header
Diagnosis, side and procedure chosen
Which toe, which condition (with angle measurements for bunions), and the specific operation performed — for example “left scarf-Akin” or “right 1st MTP fusion”.
- 02 Technique
Anaesthetic, technique and fixation
Ankle block, sedation, spinal or GA; open vs MICA; and what fixation was used (screws, K-wires, intramedullary implants) so any onward team knows what’s inside.
- 03 Findings
Joint findings and anything unexpected
Cartilage state at the 1st MTP, plantar-plate tears at the lesser toes, incidental Freiberg’s or bursal changes — what was seen and what was done about it.
- 04 Impression
Weight-bearing, shoes, driving, review
Read this first: when to weight-bear, which shoe, when to drive, when to return to sport, and when the follow-up X-ray is booked.
Recognised by major UK insurers
Cover for forefoot surgery varies by insurer, by the specific operation and by whether it’s deemed medically indicated versus cosmetic. We confirm cover in writing before booking.
Frequently asked
Everything we get asked about foot surgery for toe problems.
Quick answers on which operation, what MICA is, recovery, driving and cost.
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Bunion surgery — scarf/Akin, MICA or Lapidus? Which is right?
It depends on the deformity on weight-bearing X-ray (the IMA and HVA angles) and whether the 1st ray is hypermobile. Mild-to-moderate bunions do well with a scarf/Akin or a MICA (minimally invasive Chevron-Akin). Severe deformities or a hypermobile 1st TMT joint are better served by a Lapidus fusion. A good foot & ankle surgeon shows you your X-rays and explains why one fits your foot.
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Is MICA (minimally invasive bunion surgery) actually better?
It’s not universally better — it’s a genuine alternative with less soft-tissue trauma and similar correction in the right foot. UK adoption is increasing. The learning curve is real, so choose a surgeon who does a high volume of MICA and is honest about which bunions they still prefer to open.
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Cheilectomy or fusion for hallux rigidus?
Cheilectomy (removing the dorsal spur) works well for Mann grade 1–2 arthritis where most of the cartilage is preserved. Once the joint is grade 3–4, a 1st MTP fusion is the reliable operation — it eliminates pain and lets you walk, hike and cycle. You lose big-toe bend, so it’s a trade-off worth understanding.
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What about a Cartiva synthetic cartilage implant?
Cartiva is an option for hallux rigidus, and NICE (IPG738) allows it under special arrangements. But MHRA post-market data has flagged early failures, and revision to fusion is more complex than a primary fusion. We mention it, but we’re cautious — and we make sure you understand the alternatives.
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What does hammer toe surgery involve?
The bent joint (usually the PIP) is straightened by resecting a small piece of bone and holding it with either a K-wire that comes out at six weeks or an intramedullary implant (SmartToe, Nextra, TenFuse) that stays in. If the toe is stiff at the base, a Weil osteotomy of the metatarsal or a flexor-to-extensor tendon transfer is added.
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How much does bunion surgery cost privately in the UK?
Roughly £4,000–£7,000 unilateral and £7,000–£11,000 bilateral in London and the major private centres, all-in (surgeon, anaesthetist, theatre, implants, night if needed). Hammer toe surgery is £2,000–£4,000 per toe. We come back with a firm figure across two or three options within one working day.
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How long is recovery and when can I drive?
Osteotomies: a flat post-op shoe for four to six weeks, normal trainers at six to twelve, and swelling for three months. Larger reconstructions (Lapidus, multi-toe): a boot for six weeks and normal shoes at three months. Driving: about a week for left-foot surgery in an automatic; four to six weeks for right-foot surgery.
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When should I see a GP or A&E urgently?
A hot, spreading red toe with fever — particularly if you have diabetes — is not a clinic booking; that’s same-day GP or A&E. New severe pain, sudden inability to weight-bear, or signs of infection after surgery (fever, spreading redness, pus, wound breakdown) all warrant urgent contact with the clinic or A&E the same day.
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