Concierge peripheral nerve surgery · UK
Nerve reconstruction and repair, by a peripheral-nerve microsurgeon.
Microsurgical restoration of a cut, crushed or degenerated peripheral nerve - primary repair, grafting, allograft, conduit or nerve transfer - matched to your injury, the timing, and what is realistic to get back.
Why patients choose us
- 01
A peripheral nerve microsurgeon, in a real MDT
Not a generalist. A named plastic or hand surgeon with a peripheral-nerve subspecialty, working alongside neurophysiology and hand therapy.
- 02
Timing framed honestly
For nerve injury, days and weeks matter. We move fast when it counts, and we say plainly when a window has closed.
- 03
Independent, and free
We are paid by no clinic, so the recommendation - primary repair, graft, transfer or rehab-only - is impartial and costs you nothing.
Indicative pricing
What private nerve reconstruction costs in the UK.
Indicative ranges across our partner hospitals. Send the details and we quote firm figures across the techniques that fit your injury.
In short
A primary microsurgical nerve repair in our network: £4,000–£8,000, typically day-case.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Consultation and examination | £250–£450 | 45–60 min | Same visit |
| EMG + nerve conduction studies | £450–£900 | 45 min | Report within 1 week |
| MRI neurography | £850–£1,600 | 45–60 min | Report within 3 days |
| Primary nerve repair (simple, digital) | £4,000–£8,000 | 90 min | Day-case |
| Nerve grafting (autograft or allograft) | £8,000–£15,000 | 2–4 h | Overnight stay |
| Nerve transfer (e.g. Oberlin) | £10,000–£18,000 | 3–5 h | Overnight stay |
| Brachial plexus reconstruction | £12,000–£25,000 | 4–6 h | 1–2 nights |
| RPNI / TMR for painful neuroma | £6,000–£12,000 | 2–3 h | Day-case or overnight |
Nerve reconstruction is NHS-funded through plastic and hand surgery for the vast majority of patients. Private figures vary by hospital, by the surgeon, by the technique chosen (graft, allograft or transfer) and by the length of theatre time. We come back with a firm quote within one working day.
The problem
The right surgeon, the right technique, the right window.
Nerve injury is one of the most time-critical corners of surgery - and one where getting to a peripheral-nerve subspecialist quickly changes what is possible. We shortcut the wait.
-
A fresh injury?
Days matter. Primary repair inside 72 hours, or tag-and-return within a couple of weeks - we get you in front of the right team fast.
-
A months-old injury?
Grafting, allograft or a nerve transfer are usually still on the table for the first 3–6 months. We say so plainly, either way.
-
A long-standing problem?
Late presentations can still be helped with reanimation surgery, RPNI or a free muscle transfer - we point you at the right specialist.
The journey
From enquiry to rehabilitation - what happens, in order.
One team from first message through surgery and the long rehab that follows.
Phase 1 · Before your operation
Concierge, off-stage for you
Phase 2 · Surgery day
A few hours in theatre
Phase 3 · Rehab
12–24 months
- 01
Before
You tell us what happened
A short, confidential form. The injury, when it happened, what movement and sensation you have lost, any scans or nerve studies already done.
- 02
Before
We come back with a recommendation
Within one working day: whether a nerve surgeon is the right next step, whether electrodiagnostic testing or MRI neurography is needed first, and indicative cost.
- 03
Before
We arrange the consultation
Usually within a week - sooner for acute injuries. Blood-thinning medication and pre-op workup are coordinated with the team.
- 04
Surgery day
Arrival at the hospital
Admission, consent and a chat with the surgeon and anaesthetist. General anaesthetic and tourniquet for most reconstructions.
- 05
Surgery day
The operation itself
Two to six hours under the operating microscope - primary repair, autograft (usually sural), allograft, conduit or nerve transfer, depending on the case.
- 06
Surgery day
Recovery on the ward
Day-case for simple primary repair, overnight for grafting, longer for major brachial-plexus reconstruction. Splint fitted before you leave.
- 07
After
Rehab over 12–24 months
Nerves regenerate at roughly 1mm per day. Splinting, passive then active range of motion, sensory re-education and motor retraining - the rehab is the outcome.
Typical end-to-end for acute cases: under 2 weeks from enquiry to surgery. Full rehabilitation: 12–24 months.
When it helps
When nerve reconstruction is the right step.
The situations we see most, plus the red flag that means calling A&E today rather than booking a clinic next week.
-
Acute traumatic nerve injury
A clean laceration from a blade, glass, RTA, workplace or sports injury - a complete transection needs microsurgical repair within days.
-
Iatrogenic nerve injury
A nerve damaged during a previous operation - recognised early and referred, most can still be reconstructed.
-
Severe chronic compression
Long-standing carpal or cubital tunnel with axonal loss on nerve studies - a decompression, sometimes with graft or transfer, is usually still worthwhile.
-
Adult brachial plexus injury
A high-energy stretch or avulsion from a motorbike or fall - specialist referral within three months gives the best chance of useful recovery.
-
Obstetric brachial plexus palsy
Erb’s or Klumpke’s palsy in a baby - assessed in a specialist paediatric nerve clinic; some need nerve transfer or grafting early.
-
Facial nerve palsy
Persistent weakness after Bell’s palsy, parotid surgery or trauma - nerve grafting or a masseteric/hypoglossal transfer to restore movement.
-
Painful neuroma after amputation
A tender lump at a nerve stump post-amputation - RPNI or targeted muscle reinnervation gives the nerve somewhere useful to grow into.
-
Red flag: fresh nerve injury
A cut with complete numbness or paralysis in the nerve’s territory needs referral within days, not weeks - call the clinic or A&E the same day.
Procedure options
One name - several very different operations.
What each technique actually involves, and which fits which injury.
-
Primary microsurgical repair
A clean, fresh transection sutured end-to-end under the microscope with 9-0 or 10-0 nylon. Tension-free is non-negotiable.
-
Nerve autograft (sural)
A sensory nerve from the calf harvested and used to bridge a gap of 1–10cm. The donor site leaves numbness on the outer foot - usually well tolerated.
-
Processed nerve allograft
Off-the-shelf processed cadaveric nerve (Avance) - good outcomes for gaps under 70mm, and no donor-site loss. Increasingly used in the UK.
-
Nerve conduit
A synthetic tube (NeuraGen, Neurolac) for small gaps under 20mm - the nerve regenerates through the tube.
-
Nerve transfer
A working, expendable donor nerve rewired to a paralysed target - Oberlin (ulnar-to-musculocutaneous) for elbow flexion, spinal accessory to suprascapular for shoulder.
-
Facial reanimation
Grafting or a masseteric or hypoglossal transfer to restore facial movement after prolonged palsy.
-
RPNI / TMR for neuroma
Regenerative peripheral nerve interface or targeted muscle reinnervation - the raw nerve end is implanted into muscle to prevent painful neuroma.
-
Assessment and rehab only
For some late presentations reconstruction is unlikely to help. We say so, and refer for hand therapy or free-functioning muscle transfer instead.
Our vetted UK network
A small panel of nerve microsurgeons, we picked them.
Consultant peripheral-nerve microsurgeons across the London and regional major-trauma networks. Not listed publicly - introductions are made privately, once we understand your case.
Selection criteria
How we choose every nerve surgeon in our network.
-
Consultant plastic or hand surgeons with a peripheral-nerve subspecialty
-
Access to intra-operative electrophysiology and the operating microscope
-
Hand therapy and specialist rehabilitation embedded in the pathway
-
MDT input from neurophysiology and, where needed, pain medicine
Safety and recovery
What to expect afterwards - honestly.
Nerve reconstruction is highly specialist surgery with realistic - but genuinely partial - recovery. The plan afterwards matters as much as the operation itself.
-
Timing changes everything
A clean transection repaired within 72 hours does best. A delayed injury can still be reconstructed, but grafting or a nerve transfer becomes more likely.
-
Muscle has a shelf life
A muscle left denervated for 18–24 months usually cannot be brought back - so reconstructing a nerve years after the injury may restore sensation but not power.
-
Sural nerve donor site is usually mild
Harvesting the sural nerve leaves a patch of numbness on the outer foot and lateral heel. Most patients tolerate this well and it settles into the background.
-
Cold intolerance is common
Reinnervated fingers and hands often feel exaggeratedly cold for a year or two - this usually improves but occasionally persists.
-
A painful phase during regeneration
Pins and needles, a positive Tinel sign creeping down the limb, and short-lived hypersensitivity are all part of the nerve growing back - not a failure of surgery.
-
Splint and therapy adherence is the treatment
Rehab is not optional. Splinting, passive then active range of motion, sensory re-education and motor retraining over 12–24 months is what turns the operation into a result.
-
Realistic expectations
For an optimal case, 70–90% return of protective sensation and 50–70% of motor function is a fair aim. Brachial-plexus and late-presentation cases sit below that.
-
Complications to know about
Failed reinnervation, neuroma at the repair site, chronic neuropathic pain, contracture, infection and DVT are all recognised risks and are discussed in consent.
-
Red flags after surgery
Spreading redness, fever, a calf that swells and hurts, or sudden new severe pain after surgery - call the team or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Microsurgical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Injury, timing and technique chosen
What was injured, when, and which technique was used - primary repair, autograft, allograft, conduit or transfer.
- 02 Technique
Microsurgical detail
The suture material, the fascicular pattern, graft length and donor site, and any intra-operative stimulation findings.
- 03 Findings
Nerve quality and surrounding scar
How healthy the proximal and distal nerve ends looked, any scar excised, and whether tension-free coaptation was achieved.
- 04 Impression
Rehab plan and realistic outcome
Read this first: your splint, the therapy schedule, when to expect the first signs of recovery, and the honest ceiling of what this operation can restore.
Recognised by major UK insurers
Nerve reconstruction is usually covered by major UK insurers when medically indicated, subject to policy limits. We confirm cover in writing before booking.
Frequently asked
Everything we get asked about nerve reconstruction and repair.
Quick answers on timing, techniques, cost and how much function is realistic to get back.
-
Is nerve reconstruction the same as nerve repair?
For patients, yes - we use the terms interchangeably. Strictly, a primary repair sutures two clean ends together, while a reconstruction bridges a gap using a graft, an allograft, a conduit or a nerve transfer. The surgeon picks the technique based on the injury, the gap and the timing.
-
How soon after a nerve injury should I be seen?
A clean cut with complete loss of function needs a peripheral-nerve surgeon within days - primary repair inside 72 hours is ideal. Even a delayed presentation should be seen inside three to six months to keep grafting and nerve transfer on the table. After 18–24 months of denervation, the muscle itself may no longer respond.
-
What is a nerve transfer, and why is it used?
A working but expendable donor nerve is rewired into the end of a paralysed nerve, close to the target muscle. It shortens the distance the nerve needs to regenerate and often gives faster, more reliable recovery than a long graft. Common examples are the Oberlin transfer for elbow flexion and spinal-accessory to suprascapular for shoulder abduction.
-
What is a nerve graft, and where does it come from?
A gap between two nerve ends is bridged with a piece of nerve. The workhorse autograft is the sural nerve from the calf, which leaves a small patch of numbness on the outer foot. Processed cadaveric allografts (Avance) are increasingly used to avoid donor-site loss.
-
How long does a reconstructed nerve take to recover?
Nerves regenerate at around 1mm per day. Expect early signs after weeks to months, sensory return over 6–18 months, and motor recovery over 12–24 months. Rehabilitation runs the whole course.
-
What does a private nerve reconstruction cost in the UK?
Roughly £4,000–£8,000 for a simple primary repair, £8,000–£15,000 for nerve grafting, and £12,000–£25,000 for complex brachial-plexus reconstruction. We come back with a firm quote within one working day.
-
Will I get full function back?
For an optimal case - young patient, clean sharp injury, early repair, small distal nerve, good rehab - 70–90% return of protective sensation and 50–70% of motor function is realistic. Older patients, crush and avulsion injuries, delayed reconstruction and proximal injuries all sit below that.
-
Can a painful stump neuroma after amputation be treated?
Yes. RPNI (regenerative peripheral nerve interface) and TMR (targeted muscle reinnervation) both give the raw nerve end somewhere useful to grow into - they reduce neuroma pain and phantom pain, and they open the door to modern myoelectric prosthetics.
Related treatments
Looking for something else?
-
Carpal tunnel release
Decompression of the median nerve at the wrist.
Learn more -
Cubital tunnel release
Decompression of the ulnar nerve at the elbow.
Learn more -
Neurological rehabilitation
Specialist rehab for peripheral and central nerve injury.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more