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Nerve reconstruction and repair, by a peripheral-nerve microsurgeon.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private nerve reconstruction costs in the UK.

Indicative ranges across UK private providers.

In short

£4,000–£8,000, typically day-case.

Procedure Indicative range
Consultation and examination £250–£450
EMG + nerve conduction studies £450–£900
MRI neurography £850–£1,600
Primary nerve repair (simple, digital) £4,000–£8,000
Nerve grafting (autograft or allograft) £8,000–£15,000
Nerve transfer (e.g. Oberlin) £10,000–£18,000
Brachial plexus reconstruction £12,000–£25,000
RPNI / TMR for painful neuroma £6,000–£12,000

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.

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.

  • 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.

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.

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 UK consultant hand surgeon reviewing a patient’s microsurgical operation notes

A quiet reminder

Microsurgical language is precise and can read coldly - ask your care team to explain anything that is unclear.

Ask your care team to explain anything that is unclear.

  1. 01 Header

    Injury, timing and technique chosen

    What was injured, when, and which technique was used - primary repair, autograft, allograft, conduit or transfer.

  2. 02 Technique

    Microsurgical detail

    The suture material, the fascicular pattern, graft length and donor site, and any intra-operative stimulation findings.

  3. 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.

  4. 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

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Nerve reconstruction is usually covered by major UK insurers when medically indicated, subject to policy limits.

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.

  • 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.

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