Can Nail Bed Deformity Be Corrected Through Plastic Surgery?

Can the nail bed deformation be restored to normal?

Reason: Ten years ago, I had my toenail removed due to paronychia, and during the procedure, a tumor was accidentally discovered.
I then consulted an orthopedic surgeon who excised the tumor.
Although the toenail has grown back, it looks very unsightly.
I asked the orthopedic doctor, and he said that the nail bed has become deformed, and it is not possible for a normal nail to grow back.
Over the past ten years, the nail has grown to a normal length but has stopped growing further.
However, it has continued to thicken, and I have to keep trimming it; otherwise, it becomes painful to wear shoes.
Recently, the nail has turned gray, which seems like a bacterial infection, and it may need to be removed.

Question: I would like to ask if there is a chance that this nail could grow back normally through plastic surgery.
Thank you.

Robin, 20~29 year old female. Ask Date: 2012/04/03

Dr. Lu Daokuan reply Plastic Surgery

Chronic injury has led to nail bed deformity and a fungal nail infection.
Treatment for the fungal infection should be addressed by a dermatologist first, before consulting an orthopedic surgeon to determine if nail bed reconstruction is necessary.

Reply Date: 2012/04/03

More Info

Nail bed deformity can indeed be a challenging issue, particularly when it stems from previous trauma or surgical interventions, such as the removal of a nail due to infection or the excision of a tumor. In your case, it appears that the nail bed has been permanently altered, leading to abnormal nail growth and thickness, which can be both painful and aesthetically displeasing.
Plastic surgery, specifically reconstructive surgery, may offer some solutions for nail bed deformities. The primary goal of such procedures is to restore the normal anatomy of the nail bed and improve the appearance and function of the nail. However, the success of these interventions largely depends on the extent of the deformity, the underlying cause, and the condition of the surrounding tissues.

One common approach is to perform a nail bed reconstruction, which may involve the use of grafts from other areas of the body to create a more normal nail bed structure. This can help in promoting healthier nail growth. In some cases, a procedure known as a "nail matrix excision" may be performed, where the abnormal nail matrix is removed to allow for the regrowth of a more normal nail. However, this procedure is typically reserved for cases where the nail matrix is severely damaged or diseased.

In your situation, since you have mentioned that the nail has become thick and discolored, indicating a possible infection, it is crucial to address the infection first. This may involve antifungal or antibacterial treatments, depending on the nature of the infection. Once the infection is resolved, a consultation with a plastic surgeon or a dermatologist specializing in nail disorders would be beneficial. They can assess the condition of your nail bed and discuss potential surgical options tailored to your specific needs.

It's also important to consider that while surgery can improve the appearance and function of the nail, it may not guarantee a return to a completely normal nail. Factors such as the healing process, the presence of any underlying conditions, and the body's response to surgery can all influence the final outcome.

In addition to surgical options, there are non-surgical treatments that may help manage the symptoms associated with nail bed deformities. For instance, regular trimming and filing of the thickened nail can alleviate discomfort and improve the nail's appearance. Protective footwear can also help reduce pain during walking.

In summary, while plastic surgery may offer a potential solution for correcting nail bed deformity, it is essential to first address any infections and consult with a qualified specialist. They can provide a comprehensive evaluation and recommend the most appropriate treatment plan, which may include surgical intervention or other therapeutic options. Remember, the journey to recovery may take time, and patience is key as you explore your options for restoring the health and appearance of your nail.

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