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Overview: Cosmetic Surgery of Severe Toenail Fungus





If you have already tried everything and nothing worked to cure your unsightly toenail infection, would you be willing to have your toenails removed to allow for direct laser treatment of toenail bed to get new clear toenails to grow back? If surgery is involved the costs of treatment for your infections will of course increase. Sometimes surgery will be your only realistic option to ever get clear toenails again. Patients suffering from severe toenail fungus may have to decide whether to incur the surgical expense or would they just rather permanently live with the infections. Cosmetic toenail surgery combined with laser treatment for severe toenail fungus has an extremely high success rate. Inside the thickened infected toenail plate is a heavy residence of fungal organisms. Removing the nail plate removes the bulk of the infected tissues. The laser will then have complete open access to the residual infection. This is similar to incising and draining an abcess ( as you know topical medicine on top of the abcess will not cure the problem) for the infection to clear. This dramatically facilitates killing and eradication of the infecting organism. Once the infecting organism is killed, the end result is clear toenails.






Patients must have 48 hours to elevate their feet following the surgery. This procedure is usually done on Fridays so you can rest over the weekend. The discomfort is similar to having a tooth pulled. After 48 hours the swelling will subside and you can slowly begin your activities again. Once the skin heals it feels the same as the normal skin surrounding the cuticle. So in other words you can walk without toenails comfortably until the toenails grow back in clear. We specialize in this cosmetic toenail surgery procedure for severe infections. This procedure is performed in the office and a single toe usually takes only 15 minutes. After 2 weeks post op the included antifungal laser treatments will begin. The doctor again will clear your nail bed of any residual dead fungal matter and perform the laser treatment. This will be repeated several times over the next 90 days on the clean open nail bed BEFORE the clear toenail grows back. The cosmetic surgical / laser treatment combination regimen is very thorough and has a very high success rate. If you have any questions just call or come in for a visit.





Cosmetic Toenail Removal With Laser / Cleaning
to prepare nail bed for regrowth of healthy new clear toenails.





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Case 1:





Before:

The Keryflex toenail restoration system is a high quality resin product from Germany that is utilized to recreate a natural looking toenail from a dystrophic (abnormal / mycotic) toenail in a single office visit. Keryflex allows for the patient to achieve optimal cosmesis (good healthy looking toenail appearance) while undergoing laser treatment of toenail fungus.

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2 Weeks Post op (visit #1):

Here you can see the thickened toenail has been completely removed exposing the fungal debris/infection in the nail bed. This debris will now be gradually and completely cleaned and removed by the doctor at each of the 4 included subsequent "cleaning and laser visits".





4 weeks post op (visit #2):

Here you can see the fungal infection in the nail bed has now been cleaned and is almost completely removed from the nail bed. The laser treatment and cleaning each visit helps prevent the fungal toenail from coming back by clearing and killing residual fungal debris. So the toenail bed now has a very clean appearance and a fresh clean new toenail can now grow out.





8 weeks post op (visit #4): Here you can see the new fresh clean toenail growing in. It is now about 1/3 grown in, healthy and perfectly clear!





Before: Severe deformed fungal toenail.



Case 2:



After: 6 weeks after laser treatment and nail removal you can see the brand new clear healthy toenail starting to grow in from beneath the cuticle. The toenail will grow in completely in a few more weeks. This patient will have her toenail bed laser treated and cleaned 4 times to prevent recurrence before the toenail is fully grown back.





Post op Visit: Here you can see the new clean toenail almost half way grown in. Healthy & Clear!







Small toenails take 3 to 4 months to grow out. A big toenail takes 10 - 12 months. Toenails start growing back in immediately after removal so it is important to laser treat and kill the residual infection in the nail bed soon after removal while the nail bed is completely exposed BEFORE the new toenail grows back in and covers the area that needs to be treated.








Look Great This Summer!



Dear Patients,





If you have reached this page you may have had a laser treatment that had limited success and/or a very severe case of toenail fungus that was generally unresponsive to other treatments.


If you have had a standard or low power laser treatment that was only partially successful we would most likely first try the highly powered NdYAG G+* laser (best in class) or dual wavelength laser (best in class) to see if your toenails respond to the stronger lasers. If your toenails respond then you know you are on the road to recovery and you will continue with follow up treatment as necessary. In the unlikely event that your toenail fungus infection did not respond to the stronger laser treatment you would be a candidate for this surgical procedure.



If you have tried everything and cannot get rid of your toenail fungus pay special attention to the following two paragraphs:



This combination surgical procedure - subsequent CO2 laser - subsequent fungus laser procedure is highly successful and will work in most instances. So if you are experiencing difficulties do not lose hope! We specialize in this procedure and have a high success rate even with difficult to manage cases ( As is usual with medical procedures nothing is 100% ). If you have reached this point and want to clear the fungal infection and finally have clear toenails this may be your only choice/option.


If you are apprehensive about the surgery and multiple toenails are involved we can remove just one toenail to see how your body responds. In the unlikely event that this combination surgery-laser-laser procedure did not work, since it is the most thorough method to manage the severe fungus available, we would repeat this procedure until new clear toenails return. I have removed thousands of toenails and in most instances the fungus is substantially cleared or eliminated by this new procedure.




  • Pinpointe Laser Certified
  • NdYAG G+ Laser Certified
  • Noveon Laser Academy Accreditation


* Important see laser toenail videos page.



Cosmetic Surgery of Severe Toenail Fungus





(This procedure is NOT necessary for most toenail fungus cases)


In very severe toenail fungus cases it is sometimes necessary for the doctor to completely remove the severely infected toenail plate to allow for a new clean toenail to grow out. This surgical procedure that we utilize is as follows:


1) The patient is given an injection to the infected toe.


2) After the toe is completely numb, the toenail is removed back from the toenail root to the tip of the toenail. This is usually done without cutting the cuticle, in other words the instrument is slipped in under the cuticle. So afterwards the only the clean nail bed is exposed after toenail removal.


3) A CO2 Luxar laser is then utilized to remove infected fungal material from the toenail bed. The nail bed is remodeled, shaped and planed with the Luxar laser.


4) A bandage/dressing is then applied to the toe. Toes are sore for approximately 2 days and are slightly sore in shoes for about a week or two.


5) Toenails start growing back immediately. Big toes take about 10 months to grow back in.Lesser digits take 3-4 months.


6) Toes without toenails usually appear much cleaner to the patients and most are very pleased immediately following the procedure even before the toenail grows back.


7) Most importantly: Just because the toenail is gone temporarily it doesn't mean the fungus is gone! It is still present in the nail bed after removal! Something must be done to prevent reinfection otherwise almost for sure the toenail will grow back again with fungus. The method of treating the nail bed is as follows: Lser treatment to the exposed toenail bed beginning about two weeks after removal. This is repeated several times before the new nail plate grows back. Remember: Once the toenail is removed you have a small window of opportunity to treat the fungus in the nail bed while the nail bed is still exposed BEFORE THE TOENAIL GROWS BACK. Since the laser is being applied directly to the nail bed (skin) it is substantially more effective. Performing the fungus laser directly on the nail bed (without toenail) is more effective in killing fungus because the nail bed area is wide open for treatment. We specialize in this most advanced combination toenail removal, remodeling of nail bed with CO2 laser procedure and follow up anti-fungal laser treatment for very severe cases. Pinpointe Laser Certified NdYAG G+ Laser Certified Noveon Laser Academy Accreditation



Pinpointe Laser Certified

NdYAG G+ Laser Certified

Noveon Laser Academy Accreditation






2780 Middle Country Road
Lake Grove NY 11755
(1/2 Mile East of Smith Haven Mall)
631.669.4955