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.

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.

(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