I have been trying to research online with very little accurate results. For someone who has had their toenails removed or permanently damaged, are there any procceedures that are currently being done to surgically implant a permanent replacement toenail for aesthetic purposes? 

I have had some patients ask me about this.  There is a technique of transferring nail bed to the affected toe however at the expense of morbidity at the donor site.  I could not understand a good reason to do so in the feet.  Patients mainly request this for cosmetic nail problems in the hand.  This technique may be found in a textbook I believe textbook of nail surgery.  I dont know if it is still in print. 

I actually had the aforementioned procedure performed on my right ring finger as a child for a crush injury to the nail and nail bed.  A plastic surgeon transplanted the lateral half of my right hallux nail to the affected finger nail. The results are sub-par to say the least with chronic deformity of the recipient site.  Personally, there have been no deleterious affects to the donor site but it is likely dependent upon the surgical technique combined with my young age at the time of the procedure?

This sounds similar to artificial fingernails... but how do you adhere it to the skin and how likely is it to fall off and need replacing?

Yes the idea is to create a arteficial nail , however, this technique allows to obtain a nail  whid features very similar to normal nails.  I adhere it to the skin by using a specific Bond for composite resin non toxic, this  bond of composite resin to tooth, is especially effected by moisture contamination and cleanliness of the prepared surface. 
The probability of falling is minimal, depending on the amount of bond that is used (the ideal is 2 to 4 drops) . The lifespan of this nail is 7.8 years because composite fillings shrink with age and may pull away from the nail bed

I would love to find someone in the Dallas area who was skilled at this type of proceedure :)

I would love to find someone in the Dallas area who was skilled at this type of proceedure :)

Unfortunately I'm in Portugal ... but I have several articles about this procedure which I will translate and then send it to you :)

I would like to know if anyone provides this composite resin procedure in the UK?

I had both big toenails removed after ingrowing and the nail bed burned away. I'd love to have replacements made.

In hope,

Ross

Hi,

I am also looking for someone in the Toronto area that could do the same type of procedure.  Does anyone have any contacts?

From what I have read here, this might be an opportunity to team up with a dental lab for the actual toenail prosthesis and then, after receiving it, the podiatrist could "implant" it. This could lead to a new cash-only, cosmetic procedure.

A slight variation on this theme has started gaining favor among some clinicians, who have started to utilize the focused light energy of a laser to treat onychomycosis.  There are several products on the market which promote this modality in the treatment of nail fungus, and Dr. Satterfield is correct, it is cosmetic procedure which is a cash fee-for-service.  A colleague of mine (and former co-resident) is now one of the few "certified laser specialists" who utilize this modality, and she as reported largely favorable results (although she has only recently started to perform the procedures).

I took the opportunity to sit in on several of the treatments with her, to get the feel for things, and it seems to be fairly user-friendly.  I have encouraged her to track her cases to perform a comparative study to generate some data on this topic --the limited amount of study data is a concern that I have about this product/procedure.  While there is limited EBM available to support efficacy of such a treatment modality, i have difficulty trying to "sell" the idea of paying cash out of pocket for such a procedure....

Does anyone have any insight or experience on these laser products?  I don't know that i could find many people in my practice in rural Virginia who would be willing to pay $1000 for the potential for clean, healthy looking nails, but i know that there are many areas where such cosmetic procedures constitute a significant source of practice income....

greetings from Den Haag

Dear Mr  Andre.

i have quite a many patients who ask me about this.

May i ask. does it really work for patients who have no nail plate whatsoever - just the scar tissue left of the nail bed - witth the matrix fully removed.???

if so.. is ithere a particular composite bond adhesive thats better - that you can recommend for no irritation of the nail bed? which is best? im going to talk to a dentist friend about this.

Intesting stuff

Anneleen

Hi Anneleen

This technique works very well  in patients who do not have any nail plate, but to achieve a better result it is important to preserve the scar tissue left of the nail bed, without it will not work as well as the risk of the prosthesis fall of is greater.
There is no particular composite bond adhesive thats better , however in some patients may appear an allergic reaction to certain composite bond adhesives, although this has never happened in my clinical practice.
Regarding the composite resins by my experience, the composite flow appeasr to be easier to work and the final results are better.
If you have any more doubts feel free to contact me.

Kind Regards
André

I came across a cosmetic nail augmentation procedure on the internet called the Keriflex Nail Restoration System. I have never used this product. It appears that the artificial nail is bonded to a debrided and thinned dystrophic toenail. I am uncertain whether this artificial nail can be bonded to the nail bed such as the product described below by Andre. Here is one website ( http://carepluspodiatry.com/our-services/keriflex-nail-restoration-system/) advertising the product for anyone who is interested. 

Best regards, 

Chris  

Hi Chris

Thank you for your comment, I have found the webpage of this procedure http://www.keryflex.com and after visiting the wesite this seems similar to the technique that I use.

Kind Regards
André

Just an update:

As someone who has lost both of my big toenails due to matrixectomies, I have been doing a pretty thorough job of researching the options available to those of us with...well...no toenails. I recently contacted an authority on the Keryflex procedure (a podiatrist who received his education at Temple University where they do the trainings) and they will not place these nails in cases such as mine where there is only nail bed. The nails do NOT adhere to the nail bed in the absence of at least some sort of nail plate. There must be at least some nail plate available to adhere the resin to. 

I understand the concerns related to the use of fake nails (mainly that it is an excellent environment for fungal growth). I also understand that it must be quite a tremendous challenge to figure out a way to adhere a prosthetic nail to the nail bed (Is there any way to do this?). In my search, I have come across many patented ideas that never achieved popularity and many, many desperate patients frustrated by the aesthetic aftermath of losing their nails. Satisfied with the relief they've had, yes. But also discouraged by the appearance of their feet. Both men and women. Unfortunately many of these people use glue and the dreaded fake nail. This forum is my last hope!


My question is: Is there any way to (safely) attach a nail of some sort to a nail bed without any nail plate whatsoever? 


A final word: I understand this may seem to be merely a cosmetic concern, but it is also a quality of life issue for many people such as myself (yes, even men) and I would appreciate any feedback. I'd love to wear those flip flops again without getting all the strange looks and comments.  : )


Thanks! 

Also, the podiatrist who I contacted at suggested that "Many people, mostly female, choose to paint these toes." Please don't suggest this; it simply does not work. Especially in cases such as mine where it does not look right. If you think having no toenails is looked strangely upon, try being a male with no toenails and pink toenail polish on. Yup, strange indeed...

Thanks again!