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What is bunion surgery?
Bunion surgery, or hallux valgus surgery, is an operation that realigns your big toe and removes a bunion from the inside of your foot around your big toe joint.
It often involves your consultant orthopaedic surgeon removing your bunion by shaving it down, before cutting the bones around your big toe joint, allowing the bone to be moved into a straighter alignment of the toe, before being fixed in position.
What is a bunion?
Otherwise known as hallux valgus, a bunion is a bony bump on the side of your big toe joint, formed by your first metatarsal and your proximal phalynx – bones on either side of your big toe joint – shifting out of place.
As your big toe leans in towards your lesser toes, your first metatarsal head moves towards the inside of your foot. The fullness of your metatarsal head shifting outwards creates the appearance of a bump, which is then diagnosed as a bunion.
Not only does this movement create a bony prominence on the side of your foot, but it can push your big toe towards your other toes, causing complications such as crossover toes, hammertoe and mallet toe.
What causes bunions?
Bunions can be caused by a variety of factors, the most common being genetics. While bunions can’t be inherited directly, you can inherit traits that predispose you to bunions, such as loose ligaments, flat feet, metatarsal structure and rheumatoid arthritis.
Contrary to popular belief, tight shoes and high heels don’t directly cause bunions, but can encourage the onset of bunions if you’re predisposed, or make the symptoms of existing ones worse.
The final cost of bunion surgery will depend on various factors personal to you, but we've included some guide prices below to give you an idea.
If you are paying for your own treatment, we offer fixed-price packages so you know exactly what you'll pay ahead of time. This fixed price includes all necessary aftercare and follow-up appointments, but your initial consultation and any diagnostics done at the time will be charged separately.
Self-pay patients can take advantage of our flexible payment options, which allow you to spread the cost of treatment over a period of one to five years, with interest-free options available.
If you have private health insurance, bunion surgery will usually be covered by your policy. Speak to your provider directly to find out.
The cost of bunion repair surgery
Please be aware that the following prices are a guide price. Your final price will be confirmed in writing following your consultation and any necessary diagnostic tests.
Any diagnostic tests that are carried out will incur a fee and if you see a consultant to go through your results they may also charge an extra consultation fee.
| Patient pathway | Initial consultation | Diagnostic Investigations | Main treatment | Post discharge care | Guide price |
|---|---|---|---|---|---|
| Hospital fees | N/A | Not included | £5,516 | Included | £5,516 |
| Consultants fees from | £200 | N/A | Included | Included | £200 |
| Guide price | £5,716 | ||||
The cost of bunion repair (with soft tissue release) surgery
Please be aware that the following prices are a guide price. Your final price will be confirmed in writing following your consultation and any necessary diagnostic tests.
Any diagnostic tests that are carried out will incur a fee and if you see a consultant to go through your results they may also charge an extra consultation fee.
| Patient pathway | Initial consultation | Diagnostic Investigations | Main treatment | Post discharge care | Guide price |
|---|---|---|---|---|---|
| Hospital fees | N/A | Not included | £5,625 | Included | £5,625 |
| Consultants fees from | £200 | N/A | Included | Included | £200 |
| Guide price | £5,825 | ||||
If you have a bunion, aside from the bony lump on the side of your big toe joint, you might notice other symptoms such as corns and calluses, inflammation and redness at the bunion site.
With mild symptoms, you might find your bunions don’t cause you too much difficulty and so decide not to have bunion surgery.
You may decide you need surgery if your symptoms worsen, or if you develop new symptoms, such as pain and soreness, a burning sensation and difficulty moving your big toe. For most people, pain is the main indicator for surgery.
You might also need bunion surgery if your bunions start causing complications, from changes in your gait and bursitis, to crossover toes, hammertoe and mallet toe.
At your initial consultation, your consultant will ask you questions about your bunion, such as how long it’s been present for, the symptoms you’re experiencing, and if you’ve already undergone bunion treatment. You’ll also be asked about your general health and broader medical history.
As the symptoms of a bunion are primarily visible, with the main symptom being a bony bump on the outside of your big toe, your consultant should be able to diagnose your bunion by examining your foot.
To assess the severity of your bunion, your consultant may also order an X-ray. Foot X-rays provide images of the bones in your toe, allowing your consultant to assess whether arthritis has played a role in the development of your bunion, whether your joints are damaged, and if any other bones in your foot are starting to shift, too.
As the alignment of the bones in your toe changes depending on whether you stand or sit, your consultant will perform an X-ray while you are standing to get a better view of how your big toe is aligned.
You may need to take the following steps to adequately prepare for your bunion surgery.
Preoperative tests
To help determine your suitability for surgery and your risk of developing postoperative complications, your surgeon may need you to take the following tests:
- A physical exam
- Blood tests
- An electrocardiogram (ECG)
- Chest X-ray
You may also need additional foot X-rays, as these can help your surgeon decide where exactly along the bone they’ll need to make the cuts to realign your toe joint.
Medication review
Your consultant will ask what medications you’re taking in your consultation preparing you for surgery.
If you’re on blood thinners, such as aspirin, warfarin, or anti-inflammatories, they may ask you to stop taking these two weeks before your surgery to minimise the risk of unwanted bleeding during or after your procedure.
Stop smoking
While it’s a good idea to quit smoking anyway, it’s especially recommended you stop smoking in the week before your bunion surgery.
Smokers are at a greater risk of complications during and after surgery, and as smoking can damage your immune system, it could take longer for you to recover from your surgery.
Fasting
If you’re due to be given general anaesthetic for your operation, you won’t be able to eat or drink anything on the day of your surgery and can’t drink alcohol for 48 hours prior to your surgery.
Arrange transport
You won’t be able to drive yourself home after your bunion surgery, as you’ll still be recovering from the anaesthesia. To make sure you get home safely, it’s best to arrange a lift home from a family or a friend, or to book a taxi to come to the hospital after your surgery.
Prepare your home
For the first two weeks after your bunion surgery, you’ll need to stay off your feet as much as possible, meaning you won’t be able to move around your home as you usually would.
To make home life manageable after your operation, it’s recommended you prepare your home for when you return from the hospital. You might want to move furniture to make passageways easier to navigate with crutches or set up sleeping arrangements downstairs.
It’s also recommended you have all the supplies you need for when you’re recovering at home. Consider stocking up on ready meals or batch cook and freeze portions, and if you need anything else during this period, consider asking a family or friend to get it for you.
Bunion surgery is usually performed under a general anaesthetic, putting you to sleep for the duration of the surgery, and a block to help with pain relief for immediately after surgery. Occasionally, a spinal anaesthetic or full leg block anaesthetic is used.
Surgery typically takes half an hour, although this can vary depending on the surgery you’re due to have.
There are many different types of bunion surgery, each tailored to the type and severity of your bunion, with the most common procedures being:
- Osteotomy
- Exostectomy, although rare and the indications for this are minimal
- Lapidus surgery, where the first metatarsal base is fused to the midfoot
- Arthrodesis surgery where the big toe joint is fused for very severe bunions with arthritis
Osteotomy
An osteotomy is a medical term used to describe cutting or breaking the bones around the bunion area, either through open or keyhole surgery. It is the most common type of correction for bunion surgery.
If your osteotomy is conducted through open surgery, your surgeon will make an incision along the length of part of your first metatarsal to your proximal phalynx. This makes it possible for your surgeon to cut and realign your bones using small saw blades.
Alternatively, minimally invasive surgery is where your surgeon makes a series of small incisions in your foot and toe bones to realign your toe joint using special cutting tools called burrs.
Once realigned, your surgeon will use pins, screws or plates to fix your newly realigned joint in place.
Exostectomy
An exostectomy is usually performed on minor bunions, and involves your surgeon using a specialist tool to shave away your bunion through an open or keyhole approach to flatten the bunion bump, restoring your toe to its usual shape.
More commonly, this type of bunion surgery is usually performed alongside an osteotomy as alone an exostectomy won’t realign your toe joint, and there’s a high chance your bunion may return if the procedure isn’t done alongside an osteotomy.
Arthrodesis
If your bunion is severe, or has been caused by inflammation due to arthritis, your surgeon may suggest an arthrodesis. For this procedure, your surgeon will make an incision in your big toe joint and remove parts of your joint that have arthritis or have been damaged by arthritis.
Once all the arthritic parts of your big toe joint have been removed, your surgeon will use screws or plates to hold your bones together while they heal. During this healing process, your bones will fuse together, forming one bone.
This is usually reserved for bunions where pain is coming from the joint rather than the bunion bump itself. If the bunion bump is causing most of the pain but arthritis can be seen in the X-ray, a correction surgery either through open or keyhole approaches can be used.
Lapidus
A Lapidus procedure can be recommended if you have a severe bunion, or if your bunion is a result of hypermobility in your feet, where increased movement in your foot joints due to stretchy ligaments causes your big toe to move towards your second toe.
To correct your bunion, a Lapidus procedure works by removing your tarsometatarsal (TMT) joint and straightening your big toe joint, before fusing the joint between your first metatarsal bone (the long bone in the middle of your foot) and the medial cuneiform (one of the small bones where your ankle meets your foot).
Once your bones have fused, your first metatarsal is less likely to move abnormally, reducing the risk of your bunion returning.
The length of time it takes to recover from bunion surgery depends on various factors. From the type of surgery you had and how well you follow your surgeon’s instructions after the surgery, to your age, fitness levels and general health – these are all factors that contribute to the length of your recovery.
What to expect one day to two weeks after bunion surgery
After your operation, a bandage will be placed over your foot, and you’ll be given crutches and a special boot to wear to protect your foot as it heals. You’ll also be given time to rest, and medication should you experience any discomfort as the anaesthesia wears off.
Generally, your bandage will stay on for 2 weeks.
You will be given instructions from your surgeon of full weight bearing or partial weight bearing depending on what type of surgery you have had. If you’ve had minimally invasive surgery, you should typically be able to put all your weight on your foot immediately after surgery.
What to expect two to four weeks after surgery
After two weeks of recovery after open surgery, you should be able to put weight on your foot while still wearing your post-operative sandal, which must be kept on while you move about.
If you had undergone keyhole bunion surgery, you can wear stretchy training shoes after two weeks, once the wounds are checked.
Your dressings will also be removed at the two-week mark, but you’ll still need support from fresh dressings or a brace for a minimum of six weeks after open surgery. To reduce swelling, as with all foot and ankle surgery, it’s recommended you ice your foot.
If you had undergone keyhole surgery, you can also start gentle physiotherapy to start mobilising the scars and stretching through the big toe joint. If you had open bunion surgery, you might be able to do this depending on the degree of correction, but it’s best to check with your consultant first.
If you have a job that doesn’t require walking or standing, you can go back to work two weeks after surgery, provided you keep your foot elevated – ideally at waist height – while you work. If it’s not possible to keep your foot elevated, or you have a job that requires you to move around, you could be away from work for a month to six weeks, depending on your rate of recovery.
What to expect four weeks to two months after surgery
You’ll need to keep wearing your post-operative sandal for up to six weeks after your bunion surgery unless your consultant tells you differently. After this, you can start wearing shoes that are wide and flat, and should ideally continue to avoid wearing narrow shoes or high heels.
You should keep your foot elevated whenever possible as there will still be some swelling, which can last for around three months, or longer in some cases.
If you have a job that involves walking or standing for long periods of time, you can return to work after six weeks, although this can extend to eight weeks if you work in manual labour. Ultimately, the amount of discomfort and swelling you experience will determine when you can go back to work, and your consultant will confirm when it’s safe to do so.
You can start driving again between six to eight weeks after your bunion surgery, when you can safely do an emergency stop.
You’ll also step up your rehabilitation programme at the six to eight week mark, starting with weight-bearing, stretching and other exercises that encourage improved balance and overall strength.
You can resume normal activities three months after bunion surgery, when your bones should have fully healed. You’ll notice a small scar on your foot where the bunion surgery was performed.
While bunion surgery is the only way to correct a bunion, you can take the following steps to manage discomfort if your symptoms are mild.
- Wear wide fitting footwear, such as EE or EE+ width, to accommodate the shape of your bunion and reduce compression
- Wear bunion sleeves and cushioning pads to prevent rubbing on the inside of your shoe
- Wear orthotic insoles to improve your gait
You may also be offered a steroid injection for short-term pain relief if your bunion is particularly severe. However, as bunions can only be corrected with surgery, it’s likely your consultant will recommend surgery for you at this point.
Like any surgery, there’s a risk bunion surgery can cause one or more of the following complications:
- An abnormal toe position, where your big toe extends away from your other toes (overcorrection)
- Continued swelling and pain
- Difficulty with bone healing
- Infection
- Numbness in your toe caused by nerve damage
- Pain in the ball of your foot
- Stiffness in your big toe
- Your bunion returning
- Scars
- Swelling
- Wound bleeding
- Deep vein thrombosis (rare)
- Pulmonary embolism (rare)
You should contact your consultant if you experience any of the following symptoms:
- Discharge from your wound
- High temperature
- Redness and warmth around your dressing
- Swelling or pain in your calf muscle
- Worsening pain that doesn’t improve with painkillers
When you opt for private bunion surgery with Circle Health Group, you can expect:
- Flexible appointment times and locations to fit your schedule
- The freedom to choose which hospital and consultant best matches your needs
- Personalised, consultant-led treatment plans tailored to your particular requirements
- Comfortable and safe private facilities maintained by expert multidisciplinary teams
- Private ensuite rooms as standards and delicious healthy meals
- Affordable, fixed-price packages with aftercare included
- Flexible payment options to help you spread the cost of your care
If you would like to learn more about this procedure, book your appointment online or call a member of our team today.
Content reviewed by Consultant Orthopaedic Surgeon Mr Kumar Kunasingam in February 2025. Next review due February 2028.
- Bunions, NHS
- Bunion surgery, Bupa
- Bunion surgery, Hopkins Medicine
- Bunion surgery (Bunionectomy), Cleveland Clinic
- Lapidus Procedure, FootCareMD
