Nerve reconstruction surgery

The cost of this procedure depends on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant’s outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

Your consultant may recommend nerve reconstruction surgery if you have damage to your peripheral nerves. The peripheral nervous system is made up of 43 pairs of motor and sensory nerves that connect the brain and spinal cord (the central nervous system) to the rest of your body.

Your nerves work by sending electrical signals to your muscles that allow you to move and feel sensations. When a nerve is damaged by injury or disease, it can cause symptoms such as numbness, impaired muscle function, and pain.

An injured nerve will try to repair itself using a process called reinnervation. During reinnervation, nerve cells regenerate from the ends of damaged nerves and attempt to reattach to your skin and muscles. If this process is successful, muscle function will be restored, but if your nerves do not connect correctly, or if your nerve damage is severe,

nerve reconstruction surgery may be necessary.

Some causes of peripheral nerve damage include:

• Traumatic injury - such as a car accident, laceration, or electrical injury
• Surgery - surrounding nerves may be damaged during surgery
• Nerve tumours - such as a schwannoma or neurofibroma
• Nerve compression - such as ulnar nerve compression, peroneal nerve compression or tarsal tunnel syndrome
• Infections - including bacterial, viral, and parasitic infections
• Medical conditions - such as peripheral neuropathy

Nerve reconstruction surgery has several benefits including:

• Increased sensation in the affected body part
• Reduces or eliminates nerve pain
• Restores nerve function

At your first consultation, you will be seen by a consultant plastic, hand, or oral maxillofacial surgeon, a doctor specialising in nerve reconstruction surgery.

Your consultant will ask you about your symptoms, general health, medical history, and any medications you are taking. They will ask you about your nerve injury, including when the injury occurred, and perform a physical examination including a thorough assessment of your peripheral nerves, and any loss of sensation, movement, or pain.

Your consultant may order tests or scans such as a blood test, CT scan, MRI, or nerve conduction studies to confirm or rule out a possible diagnosis.

How is a diagnosis made?

Your consultant will make a diagnosis based on your symptoms, medical history, and physical examination.

Why is this first consultation so important?

At Circle Health Group, your first appointment is very important as it's where your consultant will ask you about your symptoms, perform a physical examination, order any necessary tests, provide a diagnosis, and discuss possible treatments.

Your first consultation is also where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible during your time with us, so please ask your consultant any questions you may have during your initial appointment.

After making a diagnosis, your consultant will decide if nerve reconstruction surgery is a suitable option for you, based on your symptoms and diagnosis. They will also determine the best type of nerve reconstruction surgery for you, give you instructions on how to prepare for your surgery, and explain what happens during your procedure and recovery.

Your consultant will tell you everything you need to do to prepare for your nerve reconstruction surgery. If there's anything you're not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice. Being well-prepared for your surgery will help to ease any anxiety you may have as well as allow your surgery and recovery to go more smoothly.

Before your surgery, tell your consultant about any medical conditions or allergies you have and any medication, including over-the-counter medicines and supplements you are taking.

Your consultant may tell you to stop taking some medications like blood thinners before your operation. This is to reduce the risk of bleeding during and after your surgery.

You will not be able to eat or drink anything from midnight on the day of your operation.

What lifestyle changes can I make before my surgery?

Being as healthy as possible before your surgery can help to reduce the risk of complications and speed up your recovery.

To ensure you are in good health before your surgery:

• Eat a healthy, balanced diet with plenty of fruit, vegetables, lean proteins, and whole grains
• If you smoke, try to stop at least eight weeks before your surgery
• Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding
• Take regular exercise

There are several types of nerve reconstruction surgery. Your consultant will decide on the most appropriate technique for you based on when your nerve injury occurred and the type and severity of your injury.

Nerve reconstruction surgery is a type of microsurgery that involves either reattaching, grafting, or transferring nerves using a microscope. It is carried out under general anaesthetic which means you'll be asleep during the procedure. Nerve reconstruction surgery is a complex and delicate procedure that can take several hours.

Direct nerve repair

When a nerve is directly cut, it may be possible to reconnect the severed ends using a technique known as direct nerve repair. Where possible, this method is usually the first choice for nerve reconstruction surgery.

During direct nerve repair, after trimming any damaged tissue at the end of your severed nerve, your consultant connects the ends together using sutures or surgical glue.

Nerve grafting

If the gap between the severed ends of your nerve is too big for direct nerve repair, your consultant may use a nerve graft to bridge the gap. The graft may be taken from elsewhere in your body or from a deceased donor (cadaver).

Nerve transfer

If nerve grafting is not possible because the gap between your severed nerve is too large, your consultant may perform a procedure called a nerve transfer. This involves connecting a healthy, redundant (donor) nerve to the damaged (recipient) nerve. The healthy nerve fibres (axons) then grow through the damaged nerve, restoring muscle movement function and skin sensation. This process occurs gradually over several weeks or months.

Recovery from any type of surgery is different for everyone and depends on factors such as your age, general health and whether or not there were any complications during your surgery or recovery.

Your consultant will be able to give you an estimated recovery timeline based on your individual circumstances.

After your nerve reconstruction surgery, you will be taken to the recovery room where the nurses will monitor you closely until the effects of the anaesthetic have worn off.

How many nights will I need to stay in hospital?

You may be able to go home later the same day as your nerve reconstruction surgery, or you may need to spend one night in hospital. Talk to your consultant about when you can expect to go home after your surgery.

Will I be able to drive home?

You will not be able to drive yourself home from the hospital after your nerve reconstruction surgery. Please make arrangements for someone to collect you, or we can organise a taxi if you prefer.

How soon can I go back to work?

How soon you can go back to work after your nerve reconstruction surgery depends on the type of procedure you had, which part of your body is affected and the type of job you do. If your job is sedentary such as office work, you can expect to return to work in around two weeks, but you will need longer if you have an active or manual job. Your consultant can tell you when you can expect to return to work based on your individual circumstances.

How soon can I drive?

You should not drive until you can safely control your vehicle and perform an emergency stop. This varies depending on your individual recovery and which part of your body is affected. Check with your consultant before driving after nerve reconstruction surgery.

When will I be back to normal?

Recovery from any type of surgery is a gradual process that is different for everyone. Nerve fibres grow at the rate of around an inch per month, so recovery depends on the distance between your reconstructed nerve and the skin or muscle it supplies. It can take from a few weeks to several months to regain movement and sensation following nerve reconstruction surgery.

Pain after nerve reconstruction surgery is usually minimal and can be managed with over-the-counter painkillers if needed. Your consultant or pharmacist can recommend a suitable painkiller.

You can help your recovery go more smoothly by following your consultant's postoperative instructions carefully. Call the hospital if you have any questions or concerns during your recovery.

During your recovery, you may need to:

• Wear a sling or brace to restrict movement for a period of time
• Attend regular physiotherapy sessions
• Limit certain activities
• Attend follow-up appointments to check your progress

Nerve reconstruction surgery is a generally safe procedure, but like all types of surgery, there is a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure. Being as well-informed as possible about what to expect from your surgery will help put your mind at rest and allow you to make an informed decision so please ask any questions you may have.

Possible complications of any surgery include:

• Bleeding
• Infection
• Blood clots
• Adverse reactions to the anaesthetic

Possible complications specific to nerve reconstruction surgery include:

• Minimal or no improvement in nerve function
• Scarring
• Complex regional pain syndrome - a condition that causes long-term pain. It is treated with pain medication and physiotherapy
• Stiffness and poor mobility - can be helped with physiotherapy
• Poor or delayed wound healing
• Rarely, a lump may develop on the donor site after nerve grafting requiring additional surgery

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of 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 see a consultant or learn more about nerve reconstruction surgery, book your appointment online today or call a member of our team directly on 0808 189 5499

Content reviewed by Circle in-house team in July 2024. Next review due 2027.

Nerve Reconstruction Surgery The Institute for Advanced Reconstruction

Peripheral nerve surgery  NHS Imperial College Healthcare NHS Trust 

Nerve Reconstruction Science Direct 

Surgical Repair of a Nerve Johns Hopkins Medicine 

Evidence that nerve surgery improves functional outcome for obstetric brachial plexus injury PubMed