Bunion Surgery

Surgical Interventions· Also known as: bunionectomy, hallux valgus surgery, hallux valgus correction, bunion correctionUpdated Oct 2026

Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026

At a Glance

Bunion surgery realigns the big toe and eases pain from a bunion, the bony lump on the inside of the foot. It is used when a bunion hurts regularly or limits what you can do, and changes to your shoes and other non-surgical care haven't helped. It isn't done for looks alone. Most people feel better afterwards, with less pain and a better quality of life. Recovery takes weeks to months, with a bandage and special shoe for about 6 weeks. Problems such as infection, stiffness, numbness or the bunion coming back can happen.

What is it?

A bunion (hallux valgus) happens when your big toe moves towards the other toes and a lump forms on the inside of your foot. The lump is mostly the long bone behind your big toe (the first metatarsal) sticking out. It is not extra bone growing.

Bunion surgery aims to straighten your big toe and ease pain from the joint or from shoes rubbing. Most operations combine two steps. The surgeon releases and rebalances the soft tissues around the joint, and cuts the bone (an osteotomy) so it can be moved into a better position.

There are many different operations. Common ones include the scarf and Chevron bone cuts in the long bone behind your big toe. An Akin cut takes a small wedge of bone from the big toe bone itself to straighten it, and it often makes the toe slightly shorter. A Lapidus operation fuses (joins) bones at the base of the long bone so they heal as one. Other options include fusing the big toe joint, removing part of the joint, or replacing it with an artificial joint.

What is it used for?

Surgery is used for a bunion that causes regular pain or noticeably limits how your foot works, when changes to your shoes and other non-surgical care haven't helped. This is the main reason for the operation.

Surgery is not done for looks alone. If a bunion doesn't hurt, you could have pain for weeks or even months after the operation that you didn't have before.

Severe bunions are usually treated with a bone cut or fusion at the base of the long bone, such as a Lapidus operation. Children whose bones are still growing may have a different procedure on the first metatarsal (called hemiepiphysiodesis). It improves how the foot looks and works, but the angles stayed in the mild to moderate bunion range. How well it works and how safe it is in children over the long term still needs to be shown.

Is it right for me?

Surgery suits otherwise healthy people with a painful bunion when other measures haven't worked. Usually that means about 3 months or more of non-surgical care, such as changing your footwear, pain relief medicines and shoe inserts (orthoses). It also means your pain is regular and affects how your foot works.

You also need to be ready to stay off your feet for several weeks afterwards. If this sounds like you, your podiatrist can refer you to an orthopaedic surgeon.

Surgery is not recommended if you have poor blood flow to your legs and feet (arterial occlusive disease). If you have this, or another condition that affects healing, you need a medical or surgical review before surgery is planned.

Smoking makes it much more likely that bones won't heal properly. If you smoke, you should stop before surgery and stay stopped until your bones have healed. Having diabetes (even with early nerve damage) or rheumatoid arthritis doesn't rule surgery out, but your surgeon needs to choose the operation with care. After a fusion, bones are also more likely to fail to join in people with diabetes or rheumatoid arthritis.

What happens?

Your surgeon chooses the operation based on how severe the bunion is, its size, how much it hurts and what you need your foot to do afterwards. A mild bunion usually gets a bone cut near the toe end of the long bone, such as a Chevron. A moderate bunion usually gets a cut along the shaft, such as a scarf. A severe bunion usually gets a soft tissue release with a cut at the base of the bone, or a Lapidus fusion. It isn't yet known which operation works best for which bunion, so ask your surgeon why they suggest theirs.

In a scarf operation, the bone is cut and moved into place, then held with two small screws. These usually stay in for good. The fix is stable, so you usually don't need a plaster cast. Adding extra procedures at the same operation doesn't seem to change the results.

If you have your big toe joint or the base of the long bone fused, the surgeon holds the bones together with a plate, screws or staples. Plates are generally the better choice on several measures, including fewer complications, stability, walking sooner and how well the foot works, although staples gave the highest rate of bones joining. Your surgeon will choose what suits your bone quality and your situation.

For the first two to three days you rest with your foot raised to hip level. Your dressing is taken off at a visit about two weeks after the operation.

How well does it work?

Most people do well. At 1 year, 83 per cent of people who had surgery felt they had improved. That compares with 46 per cent of people who used a shoe insert (orthosis) and 24 per cent of people who simply waited. People who had surgery also had the fewest painful days and the fewest problems with how the foot looked and with shoes. They also had the best foot function and the highest satisfaction.

Across many people, surgery reduced pain and improved quality of life. The biggest gain was in pain, with a smaller gain in how well the foot works.

Remember that results vary from person to person. It isn't clear yet which personal factors predict a better or worse result.

Risks and side effects

Problems are generally uncommon, and most settle without lasting pain or disability. Problems may be a little more common than the published figures suggest, so ask your surgeon about their own results. The general risks of foot surgery are infection (two in 100 people in one hospital's figures), scarring, swelling, numbness and blood clots.

Other things that can happen:

Stiffness: the big toe is often stiff afterwards.
Numbness: you may have less feeling, or none, in the operated toes, and this can last indefinitely.
The bunion coming back: estimates range from about 2 in 100 to about 1 in 10 people. Some people need more treatment, including repeat surgery.
Over-correction: the big toe can drift away from the other toes. This is rare and may need more surgery.

After a fusion, the main specific risk is that the bones don't join (nonunion). After big toe joint fusion, 95.7 per cent of joints joined, taking 83.5 days on average. Overall complications were 5.8 per cent. After a Lapidus fusion, the bones failed to join in 0.7 per cent with one type of plate, 1.4 per cent with another type of plate and 5.3 per cent with screws. How the bones are held seems to matter more than how early you walk on the foot.

If a first operation doesn't work, a repeat operation is possible. After repeat surgery, the bunion came back in 5.1 per cent, bones failed to join in 4.1 per cent and extra procedures were needed in 8.7 per cent.

Afterwards

Recovery is gradual, and your surgeon's plan comes first. Timelines differ between hospitals and operations, especially after fusion, so ask for your own plan and dates.

In general, your toe is held straight in a corrective bandage for about 6 weeks. You wear a flat-soled healing shoe that lets you put your full weight on the foot. Some people move around normally without special shoes within 4 to 6 weeks. Others stop the special shoe at about four weeks and build up activity after six weeks.

In the first 2 weeks, move your ankle up and down and wiggle your toes many times an hour. Between weeks 2 and 6, do these exercises more often.

Return to normal activities depends on your job and your footwear:

Desk work: from about two weeks if you can keep your foot raised, or after six weeks, depending on the work and the shoes you need.
Physically demanding work: about three months.
Sport or gym work: from 12 weeks to six months.

Know who to contact after surgery, including out of hours. Stay off cigarettes until your bones have healed.

When to see a podiatrist

Book an appointment if

Your bunion is painful, getting worse or making shoes hard to wear, and changes to your footwear and other non-surgical care haven't settled it. Your podiatrist can check it and, if surgery is a sensible next step, refer you to an orthopaedic surgeon. Also book if you have circulation problems, diabetes or rheumatoid arthritis, or if you smoke and are thinking about surgery, so these can be looked at before any operation is planned.

Seek prompt assessment if

after bunion surgery you suddenly become short of breath, have chest pain, or cough up blood: call your local emergency number. Also seek help if, after surgery, you have severe pain, a lot of swelling, or a lot of numbness or pins and needles, or if your pain isn't eased by painkillers after three to four days: contact your surgical team or see a doctor today. If you have pain, swelling or warmth in your calf, see your GP or another doctor today, because these can be signs of a blood clot. If your GP can't see you today, go to an urgent care clinic or an after-hours GP. If you can't reach your surgical team out of hours, see an after-hours GP or go to an urgent care clinic.

Frequently asked questions

What can I try before surgery?

Start with changes to your footwear, pain relief medicines and shoe inserts (orthoses). Inserts can ease symptoms for a short time, but they don't correct the bunion. Surgery is the only option that straightens the toe, and it is usually considered after about 3 months or more of this care. Your podiatrist can help you work through these steps.

Why can't the surgeon just shave off the bump?

Removing only the bump doesn't fix the underlying problem, which is the position of the big toe and the long bone behind it. The bunion is then very likely to form again. That is why successful operations realign the bone and rebalance the soft tissues instead.

What should I ask my surgeon?

Ask which operation is planned and why it suits your bunion. Ask what the aftercare involves, including how long you will be in a bandage and special shoe, and when you can return to work and sport. Also ask who to contact if you have a problem after hours.