Hand Surgery at Cathedral Dermatology
At Cathedral Dermatology, our Consultant Plastic Surgeons provide surgical treatment for a range of common hand conditions, including trigger finger, carpal tunnel syndrome and Dupuytren’s contracture.
Our approach is focused on understanding how your condition is affecting you, assessing your symptoms carefully and recommending treatment based on your individual circumstances. Where surgery is appropriate, our procedures are performed under local anaesthetic as a day case, allowing you to return home following your treatment.
Following surgery, you will receive personalised holistic aftercare advice to support wound healing, movement and recovery, through our experienced multi-disciplinary team, supporting you from initial consultation to full recovery. You may also be referred to our hand physiotherapy team.
Meet Our
Plastic Surgeons
With decades of combined expertise and national recognition for excellence, they welcome patients from across Ireland, offering safe, effective, and individually tailored treatment plans.
Mr Michael McBride, FRCS (Plast)
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Mr Michael McBride completed his medical studies at Queen’s University Belfast. His early surgical training took place in Northern Ireland and subsequent advanced specialist training / Fellowships in Plastic, Reconstructive and Aesthetic surgery across several UK, European and International centres. These included Belfast, Glasgow, Salisbury, Southampton, Newcastle, London, Hull, Paris, Barcelona, Zurich, Helsinki, Florence, Pakistan and India. During this period, he completed the only nationally awarded fellowship (BAAPS / BAPRAS) in Aesthetic Surgery and Medicine. He has been comprehensively trained across the breadth of Plastic Surgery including many advanced, innovative techniques.
Mr McBride is a fellow of the Royal College of Surgeons of Edinburgh, fully licensed with the General Medical Council (GMC 7140624) and fully accredited on the Specialist Register for Plastic Surgery. He is a full time Consultant Plastic Surgeon in Belfast and Dublin.
His specialist interests are in aesthetic surgery, lower limb reconstruction, hands, peripheral nerve surgery, facial palsy and head and neck reconstruction.
His academic achievements include the completion of 6 post-graduate degrees with distinction – Surgical Sciences (Royal College Surgeons of Edinburgh), Reconstructive Microsurgery (The European School of Microsurgery, Barcelona), The European Board of Hand Surgery Diploma, Diploma in Orthopaedic Oncology, European Board of Plastic, Reconstructive and Aesthetic Surgery Diploma (EBOPRAS) and European Board of Facial Plastic and Reconstructive Surgery (EBCFPRS).
He has published extensively in the peer-reviewed Plastic Surgery literature, in addition to presenting his work both nationally and internationally, receiving prizes for these. He is actively involved in teaching both at undergraduate and postgraduate level and is a member of 9 learned Plastic Surgery societies.
He is dedicated to providing the highest possible standard of care, outcomes and safety to every cosmetic and reconstructive surgery patient under his care.
Mr Nicholas Hodgins, FRCS (Plast)
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Mr Nicholas Hodgins FRCS (Plast) is a fully accredited UK Consultant Plastic Surgeon with extensive expertise in reconstructive and aesthetic plastic surgery. He is a substantive NHS consultant with a subspecialist interest in reconstructive breast surgery. He is also a Board Certified Cosmetic Surgeon by the Royal College of Surgeons.
Mr Hodgins completed his medical degree at the University of Newcastle Upon Tyne in 2009 and commenced his surgical training in 2011. In 2015, he entered the Specialist Higher Surgical Training Programme in Plastic Surgery, gaining comprehensive experience in renowned plastic surgery centres across the UK, including Newcastle Upon Tyne, Durham, Manchester, Middlesbrough, and Belfast.
On completion of his plastic surgery training, he was nationally appointed to an oncoplastic breast surgery fellowship at the prestigious Nightingale Breast Centre in Manchester. There, he received subspecialist training in all aspects of oncological, reconstructive, and aesthetic breast surgery.
Following this period of specialist training, Mr Hodgins was awarded the Niall Kirkpatrick Fellowship in Aesthetic Surgery by the British Association of Aesthetic Plastic Surgeons (BAAPS). During this dedicated period of subspecialist practice, he honed his skills in a wide range of cosmetic surgeries, including breast, abdominal, facial, and eyelid procedures, under the mentorship of UK leaders in this field.
Mr Hodgins is a member of several professional organisations, including the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), the British Association of Aesthetic Plastic Surgeons (BAAPS), the Royal College of Surgeons of England (RCS), the Association of Breast Surgeons (ABS) and the International Society of Aesthetic Plastic Surgeons (ISAPS).
Mr Hodgins is well known for his professional and warm manner. He continually strives to achieve optimum aesthetic surgical outcomes for his patients as he finds this to be one of the most satisfying parts of being a doctor and plastic surgeon. Your safety and comfort are his top priorities. He will provide you with bespoke care centred around your individual needs and expectations and will guide you along each step of your treatment journey.
Jamie Clements MB BCh BAO(Hons) MRes FRCS(Plast)
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Our team of Consultant Plastic Surgeons hold a range of leading professional memberships and accreditations, including:
- Board-Certified Plastic Surgeons with the Royal College of Surgeons of England
- Full Members of the British Association of Aesthetic Plastic Surgeons (BAAPS)
- International Members of the International Society of Aesthetic Plastic Surgery (ISAPS)
Why Choose Cathedral Dermatology?
Patient-Centred Care
We believe every patient is unique. From your first consultation to recovery, we prioritise your personal goals, health, and comfort.
Nationally Awarded Surgeons
Our surgeons have been recognised with prestigious national awards for their outstanding contributions to plastic and reconstructive surgery.
20+ Years of Experience
With thousands of successful procedures completed, our surgeons bring unmatched expertise and surgical precision.
Collaborative Dermatology + Surgery Approach
By working side by side with our dermatology team, we provide holistic care that addresses both medical and cosmetic needs.
Conditions We Treat
Trigger Finger
Trigger finger is a condition affecting one or more fingers or the thumb, where movement can become painful, stiff or restricted. The affected digit may click or catch as it bends and straightens, and in some cases it can become stuck in a bent position.
The condition develops when a flexor tendon, which helps bend the finger or thumb, does not glide smoothly through the surrounding pulley system. Thickening or swelling around the tendon and its surrounding structures can make movement more difficult, resulting in the characteristic catching or locking sensation.
Symptoms can include:
- Pain or tenderness at the base of the finger or thumb, usually on the palm side, with a small lump or tender area in the palm
- Clicking or catching on clothes when moving the affected finger or thumb
- Stiffness, particularly when first waking in the morning
- Difficulty fully straightening the affected digit, or the finger or thumb becoming locked in a bent position
Trigger finger can sometimes improve without surgery. Depending on the severity and duration of symptoms, non-surgical treatments may include modifying activities, splinting or a corticosteroid injection.
Where symptoms persist, significantly interfere with everyday activities or the finger becomes locked, surgery may be considered.
Trigger Finger Release
Trigger finger release is a procedure designed to allow the affected tendon to move more freely.
During the operation, your surgeon makes a small incision in the palm near the base of the affected finger or thumb. The tight part of the tendon pulley system responsible for restricting the tendon is carefully released. This creates more space for the tendon to glide normally during movement.
The procedure is performed under local anaesthetic as a day case at Cathedral Dermatology. You remain awake during the procedure, but the area being treated is numbed so that you should not feel pain during the operation.
As with any operation, trigger finger release carries potential risks. These can include bleeding, infection, scar tenderness, stiffness, persistent symptoms and, less commonly, injury to a nerve, tendon or blood vessel. There is also a small risk of developing complex regional pain syndrome or the triggering persisting or recurring following surgery.Â
Your individual risks and expected recovery will be discussed with you during your consultation.
Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when the median nerve, which passes through a narrow space in the wrist called the carpal tunnel, becomes irritated secondary to compression.
The median nerve provides sensation to parts of the hand and also contributes to movement of the thumb. Pressure on the nerve can therefore cause symptoms affecting the hand and fingers.
Common symptoms include:
- Numbness or tingling in the hand or fingers
- Pins and needles, particularly in the thumb, index and middle fingers
- Pain or discomfort in the hand or wrist
- Symptoms that may be worse at night
- Weakness or difficulty with gripping
- A tendency to drop objects
- In more established cases, reduced sensation or weakness affecting the hand
Symptoms can vary from person to person and may develop gradually.
Your surgeon will assess your symptoms and medical history to determine whether carpal tunnel syndrome is likely and whether surgery is appropriate. Depending on the severity of the condition, treatment options may include non-surgical measures such as wrist splinting or injections. Surgery may be considered when symptoms are persistent, significant or have not responded adequately to other treatments.
Carpal Tunnel Decompression
The Procedure
Surgery to release the ligament in the wrist, creating more space and relieving pressure on the median nerve.
Local Anaesthetic Day Case
Performed under local anaesthetic, allowing the procedure to be carried out as a day case.
Recovery & Aftercare
Soreness and swelling are expected after surgery. Elevating the hand and gently moving the fingers can help with recovery.
Dupuytren’s Contracture
Dupuytren’s contracture, also known as Dupuytren’s disease, is a condition affecting the connective tissue beneath the skin of the palm and fingers.
The tissue can gradually become thickened and develop into cords or bands. As these tighten, they can pull one or more fingers towards the palm and make it increasingly difficult to straighten them.
Dupuytren’s disease often develops gradually and is not necessarily painful. It can initially appear as a lump, thickened area, ridge or dimple in the palm.
Over time, however, contraction of the affected tissue can interfere with hand function. You may notice that you can no longer place your hand flat on a table or that activities such as washing, putting on gloves or placing your hand into a pocket become more difficult.
Not everyone with Dupuytren’s disease requires treatment. Surgery may be considered when the contracture is affecting hand function or the ability to straighten the affected finger or fingers.
Dupuytren’s Fasciectomy
A Dupuytren’s fasciectomy is a surgical procedure to remove affected thickened tissue from the palm and/or fingers.
At Cathedral Dermatology, treatment can be tailored according to the area and extent of the Dupuytren’s disease, with options including:
- Palm Only Fasciectomy
- Single Digit Fasciectomy
- Multiple Digits Fasciectomy
The most appropriate approach will depend on the location and extent of the affected tissue and the degree to which the fingers are contracted.
At Cathedral Dermatology, Dupuytren’s fasciectomy is performed under local anaesthetic as a day case.
During surgery, your surgeon makes carefully planned incisions to access the abnormal thickened tissue. The affected tissue is then removed to release the contracture and improve the ability of the finger or fingers to straighten.
The skin is closed with stitches and the hand is dressed following the procedure.
What Can I Expect After Dupuytren’s Surgery?
Your hand may be swollen, uncomfortable and stiff following surgery. Recovery varies depending on the extent of the disease, the number of fingers treated and the degree of contracture before surgery.
Keeping your hand elevated during the early stages can help reduce swelling. Your surgeon will also advise you on appropriate finger movement and aftercare.
Hand therapy or physiotherapy may form part of your recovery where appropriate. Exercises can help maintain movement and support the best possible functional recovery.
It is important to understand that surgery treats the contracture but does not cure Dupuytren’s disease itself. The condition can recur after treatment, either in the same area or elsewhere in the hand.
Potential complications of Dupuytren’s surgery include bleeding, infection, scarring, stiffness, delayed wound healing, incomplete correction of the contracture and numbness caused by irritation or injury to nerves. There is also a risk of recurrence and, rarely, complex regional pain syndrome.
Your surgeon will discuss these risks with you and explain what they mean in relation to your individual treatment.
Hand Therapy and Recovery
Hand therapy plays an important role in supporting recovery following hand surgery. At Cathedral Dermatology, our dedicated hand therapy service provides personalised assessment and treatment, with a focus on hand surgery recovery and pain management.
Led by Leann Gibson, an Occupational Therapist specialising in hand therapy for 25 years, the service can be provided as a standalone treatment or alongside hand surgery with our Consultant Plastic Surgeons.
Not every patient will require hand therapy, but where it is appropriate, your therapist can assess your individual needs and provide support with movement, function and recovery following treatment. This may include advice and exercises tailored to your condition and stage of recovery.
Our hand therapy service can support patients undergoing treatment for conditions including trigger finger, carpal tunnel syndrome and Dupuytren’s contracture, with the appropriate approach determined following assessment.
Hand Therapy Appointments
New consultation: £150
Review appointment: £125
Your consultation will help determine the most appropriate treatment and support for your individual needs.Â
What to Expect
Comprehensive Consultation
Your journey begins with an in-depth consultation with one of our surgeons to discuss your concerns, medical history, and treatment options.
Personalised Care Plan
Together, we design a tailored treatment plan focused on your goals, safety, and long-term results.
Expert Treatment
Whether reconstructive or cosmetic, all procedures are carried out with the highest levels of precision and care.
Ongoing Support
We remain with you every step of the way — from surgery to recovery — ensuring the best outcomes for your health and confidence.
We’ve put together some helpful information before you book your consultation.
Is hand surgery performed under local anaesthetic?
At Cathedral Dermatology, our hand surgery procedures are performed under local anaesthetic as day-case procedures. This means the area being treated is numbed during surgery and you can return home following your procedure.
Will I need to stay in hospital after hand surgery?
Our hand surgery procedures are performed as day cases, so you should be able to return home after your treatment, provided your clinical team is satisfied that you are ready for discharge.
You will receive specific instructions about arranging transport and caring for your hand following surgery.
How long does it take to recover from hand surgery?
Recovery varies depending on the procedure and the individual patient.
You may experience some pain, swelling, stiffness or tenderness following surgery. Your surgeon will advise you about wound care, movement and when you can gradually return to normal activities.
Some procedures may require a longer recovery period than others, particularly where more than one finger has been treated or where the condition was more advanced.
Will I need hand therapy after hand surgery?
Not every patient will require formal hand therapy, but movement and appropriate exercises can be an important part of recovery.
Your surgeon will advise you about the exercises and aftercare appropriate for your procedure. Where additional therapy is required, this can be incorporated into your personalised recovery plan.
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