WALANT stands for Wide-Awake Local Anaesthetic No Tourniquet surgery. It allows many hand procedures to be performed safely and comfortably without sedation or a tourniquet.
Local anaesthetic mixed with adrenaline numbs the area completely and provides a clear, blood-free field so your surgeon can work precisely while you remain relaxed and awake.
This modern technique supports faster recovery, immediate functional checks during surgery and a calm, patient-centred experience.
Procedure time
Procedure-dependent
Anaesthetic
Local anaesthetic with adrenaline (no sedation)
Recovery
Light hand use the same day; normal daily activity within days
Results
Improved comfort and function as soon as swelling settles; steady progress over several weeks
Local anaesthetic with adrenaline ensures complete numbness without the squeezing discomfort of a tourniquet.
You avoid the risks, side effects and longer recovery associated with traditional anaesthetic.
Being awake allows the surgeon to check tendon movement and joint function in real time for optimal precision.
You can begin gentle movement straight away, reducing stiffness and supporting better long-term hand function.
Procedures take place in a dedicated treatment room, with quick discharge and minimal disruption to your day.
We support you through surgery and beyond
Your consultation takes place in a calm, unhurried setting, where your surgeon will examine your upper limb, discuss the procedure you need and explain how the WALANT technique works.
You’ll be able to ask questions about staying awake during surgery, what you may feel and how recovery will unfold. Then we’ll give you a written outline of your treatment plan and aftercare.
To prepare safely:
You don’t need to fast or do any sedation preparation.
Your procedure takes place in our dedicated outpatient treatment room.
Local anaesthetic mixed with adrenaline is gently injected around the surgical area; this becomes completely numb within minutes. Often we wait for up to 30 mins after the injection before starting the surgery, to allow sufficient time for the adrenaline to take effect, to enable surgery without a tourniquet in a bloodless field.
You remain awake and comfortable, and may be asked to move your fingers during surgery so we can check tendon and joint function immediately.
A light dressing is applied at the end, and you can go home soon afterwards.
Most patients can use their hand lightly on the same day.
Keep the dressing clean and dry until your follow-up appointment, and begin gentle finger movements unless told otherwise.
Mild discomfort is normal and managed with simple pain relief.
We may recommend hand therapy depending on your procedure, supporting flexibility, strength and function as you return to daily activities.
At The Antler Clinic, you’ll be cared for by Consultant Plastic Surgeon Mr David Izadi, whose work combines advanced surgical expertise with the calm, honest approach patients value most.
He has completed hand surgery fellowships at the world famous Pulvertfat Hand Centre and Insitut de la Main, where he has refined his techniques. He is a core member of the Warwickshire Hand Surgery MDT and practices safe, evidence based surgery.
With over two decades of experience in reconstructive, aesthetic, and hand surgery – every plan begins with listening to what matters most to you.
A quick guide to the things most people want to know before and after their procedure.
The local anaesthetic fully numbs the area, so you shouldn’t feel pain during a WALANT procedure. You may feel light pressure or movement, but this is not uncomfortable. Most patients are surprised by how relaxed the experience feels.
Adrenaline gently constricts small blood vessels, creating a clear, blood-free field. This removes the need for a tourniquet, which many people find uncomfortable, and allows your surgeon to work precisely while keeping the hand fully numb.
WALANT is well established, with an excellent safety record supported by international studies. Avoiding sedation reduces anaesthetic risks and helps you recover more quickly after the procedure.
WALANT can be used for many hand operations, including carpal tunnel release, trigger finger release, Dupuytren’s contracture release (including needle fasciotomy), tendon procedures, tendon transfers, nerve transfers, neuroma surgery, ganglion removal, skin lesion excision, hand lump removal, multiple injections for excess palm sweating. Your surgeon will advise the best approach for your needs.
The anaesthetic usually lasts 6 – 10 hours, meaning the area remains comfortable for the rest of the day. As sensation returns, any discomfort can be managed with simple pain relief.
Gentle finger movement typically begins the same day as your WALANT procedure to prevent stiffness. You can get back to most daily activities within a few days, though your surgeon will advise depending on the specific procedure performed.
All surgery carries some risks. With WALANT, these may include bruising, temporary tenderness at the injection site, mild swelling, or sensitivity near the incision. Infection or nerve irritation is uncommon. Your surgeon will carefully explain any risks specific to your operation during the consultation.
It’s normal to feel unsure at first. Many patients find the experience of WALANT far easier than expected, as the room is calm, the team speaks to you throughout and you remain fully numb. You can ask questions or simply relax while the procedure is carried out.
clear and transparent costs
You will receive a clear quotation setting out the cost of your treatment and what is included before you decide whether to proceed.
A new consultation is charged at £200.
Follow-up consultations are charged at £150, unless the appointment forms part of an agreed surgical package or postoperative follow-up pathway.
Consultation fees are payable regardless of whether surgery is subsequently arranged. A consultation provides assessment, advice and discussion of treatment options; it does not guarantee that surgery will be recommended or offered.
Patients are kindly asked to provide at least three working days’ notice if they need to cancel or rearrange an appointment.
Non-attendance, or cancellation with less than three working days’ notice, will incur a fee of £125. This fee reflects the clinical time reserved for the appointment and the difficulty of offering the appointment to another patient at short notice.
For self-pay patients, surgery is usually provided as a fixed-price package. This is intended to give patients clarity and reassurance about the cost of their planned procedure.
Your written quotation will confirm what is included. In most cases, the package price includes:
Hospital fees for the planned procedure
Surgeon’s fee
Anaesthetist’s fee, where applicable
Standard postoperative follow-up appointments relating to the procedure
Routine aftercare directly related to the planned surgery, as specified in your quotation
Package prices are based on the procedure agreed at the time of booking. If the surgical plan changes, if additional procedures are requested, or if further treatment is required outside the agreed package, additional fees may apply.
Self-pay surgical packages usually include a period of cover for the treatment of complications directly related to the procedure. The exact terms, duration and exclusions of this cover are set by the hospital where your surgery is performed.
Depending on the hospital, complication cover may apply for a defined period, which may be 6 or 12 months. Full details will be provided by the relevant hospital before surgery.
Complication cover is not a guarantee that all future treatment, revision surgery or additional procedures will be provided without charge. Cover may not apply to unrelated medical problems, pre-existing conditions, treatment required outside the hospital’s terms, or surgery requested for aesthetic preference rather than a recognised complication.
In an emergency, patients should seek urgent medical attention through the most appropriate service, including NHS emergency care where necessary.
Every effort is made to achieve the best possible outcome, but no surgical procedure can guarantee a specific result, perfect symmetry, invisible scarring or complete satisfaction. Healing, scarring, swelling and final results vary between individuals.
If revision surgery is required because of a complication, eligibility for cover will depend on the hospital’s package terms and the clinical circumstances.
If surgery has been performed to an appropriate clinical standard, but a patient remains dissatisfied with the aesthetic outcome or wishes to pursue further refinement, any revision or additional surgery will usually incur further charges. These may include hospital fees, surgeon’s fees and anaesthetic fees.
Unless specifically included in your written quotation, additional costs may apply for investigations, scans, specialist opinions, extra procedures, further hospital admissions, prescriptions, dressings, garments, travel, accommodation, time off work or treatment unrelated to the planned surgery.
The written quotation and the hospital’s own terms and conditions will take precedence over any general information provided on this website.
Payment terms, deposits, cancellation policies and refund arrangements are determined by the hospital where your procedure is booked. These will be provided to you before surgery.
Surgery can only proceed once all required payments have been received and all relevant consent, preoperative assessment and hospital requirements have been completed.
To help make treatment more affordable, you may choose to spread the cost of your procedure through a personal medical loan with Chrysalis Finance. Subject to eligibility and approval, Chrysalis offers a range of flexible finance options, allowing you to pay for your treatment in manageable monthly instalments rather than a single upfront payment.
The hospitals we work with offer finance options through Chrysalis Finance. Please contact your chosen hospital directly for further information or to discuss any questions.
Mr Izadi is registered with the private medical insurers shown below. Coverage for consultations and treatment is subject to the terms of your policy and insurers approval.
Get in Touch
A consultation at The Antler Clinic is simply a chance to talk – to ask questions, explore your options, and decide what feels right for you.
You’ll leave with clarity, reassurance, and the same calm support that defines everything we do.
