Wasn't my experience FWIW. (Mostly commenting so others won't necessarily avoid.)
Just an in-office procedure using some local anesthesia and acid I think. The first time the whole cycle went on for months while I was regularly going to the podiatrist because of a fairly severe foot fracture of the same foot which may or may not have been connected.
This last time--a good 15 years later symmetrically on the other foot--I was pretty much just "Let's do this" after a couple times trying to just cut the toenail.
