Cosmetic Foot Surgery
Despite debate in the podiatric community about the appropriateness of surgery for purely cosmetic reasons, it’s being done…and often has legitimate health benefits. Note that most of these procedures are performed on patients suffering some form of pain, even though they are being labeled as cosmetic.
Have you ever gazed longingly at that stylish pair of open-toed shoes, wishing you could wear them without feeling self-conscious about how your toes look? Do you wish you could fit into those fabulous, new high heels without crushing or cramping your toes? Do you want to look your best from head to toe? If you’re interested in putting your best foot forward (pun intended), cosmetic foot surgery may be just the thing for you.
What is the difference between cosmetic foot surgery and conventional reconstructive foot surgery? Cosmetic foot surgery is plastic surgery performed on a healthy, functional foot for the sole purpose of making the foot look better. Reconstructive foot surgery is surgery on a foot that is not functioning properly or that is in pain. There is a large gray area that exists between reconstructive and cosmetic foot surgery.
I was asked a few weeks back to write on this controversial topic. First, you should be aware that foot surgery purely for aesthetic purposes is not recommended by the American Podiatric Medical Association or the American College of Foot and Ankle Surgeons. Most experts in the field agree that it should not be performed purely for cosmetic reasons. Still, within the podiatric and orthopedic community, there is a great deal of debate regarding this topic. It is thought that cosmetic foot surgery is increasing in popularity.
WebMD describes a study presented at the 2004 American Academy of Orthopedic Surgeons annual meeting, in which out of 150 podiatric surgeons surveyed, half reported their patients were requesting cosmetic foot surgery. There are even stories of women having their fifth toe amputated just so they can fit into their Jimmy Choos or Manolos. This is a bit far-fetched, and I have never personally known of such a case. There are only a select few doctors who claim to do pure cosmetic foot surgery. These doctors are generally found in metropolitan areas.
However, after speaking to several of these doctors, I quickly realized that these podiatric surgeons were actually performing surgery on patients who have genuine structural deformities with pain. The critical difference is that the pain only arises while the patient is wearing the stylish shoes that she wants to wear. The patients would in fact, not have considered the expensive, elective procedures, which come with risk factors associated with surgery, if they could wear their fashionable shoes without any pain. The question is, is this truly cosmetic foot surgery? Or is it reconstructive foot surgery that is performed to meet one’s stylish footwear desires?
On his website, Dr. A. Sedireh, a Beverly Hills cosmetic podiatric surgeon, relates, “Foot surgery has always been reserved for those situations where pain is present. This is a valid and important principle to adhere to when you are making a decision to treat a patient.” He then goes on to state that “foot deformities such as bunions, hammertoes, wide feet, and short toes can present with pain. But this is usually the case after many years have passed and the condition has manifested itself with secondary problems. If you have a bunion deformity, and you have no pain, there is a good chance that you will develop pain in the future. As we age, the surface of the joint where the bunion exists is slowly eroded away. When the surface is void of cartilage, degenerative joint disease begins, leading to painful foot conditions. Many doctors [advise] patients to wait until they have pain before they consider surgery. However, these doctors could really be telling their patients to wait until the surface of the joint gets damaged before they take action.” So, is cosmetic foot surgery to be considered a prophylactic treatment to prevent degenerative joint disease? This is a question that should be answered by you and your foot surgeon.
What are the types of procedures that are being done? Here are some common “cosmetic” foot surgery procedures that are being performed. Note that most of these procedures are performed on patients suffering some form of pain, even though they are being labeled as cosmetic.
Cosmetic Bunion Surgery
Bunion surgery removes the painful bump either on top of or on the side of the big toe joint. It is often performed to alleviate pain in the big toe joint and/or to remove an unsightly foot condition. For cosmetic purposes, the incision is usually placed on the side of the foot whenever possible, versus traditional incision placement, which leaves a highly visible scar on top of the foot.
Cosmetic Hammertoe Surgery
This surgical procedure corrects painful contracted toes. It may also remove unsightly corns. Visible scarring may sometimes be minimized by placing the incision in between the toes. This eliminates highly visible scars left by traditional incision placement on the top of the toes.
Cosmetic Tailor’s Bunion Surgery
This surgery removes a painful bump just behind the pinkie toe. Visible scarring is minimized by placing the incision on the side of the foot as opposed to the top of the foot. This is a departure from traditional incision placement.
Cosmetic Toe-Shortening Surgery
This procedure is most often performed on the second toe (next to the big toe), although any toe can be shortened. Like the hammertoe surgery, incisions are many times carefully placed between the toes so visible scarring is minimized.
This surgical procedure makes the pinkie toe slimmer and removes painful, unsightly corns. After this procedure, patients are able to wear stylish shoes comfortably and without pain.
A combination of the above procedures performed to narrow and enhance the appearance of the foot. Often patients will remark that their shoes feel “roomy” and wearing stylish shoes or heels is now a comfortable option.
Cosmetic Nail Surgery
This surgical procedure eliminates painful ingrown toenails and fungal toenails that cause stylish shoes to be uncomfortable.
The approach these procedures use is slightly different from that of traditional foot surgeries. Specifically, during cosmetic foot surgery, extra care is used on the incision planning, and the plastic surgical closure is utilized. Additionally, special suture materials are used that have a low tissue reactivity, to help minimize scarring. During the post-operative course, topical ointments such as Cimeosil, Mederma, or Scarguard can be used to minimize scarring. It is especially important that the patients aggressively ice and elevate their feet for the first four to seven days to decrease swelling, reduce pain, and improve the recovery time.
The question of whether or not to perform cosmetic surgery on a healthy, well-functioning foot is a complex one. Any surgery performed anywhere on the body has inherent risks such as infection, swelling, pain, nerve damage, and poor healing. The risks of cosmetic surgery are increased in the foot compared to other areas of the body because of the mechanics of the foot. The feet have to withstand enormous amounts of pressure even when one is just standing still. Each foot is a complex structure, with 26 bones and more than 30 joints, along with tendons, nerves, and skin that all have to interact to allow one to walk or run with comfort.
The decision to perform cosmetic foot surgery should be made on a case-by-case basis. Call my office today to weigh the risks and benefits of performing any foot surgery and to go over the details of the procedure in depth with you individually.
Overall, cosmetic foot surgery has become more acceptable in dealing with foot conditions that may be unattractive and painful. However, most experts still agree that true cosmetic foot surgery, performed purely for appearances, is not recommended. Be sure to know all the risk factors involved so that you can determine if the benefits outweigh the risks for your foot surgery.