CosmeticSurgery.com Staff Report
Medically reviewed by Sam Speron, M.D.
When Alisia Burch, 33, a New York City customer service representative looked down at her stylish sandals, the only thing that really struck her eye was three corns and a bunion on her feet. Then, after glancing at those defects, the next thing she saw was her second and third toes – stretching out farther than her big toes -- hanging over the edge of her sandals. It was summer in the City and it seemed like every woman in town was wearing some type of open footwear that revealed most of her feet. But Alisia continued wearing clunky shoes that covered her feet, which she had always considered unattractive.
Things changed when Alisia saw Dr. Oliver Zong, a Manhattan podiatrist and cosmetic foot surgeon, to have the bunions and the corns removed. There, she met another patient who was having stitches removed after some cosmetic surgery to make her feet more attractive.
Says Alisia: “Seeing that patient and how nice her feet looked really gave me some peace of mind about having cosmetic surgery on my own feet.”
Alisia asked about shortening her overlong toes, liked what the surgeon said, and went ahead with the operation on July 9th. She was still on crutches with swollen feet, walking with a cane and doing physical therapy several times a week by the end of July. But most of all, she was looking forward to going back to work and, above all, doing some serious styling around town in some high-class, open footgear.
Saving soles has taken on a whole different meaning with the groundswell interest in all types cosmetic and plastic surgery. While millions of Americans are spending more on cosmetic and plastic surgery, most of the time, effort and money go into face and body procedures.
But a foot “facelift” for better looking feet? And “toe tucks?”
Many women are getting, and often loving, cosmetic improvements on their feet. “Toe cleavage” is now being mentioned in cosmetic surgery hotspots like Florida, New York and California with the same sense of awe and reverence once given to the latest diet.
So what’s involved in cosmetic surgery of the feet? Some are having fat removed, making high heels look better, while others have fat added to the balls of their feet so heels feel better. Still others, like Alicia, don’t like toes that jut out past the big toes. The answer: in some cases: surgically shortening the toes. That’s why Alicia was on crutches – bone was removed from four of her toes. Conversely, some women with stubby toes ask their podiatric surgeons to lengthen the phalanges in a procedure known to doctors as Brachymetatarsia. Others want their wide feet narrowed a size or two so fashionable footwear both look and feel better. Other common cosmetic procedures include correcting hammer toes and even microdermabrasion(related Dermabrasion
), which resurfaces, smoothes and softens the skin on the feet, making the tootsies look more radiant. Other common foot procedures that lead to beauty down below include professionally treating fungal nails, exfoliation with pumice stone, moisturizing and trimming toe nails and getting hooked up with orthotics -- custom-made inserts to support those tired, achy dogs.
Of course, there is a down side. While nobody seems to be keeping an exact tally of the number of foot facelifts, the American Orthopaedic Foot & Ankle Society (AOFAS) surveyed their podiatric surgeon members recently and found 51 percent reporting their patients are asking for cosmetic procedures on feet.
However, AOFAS is against any type cosmetic surgery on the foot, saying the inherent risks can far outweigh the benefits. The yardstick? Well, sorry, Jimmy Choo lovers and fashion buffs, but AOFAS says foot surgery should not be performed in the absence of pain or limits in function of the feet.
Nonetheless, thousands of women are opting for cosmetic surgery enhancements to bring about more attractive feet.
“Cosmetic foot procedures are operations that have been done for many years,” Oliver Zong, M.D., a podiatrist and cosmetic foot surgeon in New York City told CosmeticSurgery.com Moreover, having a short toe lengthened is not purely cosmetic, says to Dr. Zong, because the surrounding toes must take on the weight bearing. Thus, making all the toes the proper length can help alleviate painful symptoms.
The down side of cosmetic surgery of the feet, according to experts, include: Complications like infection, corns, nerve injury, and even chronic pain when walking, according to Sharon Dreeben, M.D. in La Jolla, California, and chair of the AOFAS Public Education Committee.
“Changing the shoe to accommodate the foot is a perfectly acceptable practice,” Dr. Dreeben says. “We discourage changing the foot to fit the shoe.”
With 33 bones and many tendons, foot surgery sounds like serious business indeed. Hammertoe foot surgery straightens the toe after loosening the tendons and realigning the bone structure. Bunion surgery requires the deformation to be excised and the toe repositioned. To shorten an overlong toe, the surgeon removes some of the bone from the second and third joints of the second toe.
High heels can cause bunions, where the big toe points toward the little toe; bunionettes on the ‘pinky toe’ and hammertoes, or curled up toes, which are crooked and don’t lie flat. Not only do those imperfections look bad, left untreated, they can eventually make walking more difficult.
Some podiatrists see cosmetic surgery on feet as a gray area. Peter Smith, M.D., a podiatrist in Long Island, New York, says he would not undertake a toe lengthening –nor shortening – procedure after only one consultation.
“The feet don’t come in alone,” Dr. Smith says. “They are attached to a person who may lack physical pain but feel emotionally bad about some aspect of her feet. That being said, I would still have two or three consultations with the patient, explaining all the risks, perils and possible complications of a cosmetic toe-shortening operation. And then, each time, send her back home to think about it.”
New York City’s Institute Beaute’ offers callus blasting microdermabrasion and gives collagen injections to cushion the foot.
“We travel at least 150,000 miles by foot in our lifetimes,” says Dr. Suzanne Levine, D.P.M., Institute Beaute’ practitioner and author of “Your Feet Don’t Have to Hurt.” Her 90-minutes foot facial – it includes microdermabrasion, nail whitening, a chemical peel and a cream that supposedly stimulates collagen cells in the bottom of the foot -- goes for $250.00
Yet another matter to ponder is payment. While painful conditions can be covered by most health insurances, the patient must pony up for purely cosmetic operations.
One 60-year-old CPA, in Orange County, California, had been wearing high heels daily in the office and then lacing on a pair of dancing shoes for Ballroom Dancing, her weekend hobby. But her work shoes still contained enough leather to hide her feet – which, she says, had two “ugly,” protruding bunions that caused her toes to jam together. She finally had the bunions removed due to both pain and appearance. After the operation sites healed, the accountant started wearing more sandals and strappy shoes. And danced a lot more.
Thus, many foot woes are self-inflicted by fashion footgear. Dr. Zong has noted among his patients a condition he calls “high heel feet,” brought about by wearing spindly, sexy heels day after day.
The trend has been scientifically documented. When Carol Frey, Ph.D., was at the University of Southern California, she heard many patients complaining of foot pains. So Dr. Frey decided to look into their closets with a scientist’s eye to see what type shoes they were wearing. Armed with precise lab measurements of 356 subjects’ true foot size, Dr. Frey then measured the study subjects’ footgear sitting in their closets. Results? 88 percent were wearing shoes smaller than their feet.
However, if you’re a high heel aficionado, there are few things you can do to avoid the painful medical conditions of the feet.
“Choose heels with squared-off, not pointy, toes,” says Dr. Zong. “Or, look for shoes where the toe begins to taper to its point beyond where your toes end within the shoe. That way, your toes can still lie flat.”
And forget the break-in period. Shoes should feel immediately comfortable. Or, consider wearing heels one day and flats the next.
Many more people are complaining about their feet getting wider, possibly because the U.S. population overall is getting heavier and older. So experts say the foot should always be measured every time before selecting a new pair of shoes. Moreover, some flexibility can be gained by wearing lace up shoes.
FootcareMD.com, the consumer website of AOFAS additionally suggests having both feet measured when buying shoes and going with the largest size; buying shoes at the end of the day when your feet are the largest and standing during the fitting process.
And then perhaps no foot facelifts at all will be needed.
So modern life has provided yet another choice: Those little piggies can stay home, go to market or visit the cosmetic surgeon.