Foot Care of Manhattan Blog

With the popularity of designer shoes on the market, “designer feet” are now being created to fit into our designer shoes. While dozens of cosmetic procedures are performed all over the face and body; are foot procedures part of a growing trend? A New York Times article, was published describing various surgical foot procedures women are undergoing in order to fit into their designer shoes. What are some of these procedures being performed?

One procedure mentioned is the Cinderella procedure, or hallux abducto valgus procedure. This is basically a bunion procedure. A bunion is a structural problem originating from the big toe causing a bony bump or protrusion. They can become red, swollen and painful, as well as unsightly. Once it develops not only may it be painful to walk, but it may also be painful just to put on a shoe. Simply put, the procedure involves cutting the bone and repositioning it into a more aligned position using a screw or other hardware.

Toe shortening: A very long toe may develop into what is known as a hammer toe. Hammer toes can be very painful, and can cause difficulty in walking. Women who wear constricted shoes and high heels are more prone to this deformity. This is when the toes contract and curl. When a hammer toe procedure is performed, a small amount of bone can be removed to reduce the “curling” and straighten the toe. By removing bone, the toe can shorten.

Foot tuck/Fat pad augmentation: As we age, we do unfortunately lose our natural padding or fat in our feet. For some patients, it may actually feel as if they are walking “on their bones.” Injections to temporarily ease symptoms of fat pad atrophy include injectable fillers into the bottom of the feet. Since long term studies of use of these injections in the feet are limited, there are mixed opinions about safety and efficacy. Repeated injections are required since they last for a short duration. Other injections include Botox and Myobloc for sweating.

How radical are these procedures? Typically if a bunion or hammer toe procedure is being performed, the patient was likely developing a structural and /or functional problem inducing pain. In such cases, it is may be more of a medical necessity than a cosmetic one. For many, wearing high heels is necessary, for job-related or other reasons. I can tell a woman to reduce the number of hours in her heels, or wear a lower heel, but the truth she will likely not stop wearing them. (I am also guilty as charged!) Therefore, in such cases, if pain persists, surgery may be the best option.

As long as fashion dictates what we wear on our feet, the surgical trend to fit into them may likely follow. Choosing an experienced surgeon who understands the needs of the individual patient is important. The surgeon should evaluate all aspects of the condition so that he or she may choose the best procedure in obtaining the best possible outcome.