Thinking about Cosmetic Foot Surgery? Think Again!

Thinking about Cosmetic Foot Surgery? Think Again!

Thinking about Cosmetic Foot Surgery? Think Again!

By Brian Przystawski, D.P.M., F.A.C.F.A.S.

Much attention has been given to cosmetic foot surgery lately in the national news. From local news to network primetime programs, the topic has drawn much attention. But what is all of the controversy about?

Many people tune in to watch "Extreme Makeovers" every week to see ordinary people miraculously transformed through modern plastic surgical procedures. The improvement in physical appearance is usually accompanied by an increase in self-esteem and greater acceptance by family members and friends. We feel good for the recipients of the makeovers as their lives change in very positive ways.

There are many men and women in the United States who undergo plastic surgery procedures for any number of personal reasons. Unfortunately, an alarming trend has emerged in women''s health and fashion to have foot surgery merely to fit their feet into more "fashionable" shoes.

The American Orthopedic Foot and Ankle Society (AOFAS) released a recent official statement on cosmetic foot surgery. Doctors warn consumers that the risks of surgery can far outweigh the benefits. They said that foot surgery should only be performed in the presence of pain or functional limitation. The Society decided to take a stance after recent consumer magazine articles included testimonials from women who had undergone foot surgery so that their feet would look "prettier" and fit better into high-fashion shoes. AOFAS President Glenn B. Pfeffer, M.D., declared, "The public needs to be aware of the risks associated with these procedures."

Studies have shown that many common forefoot deformities including bunions, hammertoes, neuromas, claw toes, corns and bunionettes can be associated with the long-term use of ill-fitting shoes. Therefore, a much better alternative would be to wear better-fitting shoes. It is also possible to alter shoes in ways to reduce stresses on the feet.

Some of the procedures that women are choosing to undergo include shortening of the toes, collagen injections into the fat pad of the foot and narrowing of the feet.


"Patients who have these types of surgical procedures run the risk of suffering complications that could make them unable to walk or wear shoes comfortably," says Dr. Pfeffer. "Complications can include infection, nerve injury, prolonged swelling of a toe and even chronic pain when walking." These potential complications become even more of a concern when surgery is performed on pain-free feet.

A recent online survey of members of the American College of Foot and Ankle Surgeons (ACFAS) revealed that approximately ninety percent of the podiatrists who responded had been asked only "rarely" or "occasionally" by a patient to perform some type of cosmetic foot surgery. At this time it seems that there may be only a few "high-profile" surgeons performing these particular types of procedures for cosmetic purposes.

A search of the Internet did reveal several surgeons - mostly in major cities in California and New York - advertising their cosmetic surgical skills for women desiring to wear more fashionable shoes. Several of the sites even included testimonials from satisfied patients.

The same search also produced a physician who "specializes" in performing reconstructive foot surgery on women who have had cosmetic foot surgery that went awry.

What makes foot surgery so different from other types of surgery? The great majority of patients who undergo foot surgery do so because of some structural problem with the foot that has led to pain unresponsive to conservative, non-surgical treatment options. With constant advances in surgical techniques and procedures, complication rates do remain relatively low and most patients see improvements in function as well as a reduction of the structural deformity. However, the risks as well as the potential for worsening of a deformity, under-correction of a deformity or future recurrence of a deformity reinforce the fact that there are no guarantees as to the final outcome of any foot surgery.

Weight-bearing stresses, shoe gear and functional demands post-operatively can all affect a surgical result. Continuing to wear ill-fitting shoes will most likely lead to a recurrence of the foot deformity, pain or new forefoot problems. Obviously, there will always be "high-fashion" shoes that are simply designed "for the eye" and not the foot. There will be women who choose to wear shoes that just don''t fit their feet. The "price" of wearing these shoes is not always reflected on the sales tag. The forefoot deformities that may result can last much longer than the fashion.

A final word of caution: it is much better to fit the shoe to the foot than to try to change the foot to fit the shoe.

Brian Przystawski, DPM, FACFAS is a podiatrist with offices in Louisville and New Albany. In practice for 14 years, he is board certified in foot surgery by the American Board of Podiatric Surgery and is a Fellow of the American College of Foot and Ankle Surgeons. As a runner and competitor in triathlons, he enjoys an active lifestyle with his wife and two daughters.

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