Since the ’80s, trends in plastic surgery have spiralled downward. Beginning with facelifts, the focus has moved from breast implants and tummy tucks to butt lifts, sex-organ remodelling and thigh liposuction. But now women are casting a critical eye on their toes. “Feet are the final frontier,” says Dr. Robert Chelin, a podiatrist in Toronto and vice-president of the International Federation of Podiatrists.

The practice of cosmetic foot surgery started about 10 years ago in select clinics in Los Angeles, Miami and New York. Now, the pressure to have younger-looking feet has never been greater, says Dr. Oliver Zong, a Manhattan-based podiatrist whose clinic, NYC FootCare, specializes in foot facelifts and toe tucks. “Everybody wants to wear Manolos or those types of shoes,” he says, “and because the current fashion focus is on shoes, the cosmetic focus has moved there too. I’m so busy right now, I have to book an appointment just to eat my lunch.”

In Canada, however, the trend has yet to be embraced. “The Canadian attitude to foot surgery is that it’s for treating structural pain that causes deformities, not for cosmetic reasons,” says Dr. Mario Turanovic, president of the Canadian Podiatric Medical Association. Ironically, the procedures that Canadian podiatrists are using to treat foot problems are the very same ones that cosmetic foot surgeons are using south of the border to give their clients fashionable foot makeovers. “Our main focus is still on fixing foot problems, and rarely is a procedure strictly for cosmetic reasons,” says Zong. “But now we also try to make everything look as good as possible.”

Get shorty Dubbed “toe
shortening” by cosmetic foot surgeons in the United States, arthroplasty is the surgical procedure that shortens toes — most commonly, the second toe. “The perfect second toe is longer than the first but not by much,” says Turanovic. “When it’s longer than that, the toe hits the end of the shoe and eventually stays bent.”To correct the deformity-and the resulting discomfort — a section of bone is removed from one of the three bones in the toe. The 30-minute procedure can be done in a podiatrist’s office under local anaesthetic. Patients are able to walk home and return to work in a couple of days, but they need to wear supportive surgical shoes for two or three weeks before they can slip back into their usual footwear.

Straight talk Straightening out hammertoes or claw toes is another form of arthroplasty. To fix a toe that is contracted or twisted — the result of genetics or years of wearing ill-fitting shoes — the joint must be surgically remodelled. “You need to remove half of the knuckle that is buckling, and that is usually enough to solve the problem,” says Turanovic. “If the toe is still not completely straight, you may need a splint or pin to keep it in place while it’s healing.”This 45-minute procedure is also performed in a doctor’s office under local anaesthetic and involves the same approach to post-operative care: patients can return to work in a few days but must wear supportive surgical shoes for several weeks.

Photo courtesy of BrownsThe skinny on toes Toe tucks involve slimming down plump or sausage toes. They’re designed to remedy pain in the toes, which is usually caused by friction from high heels or ill-fitting shoes and often accompanied by unsightly corns. Treatment involves removing the scar tissue as well as some skin, explains Chelin. The 25-minute procedure involves a local anaesthetic and requires that patients avoid strenuous activity for two weeks until the stitches are removed.

Slimmer feet Bunion surgery — part of a foot facelift at NYC FootCare — is designed to make feet slimmer and more attractive. A bunion is a deviation of the big-toe joint, which creates a chevron-like shape on the inside of the foot. (A bunionette, or tailor’s bunion, is a deviation of the small-toe joint, creating the same shape on the other side of the foot.) Mild bunions that cause little or no pain are generally treated with orthotic shoe inserts and physiotherapy. If the bunion and pain become severe and start to affect your daily activities, surgery might be necessary. “The procedure involves removing the protruding bump, realigning the joint and correcting its position so that the big toe is pointing forward,” says Turanovic. It can be performed in about an hour in a doctor’s office under local anaesthetic, and the patient can return to work in two to four weeks. Because the bone realignment needs six weeks to heal completely, supportive surgical shoes are usually worn for four weeks after the surgery, and an additional four weeks’ recovery time is needed before the patient can take part in any kind of strenuous physical activity.

Foot plumping For years, collagen has been used to plump up lips and fill in wrinkles. Now it’s being injected into the balls of the feet to ease pain and discomfort caused by aging and to make stilettos more comfortable. “As you age, the body dehydrates and the whole foot pad becomes thinner,” explains Turanovic. “This procedure makes it possible to put cushioning back into the foot.”Collagen lasts between nine and 12 months. “After a year, the body absorbs the product and you have to do it again,” says Chelin. A quick in-office procedure involving local or topical anaesthetic, collagen injections require only a few days off from your fitness routine before you can resume your usual daily activities.

Photo courtesy of Browns