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Secrets of a Beverly Hills Cosmetic Surgeon

with Robert Kotler, MD, FACS

Dr. Kotler's blog has now been retired. We appreciate all the wisdom and support he has brought to the WebMD community throughout the years.

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Thursday, July 29, 2010

The Folly of Foot Lifts

bare feet

Hemera Technologies

A recent article in the Wall Street Journal‘s Health and Wellness section, “Toe the Line: Doctors Fight Cosmetic Foot Surgery,” covered a new trend and its consequences.

The article, by ace medical writer Melinda Beck, highlights what some foot surgeons are doing to improve the appearance of feet. Yes, cosmetic foot surgery is “the latest.” But, is it the greatest?

Beck reported on foot narrowing and Botox injections to curb sweating. And foot padding whereby fat or fillers are injected into the ball of the foot to replace diminished padding and make the weight bearing, which comes with wearing high stiletto heels, more tolerable to the foot.

There is also toe slimming whereby thickened skin on the pinky toe is removed and the bone may be shaved or straightened and toe shortening, where a bone segment is removed. The opposite is toe lengthening by which a bone is cut and then stretched or fused with an implant as a means of making toes look longer. Next, toe straightening whereby a small section of bone is removed and/or a tendon is cut to correct an angular curled toe, also known as a hammer toe.

Interestingly, the claim was made by “Manhattan-based public relations maven” Peggy Siegal that “every stylish woman I know wants to do this operation and as soon as they can figure out a more efficient way, it will become as common as the nose job.”

As common as our beloved and venerable rhinoplasty? Wow! Well, that really got my attention. I will bet any amount of money that these cosmetic foot surgery procedures will never become as common as the proven, reliable and ever-popular cosmetic nasal surgery.

Now, I will tell you why I think there is going to be a limited run (pardon the pun)  for feet being altered strictly for appearance. First, there are functional consequences. If the surgery doesn’t go well, walking, jumping, running, all become difficult if not impossible. That is a big price to pay for a cosmetic procedure. Contrast that with the nose, where if it doesn’t work out well. it can be either revised surgically or now, as we commonly do, corrected with one-minute office treatments.

As writer Beck said, “The feet are especially delicate with 26 major bones, 30 joints and a complex web of nerves and tendons.” So, there is a big potential for problems. Again, contrasted with rhinoplasty or other accepted cosmetic plastic procedures where malfunction is not generally a consequence of an imperfect result.

The most telling description of the risks involved came from the description of a 2003 survey by the Foot and Ankle Society. Apparently, half of the members reported they had treated patients in pain from failed cosmetic foot surgery. That is way too high a percentage of problems for any cosmetic procedure to become mainstream.

Is having purely cosmetic surgery on a body part — strictly for appearance — worth the downside risk of having, perhaps, a lifetime of misery from pain and malfunction?

Yes, it sounds glamorous. Yes, current shoe fashions certainly show off the feet. But, what happens when styles and therefore shoe construction change — as they certainly will. When Manolo Blahniks are passé? Another round of cosmetic procedures to keep up with the fashion trends?

If so, the reconstructive foot surgeons will be working 24/7 on a group of unhappy, perhaps hobbling patients who will ask themselves: “What was I thinking?”

- Robert Kotler, MD, FACS

Would you consider getting cosmetic surgery on your foot? Share your comments about this post with the Skin and Beauty Community.

Posted by: Robert Kotler, MD, FACS at 1:30 pm

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