Cinderella Surgery: What to Know About the Lesser-Known Foot Procedure

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Your feet are made for walking, and all that walking can really add up. Whether you’re struggling with painful bunions or a disfiguring hammertoe, there are solutions to restore your feet to Cinderella proportions. Even life-long, genetic aspects of your feet can be surgically altered to fit better into shoes or relieve pain with Cinderella foot surgery.

But is there really a demand for Cinderella-style foot surgeries?

Back in 2018, the American Podiatric Medical Association conducted a survey on over 1,000 Americans and found that nearly 75% of respondents had some issue with their feet. Those issues ranged from the inconvenient to the downright painful, and plenty of these issues end up having cosmetic consequences that compound the issue and add a layer of self-esteem.

A 2008 study found that more than half of the 500 women surveyed feel embarrassment about their feet “always, frequently or sometimes.”

We spoke with experts who are meeting the demand for cosmetic foot surgery in the U.S. and look forward to what’s next.

Who Performs Cosmetic Foot Surgery?

When you want to make fundamental changes to your feet, you’ll need to know where to go. Despite the use of the word ‘cosmetic,’ foot surgery isn’t typically handled by plastic surgeons.

According to Miami plastic surgeon George Varkarakis, MD, this is primarily due to a separation of care. “It’s not that plastic surgery isn’t possible on the feet,” Dr. Varkarakis explains. “Plastic surgery training and education doesn’t focus that much on the foot outside of reconstructive procedures like wound and scar care.”

New York podiatrist and foot and ankle surgical specialist who coined the term ‘cosmetic foot surgery,’ Stuart Mogul, DPM explains that the foot is also hyperspecialized. “Most cosmetic foot surgery involves correcting deformities that are in the forefoot, and they all involve the bones and joints,” Dr. Mogul says. “Many plastic surgeons are skin or muscle-deep, and joint reconstruction is a different world.”

According to Hollywood, FL podiatrist and foot and ankle surgical specialist Abraham Wagner, DPM, the idea of cosmetic foot surgery takes traditional deformity correction and considers what the end result will look like, too. “A lot of foot surgeries, say to remove a bunion, are being considered in terms of function,” Dr. Wagner explains. “When you come here, to a cosmetic foot surgeon, we’re approaching function in the same way. We want the highest standard of care. But we are bearing the aesthetics in mind.”

Oftentimes, smaller procedures may have some overlap with procedures plastic surgeons perform regularly.

“Procedures outside of wound reconstruction are commonly handled by orthopedic surgeons, but a lot of what they do is exactly the same as what we would do on the hands, like a fat transfer,” Dr. Varkarakis explains. “It’s not out of the realm of possibility that cosmetic surgery for the feet becomes more of a plastic surgeon specialty down the line.”

According to Dr. Mogul, both podiatrists and orthopedic surgeons can specialize in foot and ankle surgery in order to correct painful issues like bunions. “Really, we are trained to correct these deformities for functional reasons,” Dr. Mogul explains. “You realize that same procedure has an aesthetic improvement. That was the springboard for me to specialize in this. These procedures work on painful deformities, and with improvements in incision placement and closure, can have an aesthetic improvement.”

For Dr. Wagner, this also prompts innovation in terms of technique. “At this point we’re talking about minimally invasive techniques to accomplish these outcomes, and that’s a huge plus,” Dr. Wagner says. “So, now not only are we often performing these surgeries in an office surgical suite, under local anesthesia, but patients are able to walk in and out 99% of the time.”

Before and After cosmetic foot surgery, courtesy of Abraham Wagner, DPM.

What is Cinderella Surgery?

You might be imagining a Cinderella surgery will make your foot smaller, slimmer and petite. According to Dr. Mogul, that’s not quite the case.

“I have had patients call up and ask if we can make their foot smaller,” Dr. Mogul says. “And these are things that cannot be done. We can shorten a toe that is jamming and causing a problem, that’s certainly feasible. But as far as slimming the foot or making the foot smaller, that’s all salesmanship.”

The term Cinderella surgery is just a trademark used to describe a few different surgeries that are frequently combined.

“The term Cinderella surgery is really about branding,” Dr. Mogul explains. “It would usually refer to correcting a bunion and a long second toe.”

According to Dr. Wagner, surgeons that offers foot slimming are typically referring to removing some soft tissue. “We can provide some slimming to the foot if we remove the extra soft tissues,” Dr. Wager says. “That’s kind of like a tummy tuck for the foot, and we can do that to the toes as well.”

So, the term Cinderella surgery could encompass several different procedures, including the correction of hammertoes, bunions, and long second toe. It can also be called foot feminization surgery, as the outcome leaves the foot slimmer and slightly smaller than before.

These are not considered to be purely cosmetic issues, as hammertoes and bunions can both grow to be very painful, and a long second toe can cause painful jamming into shoes. They are also relatively common issues to have. 3% of adults in the U.S. are affected by hammertoe, and an astonishing one in three Americans having bunions.

Additionally, Dr. Wagner points out that a large portion of his patients are receiving corrective surgeries. “Revision surgery is more common now than ever,” Dr. Wagner says. “A lot of them have had surgeries 10-15 years ago and have some serious reservations about attempting to correct these issues again.”

Spring, TX podiatrist and foot and ankle surgical specialist, Robert Moore III, DPM explains that there is a deeply emotional side to correcting these issues. “The patient stories are very moving,” Dr. Moore says. “I’ve seen patients that are too embarrassed to go swimming or wear open toed shoes amongst their friends. We are able to give them a new start.”

Dr. Mogul agrees, noting that it’s difficult to view these corrections as entirely cosmetic. “I’ve had patients who have never shown their feet to their own partners of forty years,” Dr. Mogul explains. “So cosmetic surgery is life-changing.”

Cosmetic Foot Surgery Options

Not just anyone is a good candidate for a Cinderella-style cosmetic foot surgery. These are highly specialized surgeries designed to be able to bear your weight as soon as they’re over. For this reason, Dr. Mogul only operates on patients who are experiencing deformities that reduce their quality of life.

“There has to be a deformity, for me,” Dr. Mogul explains. “There’s a threshold of deformity that I will or will not operate on—it can’t just be a desire.”

And just like for any surgery, it’s important for your doctor to know about your health history and if you smoke.

“Things like the presence of osteoporosis are important, because most of these surgeries involving the surgical fracturing of bones,” Dr. Mogul explains. “So, we need to know how they’ll heal.”

Hammertoe Correction

Dr. Moore explains that hammertoe correction is extremely common as part of cosmetic foot surgery. “The most common digital deformity in my profession is the infamous hammertoe,” Dr. Moore III says. “The procedure is quite simple. We make a small bone cut at the affected joint and remove the portion that is causing the toe to lockup. Once that is removed, the toe will straighten naturally, but to ensure it remains straight, we place a pin through the middle.”

Bunion Correction

Predominately genetic deformities, like bunions, can also be surgically altered. “The bump is the head of the first metatarsal,” Dr. Moore explains. “That’s the part that’s unsightly and causes pain.”

When bunions are corrected, the technique used will depend heavily on how bad the deformity is. For smaller bunions, the traditional method of cutting down and removing the bunion is still a viable option.

“For more advanced bunions, we perform what’s called a bone cut, or osteotomy, so that you can slide the head of the metatarsal over,” Dr. Moore says. “That not only removes the bump, but the big toe pulls away from the center and is straightened out.”

Second-Toe Shortening

When it comes to the Cinderella aesthetic, Dr. Mogul explains that it all really started with the advent of cosmetic second-toe shortening. “I developed second-toe shortening because I saw a lot of patients that had long second toes that were jamming into their shoes. That was back in 2009 when cosmetic foot surgery was very much in its infancy.”

Since then, an awful lot has changed.

“It’s a really exciting time to be a foot and ankle surgeon with all the advances in medicine, equipment and fixation devices,” Dr. Moore says.

These changes have made aesthetic improvement a tangible outcome to surgeries that would otherwise only correct the painful aspects of the conditions that patients struggle with. That makes cosmetic improvement to feet more accessible to all kinds of patients.

“It’s important that people know that treatment is available,” Dr. Mogul says. “These treatments work and they can help you achieve an aesthetic improvement.”

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