By LISA TOLIN
Associated Press Writer
NEW YORK (AP) _ Deborah Wilton was so embarrassed by her toes, she used to bury her feet in the sand when she lounged at the beach.
"When people would see my feet they'd say, 'Oh, my God, look at your toes!'" says Wilton of Bridgewater, N.J.
Since having surgery in April to shorten her elongated second toes, she says happily, "I am wearing open-toed shoes for the first time in my life."
With nips, tucks and breast enhancements almost routine, foot surgery may be the final frontier for cosmetic makeovers. Podiatrists say a growing number of patients are seeking corrections for unsightly foot problems.
"Nail polish makes your feet look prettier, but there are people with more significant deformities like hammertoes or bunions," says Dr. Stuart Mogul, a podiatric surgeon in Manhattan. "They don't want to wear open-toed shoes or they don't want to go barefoot because they're embarrassed to show their feet."
Mogul has performed 40 cosmetic operations this year, up from five or six last year. One of his more common procedures involves shortening a second toe that protrudes past the first, a condition called Morton's toe.
Some patients want to correct bunions, or bumps caused by a misaligment of the big toe, or straighten a hammertoe, which is bent in a clawlike position.
In Houston, Dr. Sherman Nagler says cosmetic surgeries make up 10 percent of his 200-patient-a-week practice. Five years ago, he says, such procedures were unheard of. He attributes the rise in numbers to advances in surgical techniques, a growing acceptance of plastic surgery and the foot-baring shoes now in fashion.
"The shoes they wear in 'Sex and the City' probably make people more aware of their feet," he says.
Most patients who request cosmetic fixes are women between ages 20 and 40, many of whom have already had plastic surgery on other parts of their bodies, Mogul and Nagler say.
Susan Lindenbaum of Manhattan got the idea to have her bunion removed and hammertoe straightened after years of having good shoes warped.
"I was in the Yves St. Laurent shoe store, and I looked down at this woman's feet and I told her her feet were fabulous," says Lindenbaum. "She said, 'Oh, they weren't. I had the ugliest feet in the world, but I had my bunions done.'"
Costs can vary by region, and cosmetic operations are not covered by insurance. At Mogul's practice in New York, the costs can run from $1,200 for removal of a bone spur to $5,000 to have a bunion removed. In Houston, surgeries can range from $1,000 to $2,500.
The number of cosmetic foot procedures performed in a given year is unknown because plastic surgery groups don't track work done by podiatrists, and podiatry groups frown on cosmetic foot surgeries and don't keep figures on them. The American Podiatric Medical Association and the American College of Foot and Ankle Surgeons both say surgery should be performed only if a patient has pain or limited mobility.
Cosmetic procedures, for the most part, are the same as surgeries for painful foot problems. But with any operation, patients run the risk of post-operative infection, swelling or bleeding.
"Most podiatrists would tell that person that if it's not bothering you, they would recommend not to do surgery," says George Tzamaras, a spokesman for the APMA.
Dr. Stephen Smith of Irvine, Calif., says he turns away at least 50 patients a year who seek cosmetic fixes. "We have some people come in and say, 'My foot is too wide. Can you get rid of my little toe?'" he says.
In Wilton's case, her toes sometimes bled from being crammed into closed shoes. The attractive result of her surgery, she says, was "just a bonus."
Podiatrists say the high heeled-shoes many women strap on may cause, or aggravate, the problems they want corrected. Shoes that are too small, for instance, can worsen hammertoe or bunions.
"People tend to be slaves to fashion," Tzamaras says. "Obviously you're not going to be able to stop people from wearing those types of shoes, but if you can limit the amount of time you spend in those types of shoes, that's the key."
Nagler says cosmetic foot surgery is no different from more common plastic surgery and shouldn't be considered unnecessary.
"Someone who's embarrassed or unwilling to wear an open shoe because their toe is crooked deserves the same respect and concern as someone who has a big bump on their nose" and wants plastic surgery, he says. "I don't find any reason not to straighten a toe that's crooked."
American Podiatric Medical Association: http://www.apma.org/
American College of Foot and Ankle Surgeons: http://www.acfas.org/
EDITOR'S NOTE _ This is Part V of a six-part look at Americans' growing comfort with plastic surgery and other cosmetic treatments.
