‘Cinderella surgery’ for the tootsies
Controversial ‘Cinderella surgery’ is becoming a trend for those tormented by their feet
As Elle Macpherson stretched out by an infinity pool overlooking the ocean, it must have seemed the perfect spot to take an envy-inducing Instagram “footsie” — the sun-lounger selfie beloved by influencers. But after posting the snap, her followers’ attention was focused less on the glittering view and more on her knobbly, 54-year-old feet.
Some remarks were unkind, but plenty of mid-life women, living in sandals in this scorching summer, empathized. After all, it’s hard to escape the effects of time on our feet. Which is perhaps why “footlifts” are a fastgrowing sector of the cosmetic surgery industry.
Jason Hargrave, a consultant podiatric surgeon, is a pioneer of what’s been called “Cinderella surgery.” Procedures include foot slimming via bunion removal, toe shortening (and even lengthening), the shaving of lumps and bumps and separating webbed toes. Other surgeons tackle bulging veins and add fillers to smooth scrawny feet. The effect? An anti-aging foot facelift and a renewed ability to fit into designer shoes.
“Life takes its toll on feet,” says Hargrave, who runs the Cosmetic Foot Surgery in the U.K. Hargrave’s patients include actresses and models, as well as ordinary women tormented by their tootsies. “I get lots of requests to make feet smaller. It’s really difficult for women who love glamorous shoes and are over a size 8. By shortening toes and removing bunions, Cinderella surgery can reduce feet by up to one full size.
“Everyone wants that perfect parabola, with the toes forming a smooth arch. Shoes are usually fitted to the big toe, so women with over-long second and third toes wear shoes that are too small, causing corns, swollen, painful joints and toe deformities.”
The prominent bumps on Macpherson’s insteps, he says “may be an overgrowth of bone above her first metatarsal-cuneiform joint;” such bumps tend to develop in “people with higharched feet” and can be associated with flexible joints; they may indicate underlying osteoarthritis. Alternatively, they might be a lump of soft tissue, called a ganglion, caused when lubricating fluid leaks from a joint.
“It’s very important to have a specialist look at underlying causes before considering surgery.” But shaving down bone takes as little as 15 minutes under local anesthetic, leaving a tiny hidden scar. Patients need to stay off their feet as much as possible for two weeks — “but once healed,” says Hargrave, “they feel much more comfortable in shoes, day to day.”
However, Cinderella surgery is controversial. Some surgeons insist that nobody should have surgery unless they are in pain wearing wide shoes. But, Hargrave says, for some women, their foot phobia takes a severe physical, social and psychological toll. “Some never wear sandals; others won’t go swimming, even on holiday or with their children, ”hesays.
Despite the fairy-tale name, Cinderella surgery is a serious medical intervention, with risks as well as benefits. If you’re considering a foot facelift, there are things to consider about each of the procedures. To shorten long toes, a segment of bone is removed from the joint and an internal metal clip fuses it in the correct position. “This will also prevent a too-long toe becoming a hammer toe,” says Hargrave. Most foot surgery can be done with local anesthetic.
Risks include infection, thickened scars, failure of bone to heal and thrombosis. Toes will be swollen and bruised for at least three months afterward.
Mallet toes are fixed by removing a small piece of bone from one side of the toe joint, which allows the toes to straighten. Three stitches are used, leaving a small scar. Patients can be back at work after two weeks and in the gym after four weeks.
Hammer toes are straightened by fusing the middle joint using an internal clip. It’s similar surgery to toe shortening, with downtime roughly the same.
Sometimes, one or two toes don’t grow properly. Stunted digits can be elongated by using a bone graft from the heel. Recovery takes months and a special boot must be worn for at least six weeks. Afterward, the toe may not be perfectly aligned.
FOOT SLIMMING
Bunions form when the joint of the big toe starts to slide outward, causing the toe to lean toward the others. Bunions can occur on both sides, making feet so broad, patients struggle to find shoes to fit. They can cause pain wearing in shoes and on walking.
Bunions are mostly genetic, but may be made worse by wearing high or tight shoes. “Women are more vulnerable. Three out of four will develop bunions eventually,” says Hargrave. To remove them, the joint is cut and reset in the correct position.
Risks of surgery include infection, poor scars, increased pain and joint stiffness — especially in the big toe. Some patients may require further surgery.
VEIN REMOVAL
“Varicose foot veins can be removed via surgery or by injecting a chemical to close them down,” says Mark Whiteley, a consultant vascular surgeon. However, he says, “up to 20 per cent of women have hidden varicose veins in their legs that affect blood flow.
“If they aren’t treated, foot veins will recur,” he says. “An ultrasound scan of the leg is necessary before surgery.”
FOOT PLUMPING
Feet get bonier with age, especially in women with low body fat, says Whiteley. To “plump” them up, he uses filler made from calcium hydroxylapatite, a substance found naturally in bones. It lasts longer than typical hyaluronic fillers. “When used with local anesthetic, which inflates the area under the skin, the filler floats over the bones for a natural effect,” he says.
DISCOLOURED TOES
Fungal infections can leave toenails thick and yellow. Podiatrist Emma Supple of supplefeet.com recommends Emtrix nail cream instead. “It changes the ph of nails, so the fungus can’t live on them. It thins and softens nails and restores a pretty, youthful, pink colour.”