Cinderella Surgery

At her clinic in Park Avenue, New York, podiatrist Dr Suzanne Levine is explaining why more women are having their toes shortened or lengthened to make their feet look prettier. Let me guess. Is it because they a re shallow and self-obsessed? Perfectionists whose quest for beauty extends all the way down, down, down into the darkest corner of an innocent pop sock, where a deformed little morsel of flesh lurks, the sad runt of the toe litter, the final frontier in the war against imperfection?

“Well, it is a brave new world out there in terms of feet,” says Dr Levine.”If nature has given you something you don’t like, you can have it fixed.”

This might involve having your toe cut open, the bone sawn in two, put back together with a screw and
the whole thing sewn back up again. Ir’s a lot of effort, just so your feet are sandal-fresh for the beach or you can squeeze into those designer stilettos. But Cinderella surgery, as it is called, is the next big thing in the world of nip and tuck.

Other popular procedures include the removal of bunions, even though the protrusions are not causing serious pain , and tackling a previously unheard of condition called toe-besity. Those with the opposite problem – not enough fleshy padding in the balls of the feet, which can cause pain when wearing high heels-can have fillers injected.

There are no firm statistics on the rise of aesthetic foot procedures, but they seem to have germinated in the late ’90s, when Carrie Bradshaw in Sex and the City personified female devotion to shoes, teetering around Manhattan in her expensive heels. “The fact is,” said Carrie in one episode, “sometimes it’s really hard to walk in a single woman’s shoes. That ‘s why we need really special ones now and then to make the walk a little more fun.”

Heels or Nothing
The problem is, our feet are not designed for tottering around in killer heels for long periods, but many women choose pain over the comfort of flats every time.

“I don’t do surgery just so women can fit into shoes,” says Dr Levine. I’m helping women stay in heels because they’re going to do it anyway. They come to me and say, ‘My last podiatrist told me to stop wearing heels, but I’m not going to, so what can you do?”‘

What indeed. According to Dr Levine, aesthetic foot procedures are particularly popular with baby boomers who have the time and the inclination to treat themselves and their fading looks as an ongoing restoration project. She sees a lot of women who are trying to hold back the years in more orthodox ways, but are let down by their feet.

“Fashionable clothes and orthopaedic-type shoes? It’s not a good look,” clucks the blonde, white-coated podiatrist , rocking a pair of beige designer heels in her plush office. “My patients say to me, ‘Suzanne, if I have to take off my heels , I’m going to feel my age.’ Psychologically, it’s damaging.”

Fillers for Feet
For many women , it is cripplingly narrow and high shoes that cause the problems in the first place . “The No. 1 reason people come to see me is because they suffer from a burning feeling under the balls of their feet,” says Dr Levine . “They compare it to walking on a pebble or feeling that their feet are on fire.” This is because, as we age, we lose the fat padding on our feet, rather like a worn-down tyre. The added strain of high heels makes this worse. Dr Levine treats tortured soles by plumping them with a filling agent, Sculptra (poly-l-lactic acid), which cosmetic surgeons use to smooth lines and wrinkles on the face.

Once the filler is injected into the ball of the foot, the cushioning effect is “like walking on air”. Dr Levine calls this procedure , which costs between US$500 and US$1,500 (around S$626-S$1,878), Pillows For Your Feet. The filler breaks down over time and the procedure has to be repeated every six to nine months . She says it is especially popular with celebrities who have to walk red carpets and hang around for hours at award ceremonies.

Drop a Shoe Size?
It’s not just older women who are gingerly tiptoeing their way to foot perfection. Younger women are also demanding “extra upholstery” so that they can stay upright in their 5-, 6- and even 7-inch heels.
During her recent stint as guest editor of Woman’s Hour on Radio 4, J.K. Rowling admitted she was one of the millions of women who are passionate about heels. The 1.63m-tall author confessed that she was not a “sensible flats girl “, except when walking the dog. She describes shoes as “the most mythologised and fetishised fashion item of all “.

At his practice in downtown Manhattan, Dr Oliver Zong, who coined the term toe-besity, acknowledges that the lengths to which some women will go in order to fit into desirable shoes is “rather odd”. He recalls a woman who came into his surgery recently, having flown in from Hong Kong, and asked him to reduce her feet from a US size 10 to a size 7.
He declined.

But Dr Zong does do a lot of toe shortening and toe lengthening, and charges US$ 1,750 a toe. “People say they avoid going to the beach or they won’t go near a swimming pool because they hate their feet, and once they’ve had surgery they get back their self-esteem,” he says The latest craze is narrowing wide toenails so women can fit into narrow shoes. “We kill the nail roots on one side or both sides of the nail, either surgically or chemically,” says Dr Zong. This is the same procedure that’s used for ingrowing toenails, he says, and costs only a few hundred dollars. This is often done together with toe tucks. Dr Zong claims many women also suffer from toe-besity and want to slim down their big toes. “We take out the excess fat – it’s actually just a tiny amount – and we might shave down the bone a bit to make it aesthetically pleasing,” he says.

No Going Back
At his clinic in Beverly Hills, podiatrist Dr Ali Sadrieh says it is un realistic to expect women not to wear narrow-toed high heels. His treatments have user-friendly names, such as the Cinderella (which incorporates multiple procedures, including a bunionectomy), the Model T (aesthetic toe lengthening) and the Perfect 10 (aesthetic toe shortening).

CINDERELLAS IN SINGAPORE?
Doctors here say they haven’t seen requests for extreme foot surgery like “toe tucks” and sole plumping . Dr Dutton says toe shortening , for instance, is rare, partly because “most Asian patients are petite and can fit into their shoes”. But he adds: “The problem here is that they may continually force their feet into heels and narrow toe boxes. Over time this results in bunions, a deviation of the toe , and they then seek surgery to correct that.” The problem may recur if patients don’t change their footwear .

Ultimately, there is a trade-off between heels and healthy feet. “I always say that everyone’s feet have a ‘lifespan’,” says Fiona. “Some people have a shorter foot life pan, while others can ‘abuse’ their feet for a longer period because they were born with better foot and muscular structures. Either way, you can prolong your foot’s longevity by wearing good supportive shoes when you don’t need to wear fashionable heels.” Check in regularly with a podiatrist as well.

DANGER AFOOT
Think twice before getting surgery to shimmy into stilettos. “The foot is special because it’s a weight-bearing structure,” says Fiona Hu, chief podiatrist of The Sole Clinic and the president of the Podiatry Association (Singapore). “There’s a greater risk of post surgery complications compared with other parts of the body that don’t bear weight, like your face.”
“Changing the shape of your feet alters their biomechanics,” warns Dr Andrew Quoc Dutton, orthopedic surgeon with SMG (Singapore Medical Group) Orthopaedic Group. Shortening a single toe for instance, can have a domino effect on the rest of your leg, he says. You’ll naturally place more pressure than normal on shortened toes while walking, and the natural alignment of your ankle and knee may also be thrown off-kilter as they accommodate your newly shaped foot. The result? Greater risk of long-term pain and inflammation. “You may need more surgery to correct these things,” he adds.