How far will some women go to fit into high heels? The menu of services at Beverly Hills Aesthetic Foot Surgery in Studio City, Calif., provides a clue.

There’s the trademarked “Cinderella Procedure”—a preventive bunion correction that makes feet narrower. The clinic also offers the “Perfect 10! Aesthetic Toe Shortening” that invisibly trims toes that hang over the end of sandals or have to be crushed into tight shoes. There’s also “Foot-Tuck Fat Pad Augmentation,” in which fat from the patient’s abdomen is injected into the balls of her feet to provide extra cushioning for long days on high heels.

“It’s unrealistic to tell women not to wear high heels,” says the clinic’s founder, podiatrist Ali Sadrieh. “I came up with procedures that allow the women to function, pain-free, in the real world.”

The quote, from the Wall Street Journal, outlines a very troubling trend.

Not only have I seen patients who have wanted their toes shortened or wanted a non-painful bunion treated, I have also seen patients who have wanted an entire toe removed so their foot can fit into her shoes. I am being very serious.  Every single one of these patients was hopefully talked out of surgery, but I imagine there is an orthopod or podiatrist willing to do most anything for a price.

Is it me or is this simply insane?

So goes the line, you change your shoe to fit the foot or the foot to fit the shoe — but that always assumed that the foot was painful.

The majority of woman’s shoes are poorly designed.  How many husbands, boyfriends or partners have had to support their spouse as they limped into the car at the end of an evening of wearing a high healed narrow poorly constructed, very expensive piece of leather elevated by a very narrow heel?  Why would you subject yourself to this? There are a few manufacturers out there designing comfortable, attractive shoes, but they don’t have those expensive symbols on them which I guess are worth the pain to some.

Let’s face it, woman (and to be fair, some men) have long sought out the opinion of plastic surgeons to change certain aspects of their appearance. I will not comment on that. But if a breast implant goes wrong, you are a little lopsided. If a liposuction isn’t performed well you might be a little lumpy.

But if something goes wrong with your foot, which you had narrowed to fit a shoe, you will be reminded of it every single step that you take — perhaps for the rest of your life.  Besides, in extreme cases, if you happen to be diabetic or have poor circulation you could potentially lose part of your foot to an amputation.

I rarely like to comment on issues like this since there are very strong views on both sides of cosmetic procedures. But these are not cosmetic in the true sense. These procedures are being performed so that you can fit into a shoe!

Please think long and hard about the downsides of these procedures before considering any foot surgery, other than procedures contemplated to address painful issues which limit your ability to ambulate.

Howard Luks is an orthopedic surgeon who blogs at The Orthopedic Posterous.

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