Make Them Fit, Please!

New York Times—April 22, 2014

When Dr. Ali Sadrieh, a podiatrist, started Evo Advanced Foot Surgery in Beverly Hills, Calif., 13 years ago, he thought it seemed a little vain for women to ask for surgery because their feet hurt wearing fashionable shoes.

“Patients would bring in shoes they dreamed of wearing,” he said over tea recently at the St. Regis New York, where he was staying to see New York patients. “On the surface, it looked shallow. But I came to see she needs these shoes to project confidence, they are part of her outside skin. That’s the real world.”

For Dr. Sadrieh (who was wearing made-to-order Gucci brogues), foot surgery is a fusion of medicine and fairy tale. At his practice, you don’t have a bunionectomy; you have a Cinderella procedure.

“I had never met a patient who asked for a hallux valgus correction with osteotomy and screw fixation,” he said. “So I decided to create a name that captures the result of the procedure, without all the Latin. The point of the Cinderella: being able to put a shoe on that didn’t fit comfortably before.”

He also has coined the Perfect 10! (aesthetic toe-shortening — once administered, he said, to a 17-year-old fashion model, so she could wear the shoes her career demanded); Model T (toe-lengthening); and Foot Tuck, a fat-pad augmentation that he said helps with high heels.

And he is not the only doctor changing the face, as it were, of foot surgery.

Dr. Jonathan T. Deland, chief of the foot and ankle service and attending orthopedic surgeon at the Hospital for Special Surgery, is opposed to even less-radical cosmetic procedures.

“The most important thing about a foot is that is doesn’t hurt you and you can function,” he said. “If we’re just talking about three-and-a-half-inch-heel stilettos that cause pain and if they wear a two-and-a-half-inch heel with no pain, then that’s probably not a good reason to do surgery.”

Dr. Deland is cautious about injections designed to pad the feet. “If there was an injection that really worked and that lasted, a lot of good doctors would be using it, because it’s a common problem,” he said. “The answer is, there is not. The patient should ask, ‘Hey, doctor, can you give me the article or the reference that shows long-term follow-up for that procedure?’ ”

But to Annette Healey, an executive vice president in retail services with CBRE, elective bunion surgery felt like a necessity. “Sneakers never worked for my career,” said Ms. Healey. She had elective bunion surgery in 2011 two days after Christmas, “while everyone was away in St. Barts,” she added, so she “could camouflage it better with Uggs.”

Her orthopedic surgeon, Dr. Craig Radnay, told her that her gait had become increasingly affected by her foot issues and that she was hurting her back.

Ms. Healey said she can now walk 20 miles in fashionable boots. “If you live in New York, your feet are your wheels,” she said. Though she spends 95 percent of her time in chic flats or wedges, she also wears Prada, Manolo and Gucci heels. But there are limits. “Sadly, I will never get my foot into a Christian Louboutin,” she said.

Read the full article on NewYorkTimes.com.

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