For years now, women have been subjected to wearing shoes that aren’t necessarily the best for their feet. History has shown with customs like chinese foot binding, that the well being of a woman’s foot has taken second priority to social norms and beauty.  When I first started practice, I dealt with this contradiction in philosophy.  As a foot surgeon, correcting deformities that cause pain was the basis of my training.  But as time went on, I realized that advising women not to wear high heeled shoes, was unrealistic.  This is because in the modern world, professional or formal attire requires a woman to wear high heeled shoes due to social norms and pressures.  This is unfortunate but true.

Rather than isolate my practice form the realities of what women endure in the professional world, I decided to create a procedure that addresses the problems that women face when wearing high heeled shoes.  One such problem is a wide foot.  Bunions and Tailor’s Bunions (smaller bunion on the outside of the foot) are often the cause of pain and constant grief for women that have to wear these kinds of shoes.

The Cinderella Procedure addresses this issue with a modern, pain free, and short recovery procedure. Like my Aesthetic Bunion Correction, the Cinderella Procedure allows most patients to walk right after the procedure and be ambulatory during the post-operative period. In most cases, patients are able to be back into high heels in 4 weeks. This is a remarkable improvement form the traditional method of correcting this problem that leaves patients non-weightbearing for up to 2 months in some instances!

This procedure was recently highlighted on the CBS show “The Doctors”.  You can watch a clip of the show here: http://www.thedoctorstv.com/main/procedure_list/133

Here is a before and after Xray of the patient from the show demonstrating the procedure at just 13 days post-op!

Cinderella Before Surgery

Cinderella After Surgery

Bunion correction has been around since the beginning of Podiatric Surgery. Traditional techniques however involve long recovery time and are painful and leave the patient with a visible scar instead of the bunion.  In the recent years however, significant innovations by Dr. Sadrieh have advanced this procedure to provide patients with a permanent, easy recovery and beautiful procedure.

Bunions are silent problems, often laying dormant for decades without pain. This is an illusion however, since the mal-alignment of this joint leads to arthritis and wearing of the cartilage of the first metatarsal. This precious coating of cartilage cannot be repaired, so early intervention and preservation of the joint surface is an important part of an advanced progressive practice.

Conservative solutions to this structural problem only buy time and do not lead to a definitive solution. Surgical solutions usually involve difficult recovery periods with immobilization and less than aesthetic results. That’s why I set out to improve on the excellent techniques I was taught by my mentors.  I am proud to offer my patients the Aesthetic Bunion Correction procedure.  With this technique, my patients enjoy a painless, short recovery period that provides them with a beautiful and permanent result. Advanced technology utilizing Titanium Headless Screws and Plastic Surgical skin closure give patients the best results available today.  I redesigned the osteotomy (bone cut) so that the the ground reactive forces (force put on the foot by the ground when you stand or walk) work with the healing of the bone, and in effect assist the bone in the natural healing process.  This is different than the traditional osteotomies that risk dislocation and are opposing the ground reactive forces.

With the Aesthetic Bunion Correction, 80% of the bunions can be fixed with an easy, painless and aesthetically pleasing result.  But not all bunions are the same.  In some cases, the inter-metatarsal angle (IM°) may be so high that a correction at the head of the bone, like The Cinderella Procedure, would not be enough correction to provide the patient with a complete long lasting result.

The TightRope Procedure

In these cases, the surgeon usually has to either fuse the joint at the base of the first metatarsal (the Metatarso-cuneiform Joint) or perform a base osteotomy.  The disadvantage of these procedures is that they require long recovery periods that are non-weight bearing and require casting.  These conditions involve increased risks (infection, delayed or non-union) and usually result in less than optimal results.

That is why I always try to incorporate the newest techniques and technologies into my practice so my patients can expect the most reliable and aesthetically pleasing results.  One of these technologies the Mini TightRope by Arthrex.  This innovative little procedure uses a special suture material called fiberwire to bind the first and second metatarsals together.  Fiberwire is a new material made of a mesh and wire-like material that has a tensile strength far greater than metal. The thin suture material is actually stronger than the bones that it is repositioning.  In effect, we are creating a new permanent ligament that holds the first and second metatarsals together reducing the inter-metatarsal angle.

Combining this procedure with my Aesthetic Bunion Procedure, we are able to achieve reduction of IM angles up to 24° without the use of a cast or non-weight bearing!

Here are the basic steps involved in the Mini TightRope + Aesthetic Bunion Correction.

1. Dissection is carried to the fibular (lateral) sesamoid apparatus where the fibular sesamoidal ligament is resected to allow for repositioning of the sesamoids to the correct position.

2. The medial capsule is incised and the joint is exposed.  At this step the bump is removed and prepared for the next step.

3. The guide wire for the TightRope is placed from medial to lateral.  This is a critical step.  A surgeon who has little experience with the TightRope could attempt to place the guide wire in the correct position with more than one try, thus weakening the 2nd metatarsal and causing a possible fracture.

4. The Mini TightRope is carefully threaded through the guide hole that is drilled over the guide wire.

5. With care, the inter-metatarsal is reduced and the Mini TightRope is tied down and the excess fiberwire is cut out.  The correction is checked and we now move on to perform the Aesthetic Bunion Correction if necessary.

The procedure is simple and reliable and is used in many well respected institutions across the country like UCLA Medical Center.

The innovative combination of the Mini TightRope + the Aesthetic Bunion Correction that I pioneered gives my patients the edge that they need to have their bunions corrected without having a 2 month recovery period in a non-weight bearing cast.

Do you find yourself buying wider shoes to accommodate your bunion? Do you have pain after wearing your high heeled shoes for more than an hour?  The advanced Aesthetic Bunion Correction can provide you with a solution that liberates you from the pain and difficulties of this “Quiet Joint Killer”. Be athletic… Be comfortable… Be bold with your shoes! Ask my staff about a consultation and taking the first step to resolving this unsightly problem.