Going Under the Knife for the Perfect Pair of Heels

Time was, new shoes didn't need an instruction manual. But with daggerlike spikes now reaching a treacherous six inches, some women who dare to wear them are getting a boost.

Welcome to Stiletto Strength. After a 45-minute workout, members of the class at Crunch fitness in New York City practice walking, socializing and dancing in their high-heeled party shoes. Instructor Marie Forleo says the class is designed to help women by strengthening their legs and calves, also working on their posture and confidence so that they feel good when it's time to get into their heels. Call it aerobics on stilts!

Blame this obsession -- in part -- on the high-heel frenzy ignited by Sarah Jessica Parker's character in "Sex in the City." In this summer's fashionista fantasy, "The Devil Wears Prada," the lead character soars to success with the help of some skyscraping shoes by designers like Manolo Blahnik, Jimmy Choo and Chanel. Those big-name shoemakers have made these wobbly towers -- that can start at $500 -- a desirable woman's best friend.

Linda O'Keefe, who wrote a book celebrating shoewear, says what you slip on your feet can transform your soul -- as well as your body. "Not only do you get these tremendously long legs -- and slimmer ankles and calves that look tauter -- but you also get this semblance of an hourglass figure, because your breasts are pushed forward. Your lower back is arched. Your shoulders have to go back," she says. Which is why high-heel shoe shoppers are so devoted. One shopper gushed, "I have these black pointy-toe shoes with these heels, these killer heels. And I can wear them for half a block. And that's it. But for that block I never looked so good. It's the greatest half a block in my life."

But it's a half block that is challenging the laws of gravity. According to Dr. Suzanne Levine, wearing heels more than 2 inches high puts about three times the body weight entirely on the ball of the foot. She jokes that her clients invest more in their shoes than the stock market -- shoes with zero support, a few thin straps, and plenty of pizzazz. She calls them "limousine shoes" -- suitable mostly for those who want to walk only from the car to the restaurant. . "20/20" first spoke with Levine at her posh Park Avenue podiatry practice several years ago.

Going Under the Knife

But just because you can't walk in those shoes is no reason not to wear them. Today more and more women are choosing not to change their shoes but to alter their feet.

"The foot is the new face in 2006," says Levine. She told us the same materials routinely used to erase facial lines are now being injected into the ball of the foot to cushion it so you can wear your heels longer. And that's only one way to help women rise to the occasion. A woman named May Ling Lai told us, "I never would have bought these [shoes] if not for Dr. Levine. My first pair of Manolo Blahniks."

May wasn't kidding. She came to Levine with a crushing problem: Her toes were simply too long to fit into her beloved Manolos. Not to worry. … Levine had a solution. When women come in with toes that are too long, especially if they have corns on the joints, she generally suggests a surgical procedure to cut away the corns -- and some of the bone. "It sounds drastic, but it's not," she reassured us.

Well, you decide. Levine actually slices through the toes and then removes part of the offending bone. She showed us X-rays indicating the toe subsequently shortened to the appropriate length. This is all about results. If Cinderella's wicked stepsisters had met Levine, they could have fit into the glass slipper and married the prince. And by the way, this doctor practices what she preaches.

She wears 3-inch heels around her operating room -- and says she owns some 300 pairs. Now her patients like May can start building up their collections too. Keep in mind, this is not for everyone. You may not want to foot the bill: A thousand dollars to plump up your soles; $3,500 to get your toe-bones trimmed. All to please the fickle fashion gods, who, ironically, are now promoting this fall's essential accessory: flats.

But fashion is not physics: What goes up doesn't always come down quickly. There's always going to be a wedding or some big event, and it's appropriate to wear high heels most of the time, says Crunch fitness instructor Marie Forleo

Even if it takes a knife -- or a class -- to fit in. Says one enthusiastic participant in the Stiletto Strength class, "I want to wear the tallest, hottest, sexiest, spikiest heels there are!"