March 20, 2007 -- Lawanda Moraldo, a reggae hip-hop singer who goes by the stage name Essence, says her feet used to be a source of embarrassment for her.
And as a performer, she says her less-than-pretty feet affected her stage act -- in short, when it came to her stage show, many toe-baring fashions were simply out of reach.
So, Moraldo -- like a growing number of women -- sought out the help of a podiatric surgeon to give her feet a surgical makeover.
She had her toes straightened and corns removed last year, and she says the reward outweighs any potential risks.
"I always said, the day I do my feet is the day I get rich, or where my career starts to pick up," she said. "And as soon as I did my feet, I started getting calls."
Moraldo isn't the only woman who has sought a cosmetic foot procedure for an extra confidence boost. But as the number of women seeking the procedures grows -- along with the number of doctors who offer these surgical tweaks -- many doctors are beginning to question whether some of these procedures are worth the risk.
Giving 'Ugly' Feet a Face-Lift
Stuart Mogul, a podiatric surgeon at Lenox Hill Hospital in New York City, says that a growing number of women are seeking surgical solutions for such cosmetic worries as hammertoes, corns, crooked toes, and toes with erratic or unnatural lengths.
"Sometimes we'll see one toe that's extremely long," he said. "For example, a second toe that is a half-inch longer than the third toe."
"That's a foot that if 10 people looked at it, 9.5 of them would understand the patient's concerns," he said.
For this reason, Mogul says, many of the patients he sees are highly motivated to give their ugly feet a face-lift.
"It's not uncommon that a patient tells me that she is embarrassed to show her feet," Mogul said. "I don't think that is hyperbole -- I think that they don't take their shoes off."
"Often, their emotions are justified. They have deformed feet."
But it seems that far more people are concerned about the appearance of their feet than one might guess. New York City podiatrist Oliver Zong, who performs between 30 and 40 cosmetic foot surgery procedures every month, says cosmetic foot surgery is now the bulk of his practice.
The procedures, he says, vary widely. Women can opt for toe straightening. Or toe shortening. Or even a pinky-toe tuck -- a procedure in which fat is taken out of the toe to make it narrower.
No matter the procedure, Zong says, patients may have to dig pretty deep to foot the bill.
"People will pay anywhere from $2,000 for a toe tuck to $15,000 to $20,000 for a complete foot makeover," Zong said.
Function Over Form
However, the price that patients may pay in the name of beautiful feet could be much higher than money alone.
"People forget that in getting something that looks better, they do run a risk of getting something that feels worse," said Dr. James Brodsky, immediate past president of the American Orthopaedic Foot and Ankle Society and an orthopaedic surgeon at Baylor University Medical Center in Dallas.
"As we say in Texas, 'If it ain't broke, don't fix it.'"
Brodsky describes the foot as a "biomechanical miracle," adding that over the course of a given day, the average person will place hundreds of tons of force on each foot while walking or running.
"One should not take that lightly when changing bone structures," he said.
Even surgeons who perform cosmetic foot procedures say that above everything else, the proper workings of the foot must be preserved or a doctor could do lifelong harm to a patient.
"The foot has to function," Mogul said. "That's the No. 1 thing. The foot has to bear and transfer weight, and it has to last a lifetime."
But Mogul says that there are many situations in which a foot can be operated upon safely, without a negative effect on the foot's function.
And he says that just as important as choosing the proper procedure is choosing the right surgeon. Patients, he says, must do their homework in order to ensure that they trust their feet to a qualified expert.
"They have to be very well-versed in orthopedic podiatry in general," Mogul said. "Now that it's out there, though, many people are raising up their hands and saying, 'I can do that too.'"
As a result, Mogul says, up to 10 percent of his practice is revision work, correcting the mistakes of prior foot surgery.
"If the function of a foot is sacrificed, certainly pain -- and possibly long-term pain -- can be a problem. The patient certainly has to understand, if it is a cosmetic procedure, what the risks are," he said.
Quest for a 'Normal' Foot?
Risks and benefits aside, the attention that doctors now pay to patients' feet will no doubt remain an enigma to some. After all, nobody's perfect -- and what better place to carry a minor aesthetic flaw than your feet?
"It's good to be reminded that surgery never makes anyone normal," Brodsky said. "God or nature makes them normal; surgery makes them different."
Still, as every square inch of our bodies comes under increasing scrutiny, the appeal of beautiful feet may prove to be enough of a motivation to some to make a secret appointment with a podiatric surgeon.
"I would submit this: Is there an industry out there that caters to the aesthetics of feet? Of course," Mogul said. "Some people have said that this is wrong, but we have been doing it for years, and we have some very happy patients."