When patients seek out cosmetic surgery from New York-based Dr. Oliver Zong, they're often looking to remove fat, but not from their bellies or thighs.
Zong is a podiatrist, and one of his specialties is slimming down people's fat toes -- "toe-besity," he calls it.
He's been in practice for about a decade, and when he started, toe reshaping was unheard of.
"When people first started asking, I said 'What?'" said Zong, who is surgical director at NYC FootCare. "We were mostly doing toe shortenings in the begining."
Now, he said, more and more people are zoning in on the smaller details of their feet, like the width of their toes.
For many patients, an odd-looking toe is a source of great embarrassment.
E.R., a patient of Zong's, said he hid his fat right big toe for years.
"I always had issues with it," said E.R., who asked to remain anonymous. "It was one of those things that you're just not comfortable with and try to hide it."
On top of being unattractive, the toe also caused discomfort.
"The bone was pushing the nail up, and the nail curved up a little bit, so it was hitting the shoe," he said.
Three weeks ago, the 37-year-old New Yorker had surgery to shave off some fat and bone. His second toe was also a hammertoe, so Zong shaved down the bone of that toe as well.
There's still a lot of swelling, but E.R. said he already feels better about his foot.
"I already see improvement, and I feel so much more confident now," he said.
Procedures Entirely Elective
This type of surgery is considered entirely elective, so insurance companies will not cover the costs, which can range from a few hundred dollars to a few thousand dollars, depending on how complicated the procedure is.
E.R.'s cost $2,500, but Zong said most of the surgeries are not as complex as his was.
Other podiatrists, however, do not support the idea of cosmetic foot surgery.
"I don't think it's ethical unless you're having pain," said Dr. Hillary Brenner, a podiatric surgeon in New York and a member of the American Podiatric Medical Association.
"You're undergoing risks -- there's the risk of anesthesia, infection, deformity of the toe if the surgery is not done right, a risk of reoccurrence and the risk of surgery in general," Brenner said. "It's trauma to the foot."
The American Podiatric Medical Association says that foot surgery is typically performed for medical reasons.
"Surgical procedures of the foot and ankle are generally performed for relief of pain, restoration of function, and reconstruction of deformities. They may have the additional benefit of improved appearance," the association said in a statement.
Brenner said a number of patients -- mostly women -- have come to her requesting cosmetic surgery. Several women hoped to have their pinky toes removed in order to fit into smaller shoes. She always turns them down, however.
"Why fix something that's not broken?" she said.
But Zong doesn't see the harm in performing cosmetic procedures, as long as they are safe and as long as there is something to fix cosmetically.
"I think it's the same as if you would ask for any kind of cosmetic surgery," he said. "They're very embarrassed by the situation and afterward, they gain self-esteem and feel more confident. Some people have said they're so embarrassed that their boyfriends have never seen their feet."
As soon as the swelling is gone and his toe is healed, E.R. said he isn't going to hide his feet anymore. He plans to ditch his sneakers for a more summer-friendly option.
"My goal is to wear flip-flops," he said.