Aesthetic Toe-Shortening Surgery

Excessively long lesser toes are a relatively common deformity and typically pose a cosmetic concern for women more often than men.

Most commonly, the longest toe that hangs off the edge of an open toed shoe is the 2nd digit, which is adjacent to the big toe. Normally, the big toe is roughly equal in the length to the 2nd and possibly 3rd, followed by the 4th and 5th to create what is known as a parabola. A small percentage of the population suffers from a disruption of this parabola leading to this unsightly condition, as well as shoe fitting problems.

The aesthetic appearance of the toe often leads to its own array of psychological and social issues. Aside from being simply a cosmetically displeasing deformity, this condition can result in further deformity and deterioration of the toe. Because the longest toe suffers from repetitive micro-trauma in closed shoes, the most common result is a hammertoe contracture of the toe and bending of the tip of the toe with most of the weight-bearing occurring at the tip rather than the fatty bottom of the toe.

As a result, the nail suffers constant damage and often becomes darkened and thickened from possible fungal infection or micro-trauma. The joints on the dorsum (top) of the toe typically rub and become irritated from the top of the shoe, causing unsightly corns, blisters, scarring, pain and occasionally open wounds. There is no practical or long term method to manage this problem without surgery, especially if shoe fashion is a priority.