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Crooked Tootsies Keep Doctors On Their Toes

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This little piggy went to market, this little piggy went to the foot surgeon.

Putting your prettiest foot forward is no longer limited to shaving off calluses and lopping off bunions. Toes also are going under the podiatric knife.

Those second and third toes -- the ones that poke out beyond the big toe, the ones seen by some as embarrassing as a set of jug ears -- are getting shortened. And the fourth and fifth toes, the ones that get mashed and mangled after years of Jimmy Choo-inflicted abuse, are getting straightened.

''Shoes are like jewelry now,'' says Suzanne Levine, a podiatric surgeon at Manhattan's Institute Beauté, who has been shrinking and straightening mostly female toes for the past year and a half. Today's strappy and rhinestone-encrusted sandals are ''far more dramatic, so attention is immediately drawn to the foot.''

Toe shortening, done in an office under local anesthesia, involves cutting a small piece of bone out of the joint and reattaching the tendon. The incision is small and scars are minimized with lasers. Patients are back to the office in a weekend, back jogging in a month, Levine says. What she charges per toe: $1,500 to $2,500. Insurance may cover part or all of the cost.

But the trend toward trimmed toes is eliciting concern among some members of the podiatric community. ''We have a mixed opinion about it,'' says Lloyd Smith, president-elect of the American Podiatric Medical Association. ''It's very hard to do bone surgery on the foot and come out with a result that's highly predictable, aesthetic and functional.''

It's especially problematic when a doctor is operating on a foot purely for cosmetic reasons. ''If you start with a foot that's pain-free and try to straighten it out, you can leave someone with something that's not dramatically better-looking -- and it hurts,'' Smith says. The Newton Centre, Mass.-based podiatrist has performed a couple of the operations, ''but I usually try to talk people out of it.''

Philadelphia podiatrist Bruce Bruskoff has whittled toes for the past several years. Half of the procedures are based on foot vanity rather than foot function.

Patients typically are affluent women. ''I have a very yuppie-type practice,'' says Bruce Zappan, also a Philadelphia podiatrist. ''They're very particular. If one toe is a little longer, they want everything nice and proportional.''

Dianna Lynn, a Denver radio talk-show host, figured out her tootsies were ''not very pretty'' when she was 16, back when one of the popular boys at her high school declared her feet ''one set of ugly dogs.''

So a few years ago Levine cracked open the curled and corn-capped fourth and fifth toes on Lynn's right foot and reshaped them to lie flat. This spring Lynn, 48, plans to get her left foot fixed.

''What drove me to do it was pain, but what made it worthwhile was vanity,'' says Lynn.

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© Copyright 2003 USA TODAY, a division of Gannett Co. Inc.

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