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RENÉE LOTH

The agony of the feet

A pair of Christian Louboutins were set out for the client of a personal shopper at Saks Fifth Avenue.Joanne Rathe/Globe staff/file

The invitation to the Manolo Blahnik fall 2014 fashion show in New York.Associated Press

In the ancient Chinese practice of foot binding, the toes of little girls are bent backwards until they break, then tied to the ankle so that they keep breaking as they grow. The idea was to shape the feet into tiny hooflike deformities, so they could fit into the elaborate brocade slippers that were then considered the epitome of fashion. Thank heavens we have moved beyond such barbarism.

Or have we? The latest trend in cosmetic surgery is the so-called Cinderella procedure, whereby fashion-forward women submit to having their feet carved, the better to fit into a pair of Manolo Blahniks. Thanks to new medical-spa specialties described this week in The New York Times, women whose feet are too wide to fit into skinny pumps, or who suffer from the scourge of what is being called “toebesity,” can simply get a foot facelift or toe tuck. “I was so amazed with the result, it was a miracle,” wrote one patient in a testimonial for NYCFootcare in Manhattan. “It looked like they chopped off my old feet and replaced them with new ones.”

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Indeed. Of all the vain, foolish things women do to their bodies to conform to popular notions of beauty — injecting toxins into their brows or fat into their lips, burning or bleaching their skin — going under the knife to fit comfortably into a pair of Christian Louboutins is a step beyond. To get that Carrie Bradshaw look, women are having their toes shortened, their joints sliced, or pads of fat added under the skin. It gives new meaning to the term “killer heels.”

These procedures are not done out of medical necessity, though most of the podiatrists who cater to this clientele also treat corns, bunions, and other common afflictions. Many people suffer from painful conditions that make it difficult to walk even wearing sensible shoes, and the vast majority of corrective foot surgeries fall into this category. But you have to wonder how these few celebrity podiatrists square their willingness to nip and tuck with their medical pledge to do no harm. Rather than catering to patients who demand to fit into shoes that cause them pain, the ethical podiatrist ought to be advising women not to wear such shoes at all.

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In fact, both the American Podiatric Medical Association and the American Osteopathic Association warn against the chronic use of high heels. Anything over two inches bends the toes and shifts a woman’s weight forward so that she compensates by arching her back. That sets in motion a cascade of problems that can include osteoarthritis, torn knee ligaments, plantar fasciitis, and lower back pain. Which is to say nothing of the hurt that comes from spending $3,500 on a be-gemmed pair of stilettos.

The surgeons offering “Cinderella” treatments may have coined a more appropriate brand than they intended. In the original Grimm’s fairy tale, Cinderella’s two wicked stepsisters each cut off a toe or a piece of heel in order to fit into the golden slipper the prince is carrying in search of its true owner. “Cut off your toe,” advises their ambitious mother. “When you are queen you will no longer have to go on foot.” The telltale blood streaming from the sisters’ shoes alerts the prince that his “perfect” brides are lying.

I love a cute shoe as much as the next person. I’m even short enough to benefit from high heels that promise to “boost” my self-esteem. But I don’t think shoes that require elective surgery to fit right are some kind of empowering statement about women’s choices. And yet that is how many women explain why they want their feet sculpted: Glam shoes make them feel more confident.

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The great irony is that most of the unsightly foot problems women are electing to fix surgically occur precisely from wearing ill-fitting shoes. Is it any surprise that bunions, for example, are nine times more common in women than they are in men? Instead of mutilating the body to make it conform to a shoe, how about conforming the shoes to make them fit the body? Centuries after it was first coined, the old aphorism still applies: If the shoe fits, wear it.

If it doesn’t, get another shoe.


Renée Loth's column appears regularly in the Globe.