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Find a Encino Podiatrist at Practice Vladimir Zeetser, DPM on ZocDoc
Aesthetic Foot Surgery   Because everyone deserves beautiful feet!!
Let's face it, image is important and cosmetic surgery is here to stay. With television shows idolizing young hip plastic surgeons and reality shows chronicling patient experiences, it is clear that people are obsessed with beauty and glamour. Beautification of the feet has arrived and now being beautiful from head to toe has a new meaning!

Aesthetic foot surgery can be performed strictly for cosmetic reasons, but the benefit is twofold. Besides an increase in the attractiveness of the foot, function is generally improved and/or restored. Conservative care should be considered, but often is impractical and temporary with aesthetic surgery being the best definitive option. A more innovative and refined approach, using new modifications to time tested procedures coupled with the latest in technology is what sets aesthetic foot surgery apart. This typically leads to quicker and more ambulatory recovery periods, generally improved cosmetic appearance with minimal scarring and minimal pain. All procedures are done on an outpatient basis with the patient going home and usually being able to walk the same day.

Meticulous dissection and incision placement can be learned. An eye for aesthetics and attention to detail cannot. Anyone can claim to perform aesthetic foot surgery, but only few can succeed. Dr. Zeetser is at the forefront of innovative and progressive surgical procedures that can effectively correct a variety of conditions using state of the art implants and the latest techniques.

Cosmetic foot surgery has become much more popular over the past several years and for the best outcome, it is important to be evaluated by a qualified surgeon. Physicians who debunk it do so because they achieve less than optimal results. Don't be a bad cosmetic foot surgery statistic. To obtain an aesthetic and functional result, call Dr. Zeetser for a surgical consultation. Regain your self-confidence!

Note: All surgical procedures anywhere on the body carry some degree of risk and you are encouraged to use all sources available to you to research your condition and treatment options. However, Dr. Zeetser has done everything possible to refine his procedures to avoid the most common complications and pain. Conscious sedation with local anesthesia rather than general or spinal anesthesia removes the majority of the risk. Patient's wake up pain free and feeling as though they had a restful nap and are unlikely to experience headaches, nausea, vomiting or throat pain, common to general anesthesia.

Procedures To Consider:

Advanced Modified Mini-TightRope Bunion Surgery

Aesthetic Toe Shortening

Aesthetic Toe Lengthening

Aesthetic Toe Debulking "Toe-tuck"

Aesthetic Hammertoe Correction

Aesthetic Fifth Toe Correction

Aesthetic Bunion Correction

Plantar Fat Pad Augmentation for High Heeled Shoes

Botox injections for excessive foot sweating

Sclerotherapy for Varicose and Spider veins

Advanced Modified Mini-TightRope Bunion Surgery

The treatment of hallux valgus deformity includes the assessment of the hallux valgus angle, the intermetatarsal angle and the contribution of an interphalageus deformity. Additionally, there must be an assessment of the presence or absence of arthritic involvement of both the first metatarsocuneiform joint and the first metatarsophalangeal joint. Other considerations are the orientation of the distal metatarsal articular angle and the orientation and stability of the first metatarsocuneiform joint.

Various methods have been described to correct the intermetatarsal angle. Soft tissue correction can be achieved by suturing the lateral capsule of the first metatarsal to the medial capsule of the second metatarsal, incorporating the intervening, previously released adductor tendon. A loss of reduction can occur due to the forces that oppose the suture repair as well as the possibility that poor tissue quality can contribute to a loss of reduction.

In the presence of more rigid deformities the intermetatarsal angle is reduced by using a distal or proximal osteotomy of the first metatarsal. Such osteotomies can be tec hnically challenging. A rather daunting list of consequences and potential complications include delayed union, malunion, nonunion, excessive shortening of the first metatarsal, avascular necrosis, hardware failure and prolonged protected ambulation.

The Mini TightRope is useful as an alternative and adjunct method for reduction of the intermetatarsal angle. A FiberWire® and button construct is placed across (distally or proximally) the first and second metatarsals. As the FiberWire is tightened, the intermetatarsal angle is reduced to a normal angle (less than 9-11°) The suture tied over the lateral button maintains a secure reduction of the intermetatarsal angle. Used alone or in conjunction with the distal soft tissue intermetatarsal repair, this technique affords a greater degree of strength and security than can be achieved with the soft tissue repair alone. Additionally, the Mini TightRope System provides a more technically straightforward method of reducing and maintaining the intermetatarsal angle than with conventional osteotomies while avoiding the complications associated with osteotomies.

Aesthetic Toe Shortening

Excessively long lesser toes are a relatively common deformity and typically pose a cosmetic concern for women more often than men. Commonly referred to as "raptor toe", when the toe hangs off the edge of an open toed shoe, the most prevalent of excessively long toes 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 the tip-toe 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. Imagine being ridiculed in school as a teen-ager or being embarrassed to wear open toed sandals. Young females typically become very self-conscious about their feet and tend to shy from social activities that would expose them. But far 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 microtrauma 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 weightbearing 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 fungal infection. 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.

Fortunately, all hope is not lost. Dr. Zeetser is at the forefront of innovative and progressive surgical procedures that can effectively correct this condition using state of art digital implants which usually do need to be removed. Generally the procedure is performed at the level of the toe, but occasionally depending on other structural factors, a more extensive procedure may be required. This is evaluated on a case by case basis. With little to no visible scarring and minimal to no pain, the procedure can be done in an outpatient setting and the patient is ambulatory immediately after. Recovery times are much shorter which let you get active and back into shoes faster. In contrast, the older traditional ways of performing the procedure involve the use of a metal wire protruding from the tip of toe for at least 4 weeks. Not only does this prevent the patient from being able to properly bathe for a prolonged period of time, but there are issues associated with the wires including increased risk of infection, damage to the externally protruding wires by accident and the need to later remove the wires.

Aesthetic Toe Lengthening

Isolated short toes can be a problem which is aesthetically displeasing and lead to many similar social and functional issues as with excessively long toes. The cause of the condition can be congenital or acquired. Depending on the cause, a procedure can now be performed to improve the aesthetic appearance of the toe and restore its length.

Because no two feet are alike, each patient deserves individualized attention and a procedure geared towards their specific situation and goals may be proposed.

Aesthetic Toe Debulking "Toe-tuck"

As with all aesthetic procedures, they are merely refinements of time tested techniques. Hammertoe corrections can be performed with the intention of eliminating pain, reducing deformity or preventing future complications. Often times, with this goal in mind, the result is less than aesthetic with bunched up skin and folds, leaving the toe looking thick and stubby. Patients are usually told that this skin will contract and resorb with time, which may or may not occur over years. Disregard for aesthetics and lack of attention to detail is the real cause. This is what differentiates the average surgeon from an aesthetic foot surgeon.

Because no two feet are alike, each patient deserves individualized attention and a procedure geared towards their specific situation and goals may be proposed.

Aesthetic Hammertoe Correction

Hammertoes and their related deformities are unsightly contractures of the joints of the lesser toes, and occasionally the great toe as well. They typically occur from muscle and ligament imbalance and typically worsen from neglect. Besides being unpleasant to look at and causing difficulty with fitting into stylish shoes, these deformities tend to be progressive with time and lead to further disfigurement of the foot and suffering. Often times, they result in dislocation of the metatarsophalangeal joint (where the ball of foot meets the base of the toe) with crossover toe deformity. Furthermore, excessive hammertoe contractures cause excessive pressure on the plantar aspect of the ball of the foot, causing additional complications and pain. Besides the structural problems and inflammation that they can cause, hammertoes typically produce painful and unsightly bursal sacs, corns and calluses at the affected joints. Conservative treatment is an option, but usually minimally successful. Early correction can be as simple a soft tissue release, however more advanced deformities typically require more advanced procedures which will be discussed in detail during the surgical consultation. The key is to create a pain-free, functional and aesthetic result rather than a floppy, fat and stubby toe as is commonly the case. Dr. Zeetser has been one successfully correcting these unsightly deformities with implants that are hidden within the toe and do not require later removal, unlike the case with percutaenous wires or pins protruding from the tip of the toe. Infection risk is reduced and the result is instant stability of the toe. Incision scars can be minimal to none.

Don't continue to live with hammertoes. Comfortably fitting into your favorite shoes doesn't have to be a memory. Reclaim your life and have beautiful, functional toes again!

Because no two feet are alike, each patient deserves individualized attention and a procedure geared towards their specific situation and goals may be proposed.

Aesthetic Fifth Toe Correction

The fifth or baby toe have a variety of deformities that are not only cosmetically unattractive, but can be a major source of discomfort and shoe fitting problems. Because it can get the most pressure and rubs directly inside shoes or sandal straps more than any other toe, the fifth toe can be one's sole source of foot problems and is termed "the tyranny of the little toe." Besides being unsightly, there is also often redness, bursitis, pain and thick corns. Destruction of the nail and fungal infection can occur. Often the toe is curved and underlapping the fourth toe with the nail directed to the outside, rather than upwards. Surgically correcting this deformity with a derotation of the toe can successfully improve the appearance and position of the toe. When the toe is rigidly contracted with a sharp bone spur or inflamed bursal sac, the toe becomes fat, painful and interferes with shoe wear. Aesthetic correction of toe can be performed to reduce the deformity and relieve the symptoms.

Because no two feet are alike, each patient deserves individualized attention and a procedure geared towards their specific situation and goals may be proposed.

Aesthetic Bunion Correction

These are not merely unsightly bumps on the side of the foot. Bunions are the quiet joint killers. Although typically painful with redness and inflammation, this condition can have no symptoms for many years. During this time, the damage is being done as one of the most important joints in the foot becomes deteriorated and worn away. The cartilaginous joint surface that you are born with cannot be effectively replaced and technology to achieve this is still some time away. In the meantime, the cartilage is progressively eroded as the deformity continues to grow and pain usually follows. However, often the most disturbing aspect of this problem is the aesthetic appearance of the foot and inability to wear the desired shoes. Conservative treatment often includes wearing silicone bunion shields, wide unfashionable shoes and occasionally injections of anti-inflammatory medication. Unfortunately, since this is a fixed structural deformity, conservative care can only go so far and surgery is generally recommended. Most bunions become painful and irritate the foot inside shoes at some point and being proactive at preventing further deterioration is usually the best decision. When taking this into consideration, an aesthetic result is of major importance. Conventional bunion surgery has been performed for decades. Previously, little attention has been focused on the cosmetic result, consideration for the patient's ease of recovery and post-operative pain. Using the state of art in fixation, aesthetic incision placement and modifications of time tested surgical techniques, Dr. Zeetser has been successfully performing these procedures and changing people's lives one foot at a time. Patient's typically can ambulate the same day. All fixation is hidden and does not usually need to be removed. Gone are the days of railroad track incision scars on the top of the big toe joint, having wires or pins protruding through the skin. Casts are almost never necessary and pain is minimal to none. Contrary to popular belief and what people may tell you, bunion surgery does not have to be painful and debilitating. Compare your result to the typical bunion surgery horror story!

Plantar Fat Pad Augmentation for High Heeled Shoes

With time and age, the fat pad on the bottom of our feet begins to atrophy, losing its thickness and resilience. This is termed "plantar fat pad atrophy." It is a normal, albeit unfortunate, aging process and can contribute to considerable pain and deformity on the bottom of the foot.

Sadly, stylish and trendy womens shoes don't always take their wearer into consideration. Because many people are slaves to fashion and will sacrifice comfort and their feet for the sake of looking good in the short term, accelerated damage is done to balls of the feet. Occasionally, fractures and soft tissue injuries occur, but most of the time it is just pain at the ball of the foot from loss of natural padding and/or the shift in this padding coupled with the increased pressure placed on the metatarsal heads from high heeled shoes.

Treatment of this painful condition is performed with the use of collagen and other plastic surgery DermaFillers which can be safely injected into the areas of pain under local anesthesia without incisions. Relief can be obtained for 6-12 months depending on the specific product used. Although conservative options are available such as custom orthotics with metatarsal pads, these are impractical for extremely stylish shoes. If you must wear Jimmy Choo, Christian Louboutin and Manolo Blahnik, to name a few, you may be a candidate for this innovative procedure.

Botox injections for excessive foot sweating

Excessive sweating (hyperhidrosis) of the plantar aspect of the feet is a common problem affected many people. Besides being an uncomfortable hygienic condition, contributing to fungal infection and Athlete's foot, it can be an equally embarrassing problem creating social and psychological concerns. Botox injections for the bottom of the feet is a relatively new concept, but conforms well to the general increased awareness for aesthetic and hygienic concerns affecting daily life. Previously used safely in the foot for the treatment of spastic muscular conditions, such as in the Achilles tendon for spastic Cerebral palsy, Botox (botulinum toxin type A) has been used by plastic and aesthetic physicians for many years. In 2004, the FDA approved Botox for the treatment of excessive sweating. When topical antiperspirants and other drying agents are ineffective, Botox has been used as a safe and effective method for the treatment of excessive sweating in the bottom of the feet. Its mechanism of action is to temporarily block the secretion of the chemical responsible for activating sweat glands and thus interrupts sweating at the area where is has been injected.

Dr. Zeetser can administer these injections in the office following a local anesthetic injection to numb the bottom of the foot. Many other physicians performing this procedure rely on topical creams or ice to numb the area, which is not sufficiently effective on the foot. The procedure is relatively quick and painless once anesthesia has been achieved. After the procedure, there is no significant restriction to activities. Mild temporary bruising and tenderness can occur. Nothing can completely cure hyperhidrosis and this procedure is designed to control the condition. Sweating may return gradually on average within 6 months. Further injections may be required to maintain the desired effect at intervals varying between 7-16 months, depending on the individual patient.

Sclerotherapy for Varicose and Spider veins

Spider veins (known as telangiectasias) in the lower extremities are the result of varicose veins with leaky or incompetent valves. Patients generally suffer from venous insufficiency and can experience heaviness and swelling of the legs, ankles and feet. This condition can be hereditary or activity related. Jobs or activities requiring prolonged periods of standing or sitting in one place contribute to the condition. Left untreated, they can lead to permanent dark brown discoloration of the skin and ultimately venous stasis ulcerations.

In the short term, this condition results in the creation of superficial blue colored spider veins that often create unsightly patches on the lower legs, ankles and feet. Other than wearing compression stockings at all times, very little can be done to permanently prevent these unsightly veins from arising. Depending on the location and the specific person, their presence can erode self-confidence and affect one's self-image. Often, young women will be embarrassed to wear shorts or skirts.

Many treatments are available for this condition including laser, radiofrequency and injections. Lasers have not provided optimal results and can be painful. Previously saline injections were used which were not greatly effective and could cause superficial wounds. Dr. Zeetser has been using a type of sclerotherapy which is generally accepted to be the most safe and effective available today. The procedure is virtually painless. The amount of treatments necessary and the results depend on the individual and the size of the area affected, however improvement is typically seen relatively quickly. The specific details of the treatment will be discussed during your consultation.

Don't be embarrassed by those unsightly spider veins any longer.



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