What are Corns?

What are corns, and how do those ugly things get on our toes?  Can’t you just cut them out?

Corns are small calluses that form on top of toes or in between toes.  They are hard, and can be painful when they rub against each other or in shoes.  The calluses can be trimmed down or padded so they don’t hurt as much, but why do they keep coming back?  The cause of these little nuisances is usually deeper than the corn itself.  Corns occur and keep coming back, because there is an underlying deformity to the toe that it is on.  

A hammertoe is the number one cause of how a corn can form.  A hammertoe is when the toe becomes permanently bent over time.  This can happen with genetics, aging, or because a bunion is pushing the toe.  Where the toe bends down, it rubs on the tops of shoes.  This constant rubbing produces a callus, and eventually a deep corn.  

Another very common cause for corns is the toe is too long.  Similar to hammertoes, when a toe is too long it buckles when it goes into a shoe.  Where it buckles, or bends, the shoe rubs and creates the corn.  

Sometimes a corn is caused, because a person has a lump on the bone.  When a patient has a lump on the side of their toe, that causes corns in between the toes.  

To fix a corn, the underlying problem with the toe must be corrected, or it will just keep coming back.  

If a patient has a hammertoe we correct the underlying issue by straightening the toe.  If the toe is too long, we shorten the toe.  This prevents the toe from rubbing on the top of the patient’s shoe and the corn can eventually heal on its own.  If the patient has a bony prominence, we will file the bone down so it stops rubbing.  

We try never to cut a corn off of the toe, because it can leave a scar.  We want the corns to subside on their own so when the patient is done healing there are no visible scars, and no one can tell that surgery was even done!

Some corns are difficult to cure.  Corns are more stubborn if a patient smokes cigarettes.  Smoking cigarettes has a negative effect on the tiny vessels that keep skin soft and healthy.  We often see that cigarette smokers have a harder time healing corns even if surgery is done.  Another cause of stubborn corns is genetics.  Some patients are genetically predisposed to making calluses, and that will also make it harder for them to heal.  Lastly, if the corn has been present for many many years, then it will make it harder for the surgery to be as successful. 

If you would like to schedule a consultation because you have ugly corns, please reach out through our website at www.footfirst.com, on Instagram at footfirstpod or call 847-352-9221.

Long, short, curled or even just plain ugly toes? At Foot First we can fix that!

Before & After results with the Sklar Bunionectomy & Toe Shortening Procedure

Long toes can be troublesome for a patient for many reasons.  Toe shortening is a unique procedure that we perform alone, or along with our bunion surgery, the Sklar Bunionectomy™.   

Toe shortening has a similar recovery to our bunion surgery where you are able to weight bear immediately, and get back into a gym shoe in a short amount of time.

You may wonder why some people request to have their toes shortened.  Long toes can be problematic not only cosmetically, but also functionally.  A long toe extends past the other shorter toes so it may hit the end of the shoe first, causing the toe to curl and jam.  This can cause a hammertoe over time, or a painful corn on top of the toe as it rubs on the shoe. The constant jamming at the end of the shoe can also cause the toe to dislocate over the metatarsal bone.  This causes a painful callus on the ball of the foot. This also occurs when the metatarsal bone behind the toe is too long as well, and would require an additional procedure to the toe shortening to fix.

If you have a bunion along with long toes, we always correct the bunion with the toe shortening procedure.  This is because if we do not correct the bunion deformity, the big toe pushes against the smaller toes as they heal.  This eventually causes them to heal crooked, or become crooked over time. This is why we always address the bunion deformity as well.  The image to the right is a patient who had her toes shortened by another doctor without fixing her bunion. We then had to correct her bunion along with her crooked toes.

During our initial consultation we determine which toe shortening procedures you need by where you are feeling pain, and with X-rays of your feet.  We also determine how much you want your toe shortened. You tell us approximately where you envision your shortened toe to be in comparison to the other toes.  For instance, some patients still want their second toe to be in line with the big toe, or some patients want their second toe to be shorter than the big toe. This is where the surgery becomes more of an art than a science, because everyone has a different opinion of what they consider beautiful.

Surgery for toe shortening is done under local anesthesia (awake with numbing of the toes) or twilight anesthesia (asleep) through a small incision on the side of the toe.  We remove a section of bone that we determine before surgery. How much bone we remove will depend on how much your toe needs to be shortened. We then insert a wire to hold the toe while it heals.  The wire will be underneath the skin and will NOT stick out the ends of your toe. The wire is not meant to be permanent and will need to be removed at a later date. We then close the incision usually with only one stitch, and allow you to recover.

After toe shortening surgery patients usually experience pain for three days.  They are able to weight bear immediately and are wearing a surgical shoe. Patients wear the surgical shoe for three weeks, and also have to keep the foot clean and dry during that time.  At three weeks the sutures will be removed and patients will be allowed to wear a gym shoe. At 8-12 weeks, depending on how the bones are healing, we will numb the toes to remove the pin inside of the toe.  Then patients are allowed to return to exercise like running, jumping, and wear different shoes.

Toe shortening surgery is very successful, although it will never be perfect.  Healing is determined by the success of the surgery, genetics, and compliance with instructions all combined.  With all the surgeries we tell our patients that toes will cosmetically look ugly for 4-6 months before they start to see their true result.  This is how long it takes for most patients’ swelling to come down. Some more serious complications of toe surgery are, but not limited to, floating toe, crooked healing, creases/scarring to the skin, a swollen toe, numbness, or a toe that is painful.  Usually if we work together by us performing good surgery, and the patient follows instructions and genetically heals well, we all end up with a beautiful result.

Our unique toe shortening procedure offers patients the chance to lessen their pain, and have a beautiful looking foot.  Our before and after pictures showcase our most beautiful results. As stated before, toes take 4-6 months on average to become beautiful.  All after photos posted are usually taken at 6 months to 1 year after having toe shortening surgery.

For more information about our unique Toe Shortening procedure or to view additional before and after results, visit www.footfirst.com.

Travel to Foot First for Bunion Surgery

A lot of people lament about how we should have more offices across the country.  Although it would be nice to have the time to jetset across the country slaying bunions of all shapes and sizes, this is not a realistic lifestyle for the doctors at Foot First.  

Before & After results with the Sklar Bunionectomy

I always try to explain that our bunion surgery recovery is so manageable that you can fly in to have this procedure and safely travel home to recover in just a few days.  This patient shown here flew in from Philadelphia on a Thursday to have her bunion removed. She came to our office and had a preoperative consultation where we took her X-Rays, gave her her post-operative prescriptions and instructions, and met with my Dad and I.  Following her consultation she was able to have bunion surgery that day under twilight anesthesia. After her surgery she recovered at the office, and then was able to weight bear immediately and return to where she was staying.

If you are recovering in a hotel, our patients are able to get out of bed and take care of themselves.  We ask our patients to stay a few days so we can perform the first bandage change. The initial bandage we put on is bulky and can become uncomfortable as the foot swells from surgery.  After a few days we apply a more minimal and comfortable bandage. This way you can fly back home comfortably.

Again, we wish we could travel all around to make all the feet of the world beautiful, but we can’t.  If we can’t come to you, then come to us! We will keep you on your feet with immediate weight bearing, no cast or crutches.  Not to mention a beautiful bunion free foot with hidden scars. In our opinion an easy recovery with a beautiful result is something worth traveling for.  If you have any questions about traveling to have surgery please do not hesitate to contact us.