If the bunion is getting bigger, shoes are becoming uncomfortable, or pain or deformity of the other toes has appeared, it's worth assessing the degree of change and determining the best treatment strategy.
When a bunion is no longer just a cosmetic problem
Hallux valgus (bunion) is a deformity of the forefoot in which the big toe gradually deviates toward the other toes, and a characteristic bony prominence forms at the first metatarsophalangeal joint.
This is not simply a local bony enlargement. The relative position of the bones, the biomechanics of the forefoot, and the distribution of load during walking all change.
In its early stages, the problem may mainly affect appearance. As the deformity progresses, pain, redness, and irritation around the bunion may appear, along with difficulty finding comfortable shoes, calluses, and deformity of the other toes.
When to see a doctor
- the bunion is gradually getting bigger
- the big toe is increasingly deviating
- pain has appeared while walking or standing for long periods
- shoes press and rub against the deformity
- it's becoming difficult to find comfortable shoes
- calluses or areas of overload on the foot are appearing
- the second and other toes are starting to deform
- the shape of the foot is causing significant functional or cosmetic discomfort
What can change after surgery
The goal of modern surgical correction of hallux valgus is not simply to remove the bony prominence.
Surgery aims to correct the deformity itself and restore more normal anatomical alignment of the forefoot.
After surgery and an appropriate recovery period, treatment can help:
- reduce pain at the base of the big toe
- correct its abnormal deviation
- reduce the prominence of the bunion
- improve the shape of the foot
- improve load distribution across the forefoot
- reduce discomfort when wearing shoes
- gradually return to normal walking and physical activity
The goal of treatment is to combine functional correction of the deformity with the most natural possible foot shape.
Modern surgery is not simply "shaving off the bunion"
One common misconception is to think of hallux valgus surgery as simply removing the bony prominence.
The cause of the deformity is far more complex. The position of the forefoot bones themselves changes, so simply removing the prominent part of the bone is not enough for a complete correction.
Modern surgical treatment is aimed at correcting the underlying anatomical deformity, not just its outward appearance.
That's why it is important, before surgery, to determine the nature and degree of the deformity and to plan the method of correction.
Individualized surgical planning
Hallux valgus can look similar from the outside in different patients, yet have different underlying anatomical features.
Before surgery, we assess:
- the degree of deviation of the big toe
- the relative position of the forefoot bones
- the condition of the first metatarsophalangeal joint
- the stability of the relevant joints
- the position of the other toes
- any accompanying foot deformities
- load distribution and clinical symptoms
Weight-bearing X-rays of the foot are taken for planning purposes.
The optimal method of correction is determined based on the clinical examination and radiographic parameters.
How the deformity is corrected
There is no single hallux valgus operation that suits every patient equally.
Depending on the nature and degree of the deformity, various types of corrective osteotomies and other surgical techniques may be used.
The procedure may involve repositioning the first metatarsal bone and the big toe, restoring normal anatomical alignment, and stabilizing the bone fragments with special fixation devices.
If other forefoot deformities are present at the same time, these can also be taken into account when planning the surgery.
The surgical method is chosen to fit the specific deformity — not the other way around.
Function and the appearance of the foot
For many patients, what matters is not only reducing pain, but also how the foot will look after surgery.
This is a normal part of what patients expect from treatment.
When planning, we aim to combine two goals:
restoring more normal anatomical alignment and function of the foot, and achieving the most natural possible shape.
A good cosmetic result is founded on correct anatomical correction of the deformity.
01 — Consultation and diagnosis
We assess your complaints, the shape of the foot, the position of the big toe and other toes, painful areas, and features of your gait.
We analyze weight-bearing X-rays of the foot and determine the nature of the deformity.
02 — Planning the correction
Based on the anatomy and radiographic parameters, we determine which components of the deformity need to be corrected and which surgical technique best fits the specific case.
03 — Surgical correction
The deformity is corrected, restoring normal anatomical alignment of the forefoot and stabilizing it according to the chosen technique.
04 — Recovery
After surgery, a weight-bearing regimen and the use of a post-operative shoe are determined, along with a gradual return to normal walking and everyday activity.
Our approach
We correct the deformity, not just the bunion
Our surgical strategy is aimed at correcting the anatomical components of hallux valgus, not simply removing the visible bony prominence.
Planning based on weight-bearing X-rays
Bone position is assessed under the conditions in which the foot actually functions during standing and walking.
The technique is chosen individually
The degree and type of deformity can vary, so the same operation should not be applied to every patient.
Function + shape
When planning the correction, we consider not only the functional outcome but also the natural appearance of the foot.
Can a bunion be treated without surgery?
Conservative methods can help reduce symptoms and discomfort, especially in the early stages.
Changing your footwear, orthotic devices, and other measures can ease pain, but they generally cannot anatomically correct a bony deformity that has already formed.
If the deformity is progressing and is significantly bothering you, the possibility of surgical correction is worth discussing with an orthopedic surgeon.
Do I need to wait until the bunion gets very large?
No. The size of the bunion alone is not the only indication for surgery.
The decision depends on pain, progression of the deformity, difficulties with footwear, the condition of the other toes, and the patient's expectations.
Can I have surgery if I'm mainly bothered by how my foot looks?
Cosmetic discomfort can be one of the reasons for seeking treatment.
However, before deciding on surgery, it is important to assess the deformity itself, the expected benefit, the possible risks, and how realistic the expected result is.
Is the surgery just shaving off the bunion?
No. In most cases, complete correction of hallux valgus involves repositioning the bone structures and restoring normal anatomical alignment.
That's why the surgery is planned based on clinical and radiographic findings.
Are screws placed during the surgery?
Special fixation devices, including screws, may be used to stabilize the correction.
Whether fixation is needed, and what type, depends on the surgical technique chosen.
When can I put weight on my foot?
The weight-bearing regimen depends on the correction performed and the method of fixation.
In many cases, walking is possible early in the post-operative period using a special post-operative shoe, but the specific regimen is determined individually.
How long do I need to wear the special shoe?
The duration depends on the type of surgery and how healing progresses. The transition back to regular shoes happens gradually, after appropriate follow-up.
When will my foot look normal after surgery?
Swelling can persist for quite a long time after surgery, so the final shape of the foot should not be judged in the first few weeks.
As healing progresses and swelling subsides, the appearance gradually changes.
Will there be a scar?
Any surgical procedure leaves a scar.
Its location and length depend on the surgical technique used. Over time, a post-operative scar usually fades and becomes less noticeable, but its final appearance cannot be fully predicted.
Can the bunion come back?
Recurrence of the deformity is possible.
The risk depends on many factors, including the original type of deformity, how correctly it was corrected, individual anatomical features, and how the post-operative period progresses.
That's why it is important not simply to remove the visible bunion, but to correctly identify and correct the components of the deformity.
When can I go back to regular shoes?
This depends on the extent of the surgery, healing, and swelling. The return to regular footwear happens gradually.
In the early period, it's best to choose roomy, comfortable shoes that don't put pressure on the forefoot.
Can I wear high heels after surgery?
Returning to this type of footwear depends on how recovery has progressed, the condition of the foot, and the height of the heel.
It's best to discuss the possibility and timing individually once the main recovery period is complete.
Do you need a consultation?
If a bunion is painful, growing, making it hard to wear your usual shoes, or if the shape of your foot is bothering you, a consultation lets us assess the nature of the deformity and the possible ways to correct it.
Not every patient with hallux valgus needs surgery. Our task is to determine whether surgical treatment is needed and which method of correction would be optimal for your specific situation.