Bunion Surgery (Bunionectomy)

MIS bunionectomy uses 2-3 small incisions (3-5mm) instead of a traditional larger incision. Bone cuts are made with a specialized burr under fluoroscopic guidance, and fixation uses percutaneous screws. Benefits include less swelling, less pain, faster recovery, and smaller scars. Studies show 85% satisfaction within 6 months and recurrence rates as low as 5%. However, not all patients are candidates—severe deformities may still require open surgery, and the technique requires a surgeon experienced in MIS methods.

Yes, bilateral bunion surgery is common for medical tourists, saving a second trip. Recovery is more challenging with both feet operated simultaneously—you may need assistance for 1-2 weeks and initially use a wheelchair or knee scooter. Many patients prefer bilateral surgery to avoid two separate recovery periods. Your surgeon will evaluate whether you are a good candidate based on overall health and support system.

Recurrence rates are 5-15% depending on the surgical technique, severity of original deformity, and post-operative care. Factors that increase recurrence risk include hypermobility of the first ray (addressed by Lapidus procedure), inadequate initial correction, early return to narrow or high-heeled shoes, and underlying connective tissue laxity. Proper shoe choices and occasional orthotic use help prevent recurrence.

Low heels (2-3 cm) can typically be worn at 3-4 months post-surgery. Higher heels (over 3 cm) are generally possible at 6+ months but are not recommended for daily use as they increase recurrence risk. Your surgeon will advise based on your specific procedure and healing progress. Pointed-toe shoes should be avoided permanently.

Modern pain management significantly reduces post-operative discomfort. The ankle nerve block provides 12-24 hours of complete pain relief after surgery. Most patients report moderate discomfort for 2-3 days, manageable with oral pain medications. Pain typically decreases significantly by week 2. MIS techniques tend to produce less post-operative pain than open surgery. Ice and elevation are important for pain and swelling control.

Studies report 85-90% patient satisfaction rates. Success is defined as pain relief and improved function, not perfect toe appearance. Factors that improve success include proper procedure selection for your deformity severity, experienced surgeon, following post-operative instructions, and appropriate footwear after recovery. Individual outcomes may vary based on the severity of deformity and patient factors.

Your surgeon will recommend a technique based on severity of deformity (hallux valgus and intermetatarsal angles), presence of hypermobility at the first TMT joint, arthritis in affected joints, bone quality, activity level, and previous failed surgery. Generally, Chevron is used for mild bunions, Scarf for moderate, and Lapidus for severe or hypermobile feet. A consultation with imaging review determines the optimal approach.

Smoking significantly increases the risk of non-union (bones not healing), infection, and wound complications by 3-5 times. Surgeons typically require patients to quit smoking 4-6 weeks before surgery and remain smoke-free for at least 4-6 weeks after. Nicotine patches and gum should also be avoided. If you cannot quit, discuss honestly with your surgeon—some may decline to operate, while others may use techniques less dependent on bone healing.