Emerging Concepts In Cosmetic Foot Surgery

Author(s): 
Allan Grossman, DPM, FACFAS, Jason Sweeley, DPM, Ann Nakai, DPM, and Jeff Merrill, DPM

   The cost could be prohibitive for many people with an average price tag of $1,000 per treatment. According to PinPointe’s Web site, most patients only require one treatment but the risk of re-infection remains.10 The procedure does not give immediate gratification, however, as it may take up to 12 months for the nail to grow out to a more normal looking nail.

   The KeryFlex nail restoration system (Pod-Advance) is another type of non-invasive service being offered to hide unsightly fungal nails in conjunction with laser or pharmaceutical treatment. KeryFlex is a composite resin gel that works by creating a flexible, non-porous artificial nail while allowing the remaining natural nail to re-grow. Proponents say the nail looks and feels natural, and even allows patients to paint the nail while in use.11 It typically lasts six to eight weeks before one needs a touch-up or reapplication. While prices vary per office, the price is reportedly comparable to that of nail treatment at a salon.

Key Insights On Laser Hair Removal And Sclerotherapy For Telangiectasias

Laser hair removal works by directing a laser beam through the skin to an individual hair follicle. The laser damages a hair follicle by creating intense heat, which inhibits future hair growth. The success of laser hair removal depends on the type of laser one uses. Lasers operate on a wavelength that is better suited to certain skin tones or hair color. Multiple treatments are required for laser hair removal given the cyclical nature of hair growth. Many non-physician supervised “aesthetic centers” around the country are offering laser hair removal with complications reported in the literature of first-degree burns and hyperpigmentation.12,13

   Sclerotherapy is a treatment for telangiectasias or smaller varicose veins, which are typically asymptomatic and therefore treated cosmetically. The surgeon would inject individual veins with a small amount of sclerosing agent that irritates the vessel’s lining, causing it to become inflamed, harden and eventually be resorbed by the body completely. Anesthesia is not required and walking after treatment is encouraged. Many injections or even multiple treatments are necessary since 1 inch of vein will likely require one injection.

   Compression stockings are typically recommended following treatment to “compress” treated vessels and to prevent new telangiectasias. Mild itching and burning following treatment is normal. Complications include allergic reaction to the sclerosing agent or infection. More serious complications are reported with poor injection technique. These complications include formation of small ulcers at the injection site.13

What You Should Know About Fat Pad Injections

Fat pad injections are another practice that is gaining momentum. The plantar fat pad absorbs much of the pressures that our feet must endure. However, over time, this fat pad wears down and the cushion that we enjoyed in youth flattens. This causes painful calluses and areas that can lead to more serious complications such as ulcerations in some patients. Some of the more conservative approaches to dealing with this unpleasant certainty of fat pad atrophy include orthotics, gel cushion inserts or changes in shoe gear.

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