In a world where shoes can equal sex appeal, women's feet have become the latest front in the battle for bodily perfection.
Doctors in America say increasing numbers of women are paying thousands of dollars for surgery to get the perfect pair of feet, or at least the sort that will slip into high-end designer shoes.
Breast implants? Forget it. Nose job? Been there. Shortening toes to fit into killer Manolo Blahnik slingbacks? Sure, why not?
Spurred by advertising and product placement on shows such as Sex in the City, doctors say women are being sold on beautiful but painful high-heeled footwear, often designed by men who would not dream of torturing their feet in such a manner. The result is frequently harmful.
More than half of the 175 members of the American Orthopedic Foot and Ankle Society who answered a survey said they had treated patients for problems from cosmetic foot surgery. The society is poised to issue a statement condemning such surgery.
Dr Sharon Dreeben, an orthopedic surgeon from La Jolla, California, and chairwoman of the society's public education committee, said yesterday: "It's reprehensible for a physician to correct someone's feet so they can get into a pair of Jimmy Choo shoes.
It's not nipples, it's feet. Shoes have been around for 8,000 years and there have always been different styles. But the obsession has grown over the past few years and I am sure it is due to programmes such as Sex in the City. Every time you turn on the television you see [such advertising]. It is trying to persuade people that if you have these shoes you'll look like Sarah Jessica Parker, you'll have her job and you'll be on television."
In the popular series, Ms Parker's character, Carrie, is a devotee of Jimmy Choo. At his New York store at 645 Fifth Avenue an ordinary pair of his shoes could easily set you back $600 (£350).
A few streets from that emporium of fabulous footwear, Dr Suzanne Levine, is happy to perform surgery on women who simply want to be able to get their feet into Mr Choo's shoes. Ms Levine, a podiatrist who has been featured in many women's magazines, said critics of such surgery failed to understand the importance some women attached to wearing high heels.
"Some of these women invest more in their shoes than they do in the stock market," she told The New York Times. "Take your average woman and give her heels instead of flats and she'll suddenly get wolf whistles on the street. I do everything I can to get them back into their shoes."
One of Ms Levine's recent patients was Jennifer Cho, a 27-year-old lawyer who had started to develop corns from wearing high heels. So she had the toes on her right foot shortened. "This will help me wear the shoes I want to wear," she said. It is not just the height of shoes that can cause damage. A 1991 survey revealed that up to 90 per cent of women regularly wear shoes between one to two sizes too narrow for them. About 80 per cent of all foot surgery is performed on women, primarily because their shoes are too tight.
Doctors say some high-end designers are gradually making shoes that are stylish yet good for the feet. Others do not try to disguise that their products are designed purely for looks.
Manolo Blahnik, the Spanish designer who makes some of the most sought-after shoes, admitted: "Half my designs are controlled fantasy. Fifteen per cent are total madness and the rest are bread-and-butter designs."
The cosmetic surgery is not cheap. At Ms Levine's clinic, the Institute Beauté, she charges $2,500 to shorten a toe and $500 for a collagen injection into the ball of the foot to restore padding lost from years of high heels. She said she is "simply fulfilling a need, a need to wear stylish shoes". Demand for such surgery has risen by 40 per cent in three years. She added: "These women come in and they say, 'Listen, I just came from my other podiatrist who told me to stop wearing high heels and I don't want to do that'."
The fashionista's favourite
By Caroline McCarthy
If you're heading to a Christmas party wearing a pair of pink opened toed Moiré silk stilettos from Jimmy Choo, right, it's understandable that you don't want unsightly feet letting you down. To pull off the £650 diamante studded shoes, you'll need a good pedicure at the very least.
Beloved of celebrities such as Anna Friel and Kylie Minogue, Jimmy Choo shoes are known for their elegance and dainty sizing, befitting of the diminutive stars that wear them. Jimmy Choo once claimed that larger feet did not look good in his shoes.
Together with Jimmy Choo, Manolo Blahnik, below, remains a firm favourite among the fashionistas. His stunning designs are name checked in almost every episode of Sex and the City: a recent episode, entitled 'A woman's right to shoes,' was devoted to the tragedy of expensive Blahniks lost at a party.
This season, catwalks have also seen the return of platform shoes - Jade Jagger recently wowed party-goers at the Garrad Rock Hard bash wearing an ankle-wobblingly high pair of Christian Louboutin's peep toe platforms.
Those who are not willing to forgo a toe or take out a second mortgage in order to wear fashionable shoes may be relieved to hear of another emerging footwear trend: Ugg Boots. Spotted on Kate Moss and Gywneth Paltrow, these flat, round toed sheepskin lined boots are comfortable and affordable.Reuse content