For some women, the ultimate cosmetic surgery is a face lift. For Joyce Jaynes, it was bunion surgery.
Before founding a mobile communications business, AirWAVES, in Atlanta, Jaynes was a cellular phone saleswoman and always wore high heels, up to 14 hours a day, seven days a week. Three years ago, her feet rebelled. She developed bunions ugly knobs on the sides of her big toes. Wearing any shoe hurt.
"Every time I sat down, I would take my shoes off," she said. "My feet killed me."
She consulted a podiatrist who promised her she could still wear high heels after surgery.
"I didn't hesitate a minute," she said. "During the operation, the doctor put pins in my toes to keep the bones straight.
"I was able to walk on my feet in three weeks and back to high heels in six weeks."
Jaynes has plenty of company when it comes to sore feet, and doctors say women's shoe fashions are partly to blame.
"About 75 percent of Americans have, or are going to have, problems of one sort or another with their feet," said Dean Wakefield, spokesman for the American Podiatric Medical Association. "And between three and four times as many women as men see doctors."
Just as this spring's new shoe fashions began hitting the street, a survey of 356 women conducted by members of the American Orthopedic Foot and Ankle Society revealed that 88 percent of the women wore shoes that were at least a size too small. About 80 percent of the women also reported chronic foot pain and problems such as hammertoes, bunions, corns, calluses and pinched nerves.
Those same foot problems are also caused, or aggravated, by wearing the wrong footwear.
Californian Carol Frey, one of the orthopedic surgeons involved in the recent survey, said most American and European shoe designers use narrow or medium shoe lasts, the wooden or plastic forms around which the shoe is shaped. Many shoemakers buy their lasts from Asian countries, where women often have narrower feet than women in the West. The shoemakers often don't request wider lasts because most of them believe that a slimmer shoe is more appealing to shoppers.
Other reasons for foot problems cited by the surgeons:
Women's shoes often have thin soles, which offer little cushioning against concrete sidewalks.
Since women are not expected to wear their shoes for more than a season at best, the shoes are made more cheaply than men's shoes, with exposed seams on the inside that rub the foot, and little nails that tend to pop up.
"When it comes to shoes, women should buy American," Dr. Frey said. "The lasts are wider."