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Schoen Clinic Orthopaedic and Spinal Hospital London | 17.09 hrs. - 24.06.2021

“After ten years of hiding my feet away, I'm looking forward to trading in my sensible trainers for summer strappy sandals”

With a busy life and a business to run, Gill worried about the long healing time of traditional bunion surgery methods. But, after researching and finding that minimally invasive (keyhole) bunion surgery can get you back on your feet a lot faster, she decided to undergo the procedure with Mr Kumar Kunasingam, an expert in foot and ankle conditions and a leader in the field of keyhole bunion surgery.

Bunions run in my family and unfortunately, I hadn't escaped the genetic probability of them coming to me. For a decade or so, I'd had a worsening pain in both of my feet which I'd come to suspect were the development of bunions. 

Not only were my feet sore, I'd also noticed that they were becoming increasingly deformed. Some toes were moving beneath other toes, and I couldn't fit my feet into certain shoes. I was in such dire straits that I'd started buying sensible shoes and trainers in bigger sizes, as this was the only way I knew my feet wouldn't be in terrific pain mid-way through the day. I felt embarrassed by the whole situation, and also hesitant to find a solution as it's well-known that bunion surgery is painful with a long recovery time. Not what you need when you have a busy life and a business to run! 

At the beginning of 2020, I noticed that they were getting worse at an alarming rate. My right toes were moving out of place due to the bunion, which was making everyday life so much more difficult. There was no more ignoring the problem; I knew I had to start exploring my options otherwise I'd run the risk of them becoming even more unbearable. 

I began to look into foot surgeons in my local area, and I found a surgeon who seemed to be the go-to person for bunions. However, not being one to accept the first 'quote', I had to explore what other options were out there. 

I started researching further afield and in London found that minimally invasive, keyhole surgery is now available, which I'd never seen before. I found that Mr Kumar Kunasingam's name kept coming up in my research – a pioneer of keyhole surgery. I could see him at Schoen Clinic London and although this is quite far away from me in Kent, I couldn't ignore the glowing patient testimony that I read about him. I felt like I'd hit the jackpot, and decided to go for it! 

I put a call into Schoen Clinic London and spoke with Kumar. I asked him what the difference was between me going up the road to my local surgeon and seeing him? He told me I'd be back on my feet a lot sooner, which is what I really wanted. I was convinced I was in the right place. 

I then went for a consultation with Kumar at Schoen Clinic's specialist orthopaedic hospital on Wigmore Street, and he spoke about what the surgery entails, and showed me on a foot model what needed to be done. His calm manner and pleasant demeanour immediately instilled my confidence in him. I went back a week later for an MRI scan, the treatment plan was formalised and we set a date for surgery. A week later and a couple of days before my surgery, I went back for Covid-19 and MRSA tests. I could see the hospital has very rigorous protocols when it comes to infection control, which was reassuring. 

On the day of my surgery, I was given a lovely big room which was very comfortable. I was able to relax and meet the Anaesthetist before surgery. As the surgery was keyhole, I was able to walk after surgery and could go home the same day. 

Now, three weeks down the line after surgery, I'm moving around quite freely – much more so than if I'd opted for traditional surgery. I am planning for my second foot to have the same treatment with Kumar soon and, after that, the sky's the limit shoe-wise! After ten years of hiding my feet away, there'll be no stopping me shopping for summer strappy sandals! 

Mr Kumar KunasingamMr Kunasingam answers your frequently asked bunion questions.

Q. What are bunions?

Bunions are a swelling and fullness of the bone of the first metatarsal (the first long bone in the foot), and part of the big toe joint with the proximal phalanx, which is one of the two bones of the big toe.
Bunions cause pain which is due to mainly the rubbing of footwear, as well as deeper pain which can develop over time if the bunions aren't treated.

Q. Can bunions go away?

Bunions do not go away by themselves. If you have a particularly flat foot the shape can sometimes be improved by an orthotic or inner sole which lifts up the arch. There are some physiotherapy exercises that might help strengthen some of the muscles in the foot which may ease the pain and pressure, however this won't change the overall structure of the foot or make bunions go away.

All bunion cases are best assessed by a Consultant Orthopaedic Surgeon in Foot and Ankle Surgery, whose opinion is often formed by using images such as x-rays or sometimes an MRI scan. At Schoen Clinic London, we can offer a variety of treatments including conservative – which means no surgery – depending on the pain level and how the foot looks.

Q. What is the best treatment for bunions?

Bunions that cause pain either around the bunion area, which is the big toe joint, or pain due to the second toe being pushed out of the way either over or under the big toe can usually be treated with non-surgical options, such as broader or more stretchy footwear.

The only way to effectively and definitively get rid of bunions is through surgical treatment and at Schoen Clinic London, we're proud to offer keyhole bunion surgery (also know as minimally invasive bunion surgery) resulting in a far quicker rehabilitation than that of open surgery.

Q. Can I get rid of bunions without surgery?

A lot of bunions will not change without surgery. There are lots of pads, stretching devices and exercises advertised online, so if you do feel that this is of interest then it's worth looking at those options before any consideration for surgery. However, with exercise, whilst it may relieve the pressure, it's impossible to change the architecture (shape) of the foot through exercise alone, and therefore surgery is the only definitive option.

Q. What does bunion surgery entail?

With keyhole bunion reconstruction surgery, you will undergo a procedure under general anaesthetic to correct the shape of the foot. This usually takes around 30 minutes. If patients can't tolerate general anaesthetic then this needn't be a barrier to surgery as consideration can be made for spinal anaesthetic.

Surgery is performed at our specialist spinal and orthopaedic hospital near Harley Street in London. We use state-of-the-art theatres, and surgery is performed with an x-ray machine in sterile conditions, which facilitates live imaging to be taken during surgery.

Through small incisions in the skin, the surgeon breaks the bones either side of the big toe joint, which is called an osteotomy, and pushes these into a better mechanical position before fixing with screws. These screws generally stay in and do not need to be removed but on occasion are removed.

The shape of the bone is also further modified using a shaving technique through the same tiny incisions. This keyhole bunion surgery (or minimally invasive bunion surgery) approach is to allow rapid recovery, which means you can walk immediately after surgery, and can even go to the gym the day after for non-impact based activities.

Q. Is keyhole bunion surgery less painful than open surgery?

Keyhole surgery patients who have had previous open surgery with ongoing or recurrence of bunions have reported that the keyhole experience is a much more pleasant and they experienced far less pain. Patients enjoyed a much quicker return to quality of life and shoes (two weeks after keyhole bunion surgery) and were able to walk immediately after surgery, as opposed to a much more protracted time which can be four to five times longer, if not more, before getting into shoes and returning to impact-based activities. 

Patients often do not need any analgesia (pain relief) after surgery, however some patients may benefit from a day or two of analgesia which can vary from very mild to slightly stronger, depending on the initial shape of the foot and the severity of the bunion.

Q. What is the recovery like after bunion surgery?

Keyhole/minimally invasive bunion surgery allows for rapid recovery, meaning you get back on your feet almost immediately.

You can wear shoes – which will ideally be stretchy trainer shoes, or suede-based shoes – at the two week mark post-surgery. In the meantime, you can enjoy good quality of life, in terms of daily activities, and won't be hindered by long periods of foot elevation.

Bones always take six weeks to heal and three months to be solid, which won't slow down your return to activity and exercise. You can go to the gym the day after surgery for non impact based activities. This technique is also very kind to the soft tissue, which is why it's less painful than open surgery, as purported by patients who have had already had open surgery with residual or ongoing bunions on one foot, and have come for keyhole surgery on the other foot. 

Gill was treated by Mr Kumar Kunasingam, Consultant Orthopaedic Surgeon (Foot & Ankle) at Schoen Clinic Orthopaedic and Spinal Hospital London. For further information, call 0203 929 1086 or fill in an enquiry form. You can use your health insurance, or just pay as you go for treatment. Find out more about paying for your own treatment here or by emailing selfpayenquiries@schoen-clinic.co.uk