Minimally Invasive Bunion Surgery

Updated 8/1/2022

Minimally invasive bunion surgery before and after images

Minimally invasive (MIS) bunion surgery has become more and more common in foot and ankle surgery, however this type of surgery needs to be done by experts with extensive knowledge of MIS surgery. 


University Foot and Ankle Institute (UFAI) has advanced the different types of MIS bunion surgery for years and the surgeons have developed many of the techniques currently used across the world. Advancements in MIS bunion surgery offer patients unparalleled success due to its advanced stabilization, quick recovery, immediate weight-bearing, and virtually no post-op pain or scarring compared to any previously available minimally invasive bunion surgery.


Before we fully describe the minimally invasive procedure, here’s a short primer on bunions.

What is a bunion?

Bunions, also known as hallux valgus, are bony protrusions at the base of the big toe. They are caused by a progressive malalignment of the bones that make up the joint between the big toe and the first metatarsal (long bone of the forefoot). Ideally, the bones of your big toe would align with that first metatarsal to form a straight line that would remain straight throughout your lifetime.


But various factors can cause the joint between the first metatarsal bone and the first bone of the big toe to gradually veer outward over time. The bony bump that forms is akin to slowly bending a slender branch to form a V or chevron shape. The point of that V is the protruding bunion bump as the metatarsal drifts outward while the big toe drifts inward, pointing toward the little toe.


What are the common symptoms of a bunion (hallux valgus)?

As the bunion bump rubs against the shoe, the resulting pressure causes the overlying soft tissue to thicken. Redness, pain, calluses, and inflammation develop from constant shoe compression and friction. These symptoms can alter the way you step and cause the abnormal load to be placed on two tiny bones (the sesamoid bones) underneath the first metatarsal head. This can lead to arthritis and a restricted range of motion at the toe joint.


With nothing to stop them, most bunion deformities progress over time. Bunion pain and arthritis typically worsen, and patients can also develop corns between the first and second toes and even clawing of the second toe due to crowding from the big toe. They can also make existing conditions like plantar fasciitis worse and create new ones like a hammertoe, to name just a few.


What causes bunions?

There are a number of factors that can cause bunions. The most common include:

  • Genetics: if your ancestors had bunions, you’re more likely to have them as well.
  • Gender: though approximately 66% of bunion sufferers are women, there are plenty of men that develop them as well.
  • Structural abnormalities: if you are missing bones, have flattened arches, a short first metatarsal, asymmetry of the legs, or prolonged healing of a foot injury, these can contribute to the development of a bunion. It’s interesting to note that bunions may occur in just one foot.
  • Pregnancy: during pregnancy, the body releases a hormone called relaxin. This facilitates birth by relaxing the ligaments surrounding the pelvis. But relaxin also softens ligaments throughout the body, including ligaments in the foot. This can cause bones in the foot to spread and arches to fall. Both of these events can lead to bunions.
  • Bad shoe choices: yes, we are primarily talking about high heels. High heels cause weight-bearing to shift to the forefoot. People wearing high heels every day, or most days, can experience a gradual arch collapse over time which can contribute to bunion formation and chronic foot pain.



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What if I do nothing about my bunion?

Early-stage bunion deformities will almost always get worse over time. Complications include:

  • Increased discomfort and pain. Bunion progression cannot be stopped. Over time, your bunions will cause increased swelling, which causes more pain and will appear more pronounced.
  • Osteoarthritis or Bursitis. As the joint shifts more and more, your joints are impacted and eventually become very damaged; the cartilage tends to deteriorate, which causes the involved toe bones to rub together. As your condition worsens, a minimally invasive surgical procedure may no longer be an option for you.
  • Crossover Toe. As more time passes, many patients see that their second toe begins to cross over the first toe, which causes pain, callusing, and even ulcers in your second toe. More invasive surgical procedures are now your only option.


Why are there so many types of bunion surgery?

While there are over 40 different kinds of bunion surgeries described in the medical and podiatry literature, very few have stood the test of time. One thing that has been proven over the years is there is no “one size fits all” bunion surgical technique. That said, you’d be surprised to know how many bunion surgeons perform only one type of surgery because that’s their only comfort level. 


For years, foot and ankle surgeons have been performing what’s known as traditional minimally invasive bunion surgery that features a tiny incision. Unfortunately, most don’t use any hardware to secure the re-positioned bone that’s required to correct a bunion. Without hardware fixation, the bone may slip out of alignment, requiring the patient to return again, but this time for another more invasive bunion surgery (called a bunion revision).


What makes our minimally invasive bunion surgery ideal?

Bottom line: most minimally invasive bunion treatments have essentially been a gamble… until now. Our minimally invasive bunion surgery updated procedure now ticks all the boxes as the ideal bunion surgery. Here’s why.


Known for turning vision into practice, Dr. Bob Baravarian, DPM, FACFAS and the team at the University Foot and Ankle Institute have led the field in minimally invasive bunion surgery that offers a lasting result with shorter surgery times, minimal incision size, shorter recovery time, preservation of joint motion and minimal pain. 


How does our minimally invasive bunion surgery work?

Tiny micro-incisions, just a few millimeters long are made at the targeted positions of the foot. This is in great contrast to the 2-5 inch incisions made in traditional bunion surgery which open the great toe joint resulting in stiffness, scarring and the risk of difficulty wearing all types of shoes. Guided by an x-ray, a specialized instrument is used to shave the bone at the joint and insert two stabilizing screws. The procedure realigns the metatarsal and toe bones and causes little or no scarring.


Benefits of our minimally invasive bunion surgery?

Advantages of our Minimally Invasive Bunion Surgery include:

  • Tiny millimeter micro-incisions
  • Allows immediate weight-bearing after surgery
  • Leaves a virtually undetectable scar
  • Minimal swelling
  • Minimal pain
  • Often no need for physical therapy
  • Is paired with Amniotic fluid allograft to speed up recovery and prevent internal scar tissue formation
  • Avoids future joint problems because it does not involve opening the joint


What is the recovery from minimally invasive surgery (MIS)?

A key benefit of our minimally invasive surgical procedure is that it enables an immediate walking recovery. As the joint is not opened, our patients have little to no joint stiffness post-surgery and require far less physical therapy. 


Another huge advantage of minimally invasive bunion surgery is that our patients have minimal pain during recovery because the incisions are very small and the soft tissue is not opened extensively. Furthermore, screws hold the re-positioned bones firmly in place during healing. Less bone micro-movement and small incisions mean less pain during recovery. In fact, hardly any of our patients require more than a day or two of minor narcotics pain killers after surgery: most just ice and elevate their foot and take Tylenol.


Full recovery is usually accomplished after 4 to 6 weeks in the postop boot. The need for physical therapy is often minimized or eliminated altogether. All of this adds up to an earlier return to normal daily activities as compared to traditional bunion removal approaches.


Our minimally invasive bunion surgery, a practically perfect process

Although our minimally invasive bunion system may not be optimal for larger bunions or patients with very loose joints, it is ideal for a large majority of bunion deformities.


If you are experiencing bunion pain, we encourage you to schedule a consultation with one of our foot and ankle surgeons to see if our minimally invasive bunion procedure is right for you.


Why choose University Foot and Ankle Institute for minimally invasive bunion surgery?

If you are experiencing bunion pain, we encourage you to schedule a consultation with one of our foot and ankle surgery experts to see if our minimally invasive bunionectomy is the right bunion correction treatment option for you. We’re always here to help.


Our nationally recognized board-certified foot and ankle specialists offer the most advanced podiatric care and the highest success rates in the nation. Our foot surgeons are leaders in the research and treatment of all foot and ankle conditions.


For more information or to schedule a consultation, please call (877) 736-6001 or make an appointment online now.


At University Foot and Ankle Institute, we take our patients’ safety seriously. Our clinics’ and surgery centers’ Covid-19 patient safety procedures exceed all CDC recommendations. Masks are required in our institutes at all times.


We are conveniently located throughout Southern California and the Los Angeles area as our foot doctors are available at locations in or near Santa Monica, Beverly Hills, West Los 

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