If you're thinking about bunion removal surgery (a.k.a -  bunionectomy surgery) then you've probably tried supportive products like bunion braces, bunion pads, bunion booties, and other non-invasive solutions similar to what we offer in our Online Shop here at Dr. Frederick's Original.

Or maybe you're just ready to be done with all the temporary solutions and slip into something a little more permanent.

Good for you!

To aid you in getting the best results from your bunionectomy, we asked Doctor of Podiatric Medicine (DPM), Megan M. Ziemer, to help us think of the very BEST questions to ask your surgeon before you go under the knife.

Table of Contents

1. Why did I develop a bunion?
2. What might cause my bunion to return?
3. Can I have both bunions removed at the same time?
4. Will my insurance cover the procedure?
5. I smoke tobacco products...is it ok for me to have bunion surgery?
6. What are the risks and benefits to proceeding with bunion surgery?
7. Do you feel bunion surgery is the best option for me and if so why?
8. What type of bunion surgery is best for me and why?
9. Should I have the bunion corrected now or can I wait?
10. What bunion procedures do you perform most often? How come?
11. How long will the bunion surgery take?
12. How long will recovery take?
13. What type of anesthesia is involved with bunion surgery?
14. How soon after the surgery can I go back to work?

We've also created a handy checklist that you can print out and take with your to the doctor's office to take notes.

Otherwise, read on...

1. Why did I develop a bunion?

There are many different causes of bunions and most of them have fancy names that you probably don’t care about! But you SHOULD care about this question because the cause of your bunion could affect the way your podiatrist treats the problem. 

Some bunions, like those caused by wearing poorly fitted shoes, can usually be treated easier than bunions caused by rheumatoid arthritis for example. Still further, bunions caused by rheumatoid arthritis should have the underlying problem being managed by the rheumatologist before you have a bunionectomy.

Asking this question will help you and your surgeon work through the best plan for your situation, which may or may not include surgery!

2. What might cause my bunion to return?

Just because you have bunion removal surgery doesn't mean the bunion can’t reform if you fall back into your old habits. Ask this question to your podiatrist to better understand what your life will be like after the surgery. You and your podiatrist might talk about your shoe wear choices and the importance of orthotics in order to minimize the chance of the bunion from reforming. If you have specific lifestyle questions, ask them now!

3. Can I have both bunions removed at the same time?

If you have a bunion on one foot there is a good chance that you have a bunion on the other foot as well. You’re probably wondering if you can kill two bunion birds with one surgery stone, and the answer is….sometimes. 

Most podiatrists prefer to take things one foot at a time so you can maintain a degree of mobility and self sufficiency while you recover. There are other factors your podiatrist must also consider before deciding if you are a candidate for double bunionectomies such as your overall health. Your doctor will always want to minimize the risk of complications including infection which increases with operating room time. However, some surgeons will perform double bunionectomies on a case by case basis. 

4. Will my insurance cover the procedure?

This is a great question to ask right up front. Not only do you need to find out if the office accepts your health insurance, but you’ll need to check that your provider covers the specific procedure to be performed and bunion surgery in general. 

Most insurances do cover bunionectomies, but they usually require that the deformity is painful and/or debilitating in some way. 

Get the ball rolling with this question so your podiatrist’s office can call your insurance provider prior to surgery and make sure everything is in order.

5. I smoke tobacco products...is it ok for me to have bunion surgery?

This is a very important question to ask your podiatrist up front. While there are some podiatrists that will operate on a patient that smokes, many will not. But you have to remember, if the doctor says they won’t perform the bunionectomy due to smoking, it's because they are thinking about what is BEST FOR YOU! A bunionectomy is always an elective procedure. Patients that smoke have a much higher chance of developing an infection after the surgery and sometimes these infections can get into the bone! This type of complication often requires 6 weeks of IV antibiotics and that does not always get the infection out of the bone. Delayed bone healing is also much more common in patients that smoke. This means more visits to the podiatrist, more time spent off the foot, possibly using a bone stimulator if your insurance will cover it and the potential for needing additional surgery. 

However, there are studies that suggest quitting smoking even for one month prior to surgery makes a huge difference in surgical outcomes. Ultimately, it’s up to the surgeon to decide how long the patient must quit smoking before proceeding with scheduling the surgery. 

6. What are the risks and benefits to proceeding with bunion surgery?

Not every patient is the same, so you’ll want to understand the risks and benefits for your particular situation. 

Bunion surgery may be your best option, but you may find that your podiatrist also has some non-surgical options for you to consider.

Ask this question to help understand the nuances of your case and how having the surgery, or not having the surgery, could affect your day to day life. 

Just remember in order to proceed with surgery the benefits should ALWAYS outweigh the risks!

7. Do you feel bunion surgery is the best option for me and if so why?

There are many different treatments for bunion pain so it’s important the doctor feels that the surgical option is best for you as opposed to treatments that could be performed in the office. Your doctor will take into account many factors including your level of pain, how much the bunion is interfering with your daily activities, how long the bunion has been painful, what type of conserative (non-surgical) treatments you have already tried and also your past medical history. Based on these factors and others as well your doctor will be able to tell you if surgery is the best treatment for you and why. Asking this question will really give you insight into your doctor’s decision making process as to why or why not surgery is the best option for you!

8. What type of bunion surgery is best for me and why?

There are many different procedures used to fix bunions. The procedure your doctor chooses will be based on the extent of the deformity, your past medical history, activity level and severity of your pain among many other factors. Asking this question will give you the knowledge of what is actually being done to your foot. Will you have two screws? Will you have a plate? This information will help you more thoroughly understand the risks and benefits to the procedure choice and fixation option. This question has the added benefit of making sure the doctor is thinking about the specifics of your situation and choosing what's best for you!

9. Should I have the bunion corrected now or can I wait?

Most people have very busy lives so it can be hard to find the time to “drop everything” and schedule surgery. Asking this question will give you the information you need to make a decision about when to schedule the surgery. Can I wait until I retire next year or at least until my winter break or should I have it done now? Sometimes we want to wait until things become more convenient in our everyday lives and often times that is the best option especially with elective surgery. However, it's also important to know what could happen if you wait to have the procedure done later on. Will I develop arthritis in my big toe joint due to how big my bunion is if I wait a year? This question will help you figure out how urgent your issue is in the eyes of your surgeon.

10. What bunion procedures do you perform most often? How come?

This question will give you an idea of the bunion procedures the doctor routinely performs. It is important that the doctor is able to perform a variety of bunion procedures because every patient has different needs. As with anything, practice makes perfect!  For example, most surgeons perform an Austin bunionectomy for a healthy patient with a mild to moderate bunion deformity. However, in an elderly patient with a large rigid bunion due to rheumatoid arthritis the appropriate procedure would be a fusion of the first metatarsophalangeal joint (big toe joint). This will reduce the bunion deformity while also fusing the toe. This is just one example where the procedure used is tailored to the specific bunion deformity and the cause of the deformity.

11. How long will the bunion surgery take?

Depending on the procedure, the operative time can vary from 45 minutes to approximately 3 hours. Some bunion surgeries are more extensive than others. For example, a procedure involving a soft tissue release and removing the bony bump in order to realign the big toe should typically take about 45 minutes. However, a procedure involving fusion of the first tarsometatarsal joint (Lapidus bunionectomy) and also an osteotomy (bone cut) at the head of the first metatarsal bone is a much more involved surgery and can take 2.5-3 hours in some cases. 

Asking this question will give you a realistic expectation of when you’ll be taken to recovery and then discharged home. You will need someone to drive you home so it's always nice to give your driver a heads up of when they should be at the facility to pick you up! 

12. How long will recovery take?

This is an important question to ask your doctor so you can take the necessary time off of work and clear your personal calendar to allow for a full recovery. Surgery can be stressful enough as it is, so you want to make sure you’ll have the time off of work so you can relax and let your body heal! Going back to work too early can often lead to post-operative complications. This is also a great question to ask if you’re thinking about getting a second opinion. Different procedures can have different recovery timelines and rules. While one doctor may recommend a procedure that requires non weight bearing for 6 weeks another doctor may recommend a procedure that will allow you to weight-bear immediately in a walking boot. Fully understanding your doctors expectations for the recovery should give both of you the confidence to move forward with the surgery. 

13. What type of anesthesia is involved with bunion surgery?

This is a commonly asked question prior to bunion surgery and also an important question to ask. While the final decision is made by the anesthesiologist, if you have had any issues with anesthesia in the past it’s important to bring it up to your podiatrist prior to your surgery date. Letting your podiatrist know of any anesthesia issues you have had in the past or any fears you have about anesthesia, will help the doctor schedule the surgery tailored to YOUR needs. 

14. How soon after the surgery can I go back to work?

There are general guidelines for how long a patient needs to be at home resting after surgery, however, sometimes complications do arise which means more time off work in order to properly heal. The general guidelines are different for different procedures as well. For a procedure involving the head of the first metatarsal the general guideline is 6-8 weeks for complete bone healing. However, if the procedure is more involved, your surgeon could have you out of work even longer. Asking this question will help you plan for the time you will need off work to heal. Just remember not to rush it! There is nothing worse than having the procedure go just as planned and then you develop a complication due to going back to work early.

In Conclusion

We hope that you found these questions and explanations insightful and more importantly helpful for making your decision about bunion removal surgery.

There's a lot to think about when considering surgery. You should always contemplate your personal circumstances and your unique feet.

If there are any other questions that you found helpful when you talked to your podiatrist, please post them in the comments.

We'd love to hear them!

Co-Author: Megan M. Ziemer, DPM.
Co-Author: Benjamin Frederick, MD