Different Types of Bunion Surgery
Posted July 20, 2026 in Bunion Surgery
Bunions can be painful, unsightly, and limit your mobility when left untreated. While no one wants surgery, it is often the only true remedy when bunions form. This blog discusses how to identify bunions, what causes them, what types of conservative, non-surgical treatments are available, and finally, what each type of bunion surgery entails.
What Is a Bunion?
A bunion is a bony protrusion at the base of the big toe caused by a misalignment of the first metatarsophalangeal (MTP) joint. Bunions that form on the opposite side of the foot, the outside of the pinky toe, are called tailor’s bunions.
Patients typically notice the visual appearance of the bunion before anything else, as it looks like a small bump on the outside of the big toe joint. Others might notice pain or soreness after a long day of standing or walking, or after wearing shoes that pinch the feet or put pressure on the ball of the foot, such as high heels.
When left untreated, bunions progress over time, increasing in pain and discomfort, causing aesthetic distortions of the feet, limiting the type of shoes that can be worn, and even reducing mobility. As the bunion progresses, it begins to push your second toe toward the third, further affecting the alignment of your joints and eventually leading to debilitating arthritis.
What Causes Bunions?
Genetics and lifestyle factors typically combine for people who develop bunions. Here are some common causes of bunions:
- Genetic muscle imbalances in the feet
- Tight or narrow shoes
- The shape of your foot
- Flattening of the foot
- Arthritis or another medical condition
While bunions typically affect women more often than men, anyone can develop them at any age.
Common Bunion Treatments
There are two major types of bunion treatment: conservative therapies and surgery. While conservative measures help relieve symptoms and can limit the progression of the condition, surgery is the only way to remove the bunion and realign the joints.
If your bunions are not severe, your podiatrist may recommend one or more of the following conservative, non-surgical bunion treatments:
- Changing footwear is typically the first step in preventing bunions from progressing and in relieving pain. Shoes with a narrow toe box or those that put pressure on the bunion, like high heels, should be avoided. You need to find shoes that fit appropriately, and you can even explore shoes specifically for bunions.
- Pads or cushions are great in combination with proper footwear, as they help support the joint and reduce pain.
- Custom orthotics are medical devices molded to your feet and inserted into your shoes, redirecting weight and pressure away from the bunion and even realigning the front of the foot so the MTP joint can function properly.
What Are My Options for Bunion Surgery?
If conservative measures don’t help, or your bunion progresses to a severe degree, or your pain and discomfort are so great they affect your quality of life, a bunionectomy or bunion surgery is the next step.
The ultimate goal of bunion surgery is to realign the toe joint and remove the bony protrusion. Removing the protrusion alone does not fix the root cause, as the misalignment is the real issue. However, each procedure is tailored to the needs of the patient, and everyone is different. Your podiatrist will discuss which option is ideal for you and the severity of your case.
The four major bunion surgeries are as follows.
Osteotomy
An osteotomy is one of the most common types of bunion surgery and is ideal for those with mild to moderate deformity. During an osteotomy, your surgeon will make small cuts in the toe bones to realign them and correct the deformity. Metal screws are used to hold the bones in place as they heal.
Recovery: It typically takes six to eight weeks for full recovery, with the temporary use of a surgical boot to protect the healing foot.
Arthrodesis or Joint Fusion
Joint fusion is reserved for patients with severe bunions or arthritis and involves fusing the bones in the affected joint to correct the bunion. Your surgeon will first remove sections of the damaged joint and then secure the bones in the correct position with metal screws. As the bones heal, they fuse together.
Recovery: After arthrodesis, patients will require a longer recovery period of about 8–12 weeks. In addition to a protective boot, patients will need to avoid putting pressure on the foot by using crutches or other mobility aids.
Exostectomy
For more mild cases with little deformity, an exostectomy might be appropriate. This procedure is less invasive than others, as the surgeon only shaves the bony protrusion and does not treat the joints. This procedure is typically reserved for patients with very little joint misalignment but who are experiencing pain; however, the bunion is more likely to return.
Recovery: Recovery after an exostectomy is shorter than others, typically between four and six weeks.
Lapidus Procedure
Sometimes bunions form due to hypermobility and instability of the MTP joint; a Lapidus procedure is recommended in these cases. During this procedure, the unstable MTP joint is fused to the medial cuneiform, stabilizing the joint and preventing future bunions.
Recovery: Lapidus requires a longer recovery period, with about 8 to 12 weeks of non-weight-bearing.
Want to Learn More About Bunion Surgery in NYC?
Learn which bunion surgery or conservative treatment option is best for you: Call the bunion experts at Chelsea Foot and Ankle. Dr. Ethan Ciment and Dr. Aditi Shastri are experienced podiatric surgeons who put the patient’s needs and goals first with concierge care. While we prioritize conservative treatments whenever possible, our podiatrists are dedicated to getting you the care you need and deserve.
After an in-depth consultation, our podiatrists will recommend the ideal treatment or surgery to keep you on your feet. Call Chelsea Foot and Ankle today at (646) 929-4149 or complete the contact form to request a consultation.