Revolutionizing bunion surgery, Dr. Blitz developed the Bunionplasty procedure and a patented implant that gets patients walking immediately after surgery, resulting in extremely positive outcomes and high levels of satisfaction.
Patients are traveling to Manhattan from all over the world for Dr. Blitz and his innovative Bunionplasty procedure. For many patients, the impetus is to avoid what was once a long period of recovery after bunion surgery. A few years ago, Dr. Blitz transformed bunion surgery with the development of a patented implant that holds the bones steady, allowing his patients to walk immediately after bunion surgery without the need for cast or crutches. With this implant, Dr. Blitz has also been able to improve the aesthetic results of the procedure by moving the incision onto the side of the foot — rather than the top — in operations on bunions of all sizes. As such, bunion surgery can now be performed more cosmetically and no longer involves a painfully long, immobile recovery.
Women, specifically high heel lovers, are affected by bunions because the fancy footwear puts excessive pressure on the big toe joint, causing a structural misalignment. While bunions can have a genetic component, many result from poor footwear choices. More than half of women have bunions, according to the American Academy of Orthopaedic Surgeons.
A patient learns about Bunionplasty plastic surgery for bunions. Many of Dr. Blitz’s patients want to return to wearing high heels after bunion surgery.
“Most people think a bunion is a growth of bone at the base of the big toe,” Dr. Blitz says. “That is partially correct, but it’s really the misalignment of the big toe joint pushing out on the skin from underneath that causes the bony prominence.”
Previous surgical techniques on larger bunions often necessitated an extensive recovery period that required assistive devices and limited mobility for six weeks or more.
“Recovery was once long and painful, but that’s not the case now,” Dr. Blitz says. “Bunion surgery no longer means a cast, crutches or a wheelchair. Nowadays, with the implant I designed, my patients can practically walk out of the operating room in a small surgical shoe.”
A Better Way: Contours Lapidus Plating System
Dr. Blitz’s advancement in foot and ankle surgery has changed the perception of surgical intervention for patients suffering from bunions. Historically, surgeons have employed more than a hundred different bunion surgery operations, while only a handful are in use today, according to Dr. Blitz.
Dr. Blitz and David Wong, DPM, assistant surgeon to Dr. Blitz, perform a Bunionplasty.
“Mild bunions are treated differently than larger bunions,” he says. “An osteotomy [bone cut] at the top of the metatarsal bone, near the big toe joint, allows only that top portion of bone to be moved over, which is then held in place with a single screw.”
However, larger bunions often require alignment at the bottom of the metatarsal bone by means of a bone fusion procedure in the arch, called the Lapidus Bunionectomy.
“The fixation techniques in use 15 to 20 years ago couldn’t keep the bones steady with weight-bearing pressure, so the cast and crutches would do that while the bone mended,” Dr. Blitz explains. “Bunions were looked upon as difficult to repair from both the surgical and the recovery standpoint.”
Considering traditional bunion surgery methods utilized screws with or without a plate inserted into the foot for support, but still required several weeks to heal with immobilization, Dr. Blitz set out to create more immediate, weight-bearing mock-ups to bring his concept to fruition. Improving upon the Lapidus Bunionectomy technique, Dr. Blitz developed an implantable device that holds the bone steady with screws and a locking plate system made of titanium that is contoured to match the anatomy of the patient’s bone, and also allows him to have his patients walk immediately after surgery.
The state-of-the-art office has digital X-rays, which Dr. Blitz uses to assess the severity of patients’ bunions, as well as other foot and ankle problems.
“The concept for the plating system first started with creating a bone model out of and clay, then strategically marking where the tendons insert so that the plate would fit anatomically without irritating the surrounding structures,” Dr. Blitz explains. “It also needed to be more stable than screws we were currently using, and this was a time when plates were second-generation, generalized plates. I thought it would be possible to make a specialized plate where the screws have optimal angles to fit in this part of the bone.”
Dr. Blitz presented his idea to Orthofix International, a leading orthopedic product manufacturer based in Texas. Together, they worked on prototypes.
“One of the important things about developing the plate was that it couldn’t be just a regular device,” Dr. Blitz says. “It had to be special. It avoids the tendons in the area and sits in the sweet spot of the bone with the correct amount of fixation to meet the needs of simulated weight-bearing.”
Dr. Blitz was also adamant that these new implants be made to fit actual bones — not saw bone impressions — which had to be special ordered from a bone museum.
“I wanted to develop this based on real bone anatomy,” he says. “We contoured the plate to perfectly match the actual anatomy.”
Known as the Contours Lapidus Plating System, Dr. Blitz’s implant transformed the surgical process. Manufactured by Orthofix International, the system is available to foot and ankle surgeons in the United States.
Bunionplasty: Nip/Tuck Meets Bunion Surgery
High-fashion shoe designers have glamorized foot sex appeal, which has brought a whole new clientele to Dr. Blitz’s office seeking Bunionplasty. Many women see bunion surgery as a necessity to continue to wear high-heeled shoes without tremendous pain, and they want the result to look good, too.
“My office is filled with women who prefer to find themselves in Jimmy Choos rather than orthopedic shoes,” Dr. Blitz says.
“Coping with painful bunions is a quality-of-life issue for patients. They can now walk immediately after surgery and get back to doing the activities they enjoy.”
— Neal M. Blitz, DPM, FACFAS
Dr. Blitz’s bunion implant has allowed him to improve the cosmetic aspect of bunion surgery by relocating the incision onto the side of the foot for procedures on bunions of all sizes, in contrast to traditional approaches through the top of the foot.
To continue the success of the implant, Dr. Blitz created the Bunionplasty procedure.
“Bunionplasty is my registered procedure, which is essentially plastic surgery for bunions,” he says. “For all bunion sizes, the incision is on the inside of the foot, which is a more appealing option to many patients. Then I do a plastic surgery closure.”
These side incisions are generally made along the demarcation line where the skin from the bottom and top of the foot come together, and are angled somewhat to gain access to the bones. To complete the procedure, Dr. Blitz uses fine sutures in the superficial layers of the skin incision. This method allows for minimal scarring and a more aesthetically pleasing result.
Dr. Blitz demonstrates the Bunionplasty procedure to other foot and ankle surgeons to extend his reach to more patients, help patients overcome the pain associated with bunions and allow them to be mobile after surgery.
Dr. Blitz can perform bunion surgery on both feet in one surgical setting as well (regardless of bunion size), still allowing patients to ambulate on their feet in merely a small surgical shoe.
Revision Bunion Surgery
About half of Dr. Blitz’s practice consists of revision bunion surgery. There are several reasons a previous bunion surgery may have failed, including return of a bunion, malunion, excessive big toe shortening, severe stiffness of the big toe joint, and loss of big toe purchase. Dr. Blitz is often able to use his plating system in a revision surgery to realign the bone.
Years of working together allow Dr. Blitz and his team to better meet the needs of foot and ankle surgery patients. (L-R) Cheer Alvarez, practice manager; Dr. Blitz; Dr. Wong
“Revision surgery is more complex than primary bunion surgery because often the initial surgery needs to be undone, then properly corrected,” explains Dr. Blitz. “Performing revisions helps me refine my techniques for primary bunion surgery, as it allows me to better understand issues that lead to complications in the first place.”
Once a patient decides to move forward with Bunionplasty, Alvarez schedules a one-on-one to review the surgical booking process.
Patient care and outcomes remain at the forefront of Dr. Blitz’s Park Avenue private practice. When he opened his state-of-the-art Manhattan office, his goal was to create an environment that was high-fashion, welcoming and peaceful.
“We offer a full-service practice and believe in educating patients about the procedures so they understand what is happening to their feet,” he says. “We want to meet their functional and cosmetic needs. My motto is that your feet should not only feel good but look good.”
Dr. Blitz demonstrates his empathy for patients’ self-consciousness regarding their feet by providing a calming atmosphere and compassionate team.
“Our practice is unique in this regard,” he says. “Patients want to be discreet and may be embarrassed by their feet, so we are creating a whole different experience. Whereas they once were reluctant for others to see their feet, after surgery they are now showing them off. Our patients are our real advocates.”
The staff at Dr. Blitz’s foot and ankle surgery practice.
Dr. Blitz has designed his practice to assist patients with the practical as well as medical aspects of foot surgery. His practice manager, Cheer Alvarez, has more than a decade of experience in health administration. She assists in scheduling procedures and obtaining insurance coverage. When an international patient visits, she ensures their trip and accommodations are top-notch. Dr. Blitz employs a telehealth system, including virtual conversations via Skype, to meet long-distance patients before they come to New York for surgery.
Not ‘Just’ a Bunion Surgeon
Dr. Blitz prides himself on running a boutique foot and ankle surgery practice.
While Dr. Blitz has created a bunion empire by getting patients back on their feet fast, he also provides a full spectrum of simple and complex foot and ankle surgeries. His former leadership as chief of foot surgery and associate chair of orthopedics at Bronx-Lebanon Hospital Center provided him with years of major complex surgical expertise, which he now incorporates in private practice in the treatment of foot and ankle deformities, broken bones, and sports injuries.
“I never looked back after opening my private practice, which has become an international destination for foot surgery,” he says. Because Dr. Blitz takes on extremely challenging cases, some patients have dubbed him the “Superman of Feet.”
“I operate on simple bunions. I operate on hard bunions. I operate on flat feet. I operate on arthritic ankles. I operate on all foot and ankle conditions as well as the feet that nobody else wants, and all of these procedures can be done right here in New York,” Dr. Blitz says.
For more information about Bunionplasty and other simple and complex surgeries of the foot and ankle, visit Bunionplasty.com.