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Stage 2 of the Toe Lift

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Causes of Scars on the Tops of the Toes

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After 3 months

 

Post 12 weeks - Time for Stage 3 of the Toe Lift

 

Todays Consultation

 

Todays Toe Lift Stage 1 Patient

 

Todays Toe Lift Stage 1 Patient

Alternative to the Toe Lift - Surgery

This patient visited us and wanted to opt for surgery to remove the discoloured risen lesions on the toes, we referred her to a foot surgeon. She had 2nd and 3rd toes shortened and the lesions removed. 6 months later there is no movement of the toes (they are fixed) and a dull pain in the toes is present which has been increasing progressively. Surgery is an alternative to the toe lift but certain considerations need to be taken before embarking on this option, once you remove bone you will not put it back in!

Todays Consultation!

Tried all sorts of Home Remedies including: Potato Skin! Aloe Vera Gel Lemon juice mixed with olive oil corn pads and corn plasters Vasoline Honey Finally came to a clinic that can offer a solution!

How does Restylane Skin Booster Injections Help Scars on the Tops of Toes? Are all Fillers the Same?

Massive improvement to depth of scars after stage 1 for this shy patient

After Stage 1, massive improvement after 1 week, patient has stage 2 today

The reason not to use acids or chemical peels on your toes!

Todays Toe Lift

Todays Patients

Todays Toe Lift Consultation

12 Week Case Study - Video 2

Today's Toe Lift Patient

Listen to the latest podcast about the toe lift
12 Week Case Study - Video 1
This has been a challenge!

Stage 1 and Stage 2

Amazing results after 2 months!

Post 2 months of treatment!

Stage 2 Injection Today

You can see a huge difference from before stage 1, still needs 3-4 months for full recovered but the process has begun!

After 5 weeks

Notice the lesions have got smaller and the color is only now beginning to change, these toes need another 3-4 months

Today's Toe Lift Patient

Treatment of Scars With Hyaluronic Acid

After 5 months!

This patient is very happy with her toe after 5 months, she can finally wear sandals!

After 2 weeks!

Significant reduction in scar depth after 2 weeks post stage 1 reduction, ready for stage 2!

How do Corticosteroids Reduce Scars?

Today's Toe Lift Patient

1 Month Review!

Is there a consensus for scar treatment?

Scarring and its accompanying esthetic, functional, and psychological sequelae still pose major challenges. To date, there is no satisfactory prevention or treatment option for hyper trophic scars on the tops of toes, which is mostly due to not completely comprehending the mechanisms underlying their formation. However, providing footwear advice is the most logical prevention option but this may not balance with the individuals needs and desires.  A predominant role in hypertrophic scarring prevention and treatment still remains silicone sheeting or gel. The efficacy and safety of this gold-standard, non-invasive therapy has been demonstrated in many clinical studies, but to date, exact mechanisms by which they improve hyper trophic scars are yet to be fully agreed upon. Second most validated and more specialised scar treatment is intralesional corticosteroid injections, especially in combination with other therapeutic modalities. Current therapeutic approaches with their empi

Clinical Scar Evaluation

If a scar forms, regardless of whether or not prophylactic measures were applied, it should be evaluated clinically. When assessing scars clinically, their size, colour, contour, height (thickness), surface area, surface texture, pliability, location, and subjective symptoms such as itching and pain, and also patient’s perception should be taken into account.  It has been indicated that this subjective component of the patient’s view of the scar is as important as objective aspect and it may be very influential in determining the patient’s quality of life (1). Assessment of the scars is a frequent topic of discussion among clinicians because there is no generally accepted evaluation tool, although various ones have been proposed (2).  None of these, however, seem suitable as a stand-alone tool, suggesting that combination of objective imaging tools and scar scales and questionnaires (patient reported outcome measures that we use in clinic) may be justified to achieve comprehe

The Use of Silicone Gel Sheets and Creams for the Treatment of Hypertrophic Scars

As part of the Toe Lift procedure we provide an aftercare package of silicone gel products. The International Advisory Panel in 2001 suggested a combination of intralesional corticosteroid injection and silicone gel sheeting for the treatment of hypertrophic scars (1).  Silicone gel sheeting was first used in 1981 for the treatment of hypertrophic scarring at an Australian pediatric hospital (2). A trial involved 42 people aged between 2 and 60 with red, dark or raised scars. The trial studied the effect of Silicone gel treatment at two and six months and compared the results with untreated scars (3). Results showed 93% of scars had improved after 2 months with silicone gel.  These scars had improved in condition, colour and texture, softening to enable the skin to become more flexible.  Only 12% of untreated scars improved after 2 months, with just 38% showing improvement after 6 months.  Another study which was probably one of the most extensive of its kind, involvi

Restylane® Skinbooster Injections for the improvement of skin on the tops of toes

Restylane® Skinboosters™ are outstandingly suitable for deep hydration of the skin on the tops of toes, and their effect is long-term and safe. In our society, youthfulness and beauty free of imperfections are sadly positively attributed and also determine interactions and positioning in the social as well as the professional environment (1). This statement also applies to the appearance of your feet. Injectable  hyaluronic acid (HA)  products can be classified into two groups with different therapeutic goals for podiatry. They can either be used for  augmentation and volume substitution or as with the  skin boosters which are injected superficially for the revitalization of the skin (2). The biological significance of HA for the skin as well as its excellent physicochemical properties, especially its high water-binding capacity, determine injectable HA based skinboosters for improvement of skin quality. Although native HA is ubiquitous in the human body, the largest amount i

Psychological Impact of Scars on Toes

In a world where the “beautiful” are given many advantages, it is easy to understand why appearance is weighted so highly. The old adage, “What is beautiful is good” is very still sadly true today, in fact especially today with the influence of social media, when being perceived as attractive creates a halo effect. Feet are no different then other parts of the anatomy, especially for women who tend to wear more open toed shoes and sandals then men.  Measuring quality of life is an important aspect of delivering holistic dermatological care to feet. The lesions on the tops of toes are trivial to most health professionals and my fellow podiatrists, some individuals adapt to the change in the appearance of their toes, however, others react negatively and have decreased psychosocial performance (functioning of emotional, social, mental well-being).   The management of scars is a challenge for professionals since these lesions can greatly impact quality of life. Although scars rare

The Use of Corticosteroid for Scar Management

The International Advisory Panel on Scar Management recommended the use of intralesional steroid injections for the treatment of hypertrophic scars (1).    Corticosteroids were proved to induce scar regression through many different mechanisms. Firstly, they suppress inflammation by inhibiting leukocyte and monocyte migration and phagocytosis (2). Second, they are powerful vasoconstrictors, thus reducing the delivery of oxygen and nutrients to the scar bed (2).   Third, they have an antimitotic effect that inhibits keratinocytes and fibroblasts, slowing reepithelialization and new collagen formation. Furthermore, they may reduce plasma protease inhibitors, thus allowing collagenase to degrade collagen.  Corticosteriods also induces a significant plunge in alpha-1-antitrypsin and alpha-2-macroglobulin levels, which tend to be greater in scar tissue and are natural inhibitors of collagenase in human skin (3). Corticosteroids affect fibroblast proliferation and production capabilitie