Pulse: How We Spend: Fashionable Suffering

IT’S NOT OFTEN you see women injecting fat into their bodies — but then again, you’ve probably never told a woman it’s the only way she’ll ever take another step in her stilettos.
 
Sara Bouraee, a podiatric surgeon new to Rittenhouse Square, basically earns her living courtesy of stylish women who screw up their feet. She’s seen a rise in the sacrifices we’re willing to make in the name of strutting around in higher and higher high heels, our ankles in forced, unnatural positions, five toes crammed into a space that would be a cozy fit for three. That doesn’t even take into account our old cobblestone streets and crooked sidewalks, which Bouraee says may have Philly women suffering for fashion at a level rarely seen outside the runways of Milan.
 
The result is a menu of decidedly unpretty maladies Bouraee sees on a daily basis: bunions and hammer toes, nerve inflammation, hidden fractures and permanently shortened Achilles tendons. But instead of wearing heels in moderation (i.e., ditching pride — and pumps — and embarking on daily commutes in sneakers or flats), women are lining up for Bouraee’s short-term fixes, such as Botox shots to relieve hammer-toe spasms, fat injections to pad the balls of the feet, and, in some extreme Carrie Bradshaw cases, getting foot bones removed to more easily squeeze into those narrow Manolos. Alas, such faux comfort only lasts so long; even with these treatments, Bouraee paints a grim, arthritic picture of the fashionista set’s older years. And it turns out foot damage is only (the bottom) half of the problem.