Starting off on the wrong foot is such a bummer, right?  Now you can do something about it.

Foot facelifts and cosmetic foot surgery are becoming as mainstream as open-toed shoes.  Or maybe we should say they’re becoming mainstream BECAUSE of open-toed shoes. With sexy slides and slinky sandals as the accepted style choice, there’s nowhere for ugly piggies to hide. A pedicure alone won’t improve “toe cleavage.”

Designer feet are gaining a toehold in medical offices around the country. Even the podiatrists are evolving their thinking.  The Manhattan phone book is filled with “Cosmetic Foot Surgeons,” indicating a market need that has nothing to do with pain.  The American Orthopaedic Foot & Ankle Society (AOFAS) surveyed their podiatric surgeons recently and found 51 percent of their patients are asking for cosmetic procedures on their hoofs, according to CosmeticSurgery.com.

Made popular by runway models who are expected to balance themselves on spikes, these “toe tucks” have gone well beyond getting Botox shots in your arches to relieve the discomfort of five inch stilettos.  Women are getting their foot bones broken, shaved, reshaped – and in extreme cases, we’ve read reports of amputation of whole toes – for the sake of foot vanity.

Knowing several women who have had simple (we use the word “simple” very broadly here) bunion surgery, we can tell you emphatically that the result is amazing and beautiful and today’s surgery rarely leaves scars. We can also tell you the pain is astounding and the recovery time is long – several weeks of bandages, 6-8 weeks with some sort of cast or boot and months of swelling and discomfort. Depending on what you have done, costs may range from $4,000-$12,000, but we couldn’t find definitive price estimates.  No doctor is quoting fees for slicing off a whole toe yet, we suspect.  Of course, if your surgery is a medical necessity because of the pain and side effects from bunions or hammertoe, insurance may cover some or most of the bill.

There are 33 bones and a bunch of tendons in the feet, tasked with the job of bearing your weight and keeping you mobile. One foot surgeon estimated that we walk about 150,000 miles in our lifetime. Dog owners, speed walkers and Phish fans can probably add at least a few hundred more miles to that.  The bottom line is that your feet take a pounding like no other part of your body and eventually it shows.

Both the AOFAS and American Podiatric Medical Association have come out against cosmetic foot surgery, saying operations on the foot are too serious to be done for aesthetic reasons.

More foot surgeons, however, are acknowledging that often, the Feet Complete the style package. And everyone hates getting things started on the wrong foot.

Besides the nail technicians, about 22 states have banned or are weighing regulations to ban the use of the fish as part of a pedicure. Virginia and Ohio are OK with it. The “doctor fish,” or garra rufa by name, are finger-size swimmers that like to nibble on dead human skin cells.

In Europe and Asia garra rufa are used for pedicures and as a treatment for psoriasis. Here, they’re becoming more popular, even as states strive to reel in the operations.

Count Texas, Florida, New Hampshire, Massachusetts and Washington among the states that have put a law in the books banning the treatment. The Gilbert, Ariz., spa owner who was fighting that state’s Board of Cosmetology over its ban gave up the fight in March, deciding it was too costly.

The garra rufa may be another one of Mother Nature’s little exfoliators, but the primary argument against the treatment is cleanliness – there is no way to sanitize a fish … “unless you bake them for 20 minutes at 350 degrees,” Lynda Elliott, an official with the New Hampshire Board of Barbering, Cosmetology and Esthetics, told the Wall St. Journal.

Virginian John Ho, who with his wife Yvonne Le, is credited with offering the first fish treatments in the U.S. in 2008, devised individual tanks that are cleaned after each treatment. Fresh water is used each time. And a legislator in Ohio gave it a go herself before voting, and afterward noted that equipment may not be sterile, but it is sufficiently sanitary.

Admittedly, the treatment isn’t particularly alluring to anyone here at LookinGood, however, Lou Dobbs’ over-the-top reaction in this clip is almost enough to make us want to try it. C’mon Lou, save the indignation for something serious, like waterboarding.

So what do you think of soaking in a tub of garra rufa? Is it a gill-ty pleasure or does it sound just plain fishy?

• Florida bans bitty biters.
• Does being in the Wall St. Journal make it legit?
• Here’s a YouTube video that shows you just how it works.