Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
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Bunion Surgery Has Evolved: Introducing Lapiplasty
For decades, bunion surgery largely meant one approach: cutting and repositioning the metatarsal bone to push the prominent bump inward. While this traditional 2D osteotomy addresses the visible deformity, it doesn’t correct the underlying anatomical instability that causes bunions to develop — which is why bunion recurrence rates after traditional surgery have historically been 20-40% over 10 years. Lapiplasty® 3D Bunion Correction represents a significant evolution in bunion surgery by addressing all three dimensions of the deformity.
Balance Foot & Ankle’s podiatric surgeons in Howell and Bloomfield Township, Michigan, perform Lapiplasty for appropriately selected patients and are equipped to guide you through an informed decision about whether this approach is right for you.
Understanding the 3D Nature of Bunion Deformity
A bunion is not simply a bone pushing outward. Research over the past decade has demonstrated that bunion deformity involves three-dimensional displacement: the first metatarsal rotates on its long axis (causing the “bump” to be positioned abnormally), deviates laterally (pushing outward), and the unstable metatarsal-cuneiform joint (where the first metatarsal meets the mid-foot) elevates. Traditional surgery addresses lateral deviation only — like straightening a leaning tower by cutting it and tilting it back, while leaving the foundation unstable.
What Lapiplasty Does Differently
Lapiplasty corrects all three dimensions by stabilizing the problem at its source: the unstable metatarsal-cuneiform joint. Using specialized instrumentation, the surgeon rotates the first metatarsal back to its correct position in all three planes, then fuses the metatarsal-cuneiform joint with titanium plates and screws to permanently stabilize the corrected position. By fusing this joint rather than cutting and repositioning the metatarsal shaft, Lapiplasty eliminates the unstable foundation that causes traditional bunion corrections to drift back over time.
Early Weight-Bearing Protocol
One meaningful practical advantage of Lapiplasty is the ability to weight-bear earlier than many traditional approaches. Because titanium plate fixation provides superior immediate stability compared to a bone cut (osteotomy) held with a single screw, most Lapiplasty patients bear weight in a walking boot within days of surgery rather than waiting weeks. This faster mobilization reduces the muscle atrophy, cardiovascular deconditioning, and quality-of-life disruption associated with prolonged non-weight-bearing.
Who Is a Candidate for Lapiplasty?
Lapiplasty is ideally suited for patients with moderate to severe bunion deformity with evidence of first metatarsal-cuneiform joint instability (hypermobility), patients who want the lowest possible recurrence risk, and patients who have experienced bunion recurrence after prior surgery. It may be less appropriate for patients with mild bunions, those with significant osteoporosis affecting fusion success, or patients whose deformity pattern doesn’t involve metatarsal-cuneiform instability. A thorough biomechanical evaluation and weight-bearing X-ray analysis determines appropriate candidacy.
Recovery Expectations
Lapiplasty patients typically walk in a surgical boot within days of surgery, transition to a wider shoe at 6-8 weeks, and return to normal footwear by 3-4 months. Athletic activity and low-impact exercise is typically permitted at 3-4 months; high-impact sports require 4-6 months of recovery. Most patients are highly satisfied with both the cosmetic improvement and the functional restoration Lapiplasty achieves. Schedule a consultation at Balance Foot & Ankle to discuss whether Lapiplasty is the right approach for your bunion.
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Balance Foot & Ankle — Howell & Bloomfield Township, MI
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3980 E Grand River Ave, Suite 140
Howell, MI 48843
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43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
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In our clinic, bunion patients come in at two very different stages. The first group is women in their 30s and 40s noticing a small bump and seeking nonsurgical slowing tactics — wide toe box shoes, bunion splints at night, custom orthotics to redistribute load away from the first MTP. The second group is patients in their 50s+ who can no longer find shoes that fit and are asking, honestly, about surgery. Our standard workup includes weight-bearing X-rays to measure the intermetatarsal angle and the HVA. Patients with an IMA under 13° usually do well conservatively; 13°+ often benefits from a surgical plan.
More Podiatrist-Recommended Bunion Essentials
Bunion-Friendly Stability Shoe
- THIS MEN’S SHOE IS FOR: The Adrenaline GTS 25 is perfect for runners and walkers seeking reliable support and a smooth ride. Featuring holistic GuideRails for Go-To Support and soft, dynamic premium nitrogen-infused DNA LOFT v3 cushioning, it delivers distraction-free comfort mile after mile. This Brooks Adrenaline GTS 25 is a certified PDAC A5500 Diabetic shoe and has been granted the APMA Seal of Acceptance. Predecessor: Adrenaline GTS 24.
- GUIDERAILS HOLISTIC SUPPORT SYSTEM: Our innovative technology - known as “GTS” for “Go-To Support” - supports your body in its natural motion path while keeping excess movement in check.
- SOFT & DYNAMIC CUSHIONING: Even more premium nitrogen-infused DNA Loft v3 cushioning delivers lightweight softness, and feel-good comfort mile after mile.
- TRUSTED FIT: The breathable engineered mesh upper and flat-knit collar offer a secure, comfortable fit, providing both structure and flexibility to accommodate natural movement during active use.
- SMOOTH TRANSITIONS: The specially designed outsole and midsole work together to promote seamless transitions, ensuring comfort and support for every step, so you can stay active longer.
Brooks Adrenaline GTS 25 — wide toe box reduces bunion pressure.
Wide-Toe-Box Walking Shoe
- FuelCell foam delivers a propulsive feel to help drive you forward
- ENCAP midsole cushioning combines lightweight foam with a durable polyurethane rim to deliver all-day support
- Reflective accents designed to catch the light
- TPU back tab
- New Balance MADE contains a domestic value of 70% or more. MADE makes up a limited portion of New Balance’s US sales.
New Balance 990v6 — roomy forefoot accommodates bunions and reduces rubbing.
Orthotic Insole
- The Pinnacle Full length insoles for men & women provide maximum cushioning, from high activity to moderate support. The PowerStep arch support shape provides stability to the foot and ankle, helping to relieve foot pain.
- When you spend all day on your feet, every step counts. PowerStep insoles are a podiatrist-recommended orthotic to help relieve & prevent foot pain related to athletes, runners, Plantar Fasciitis, heel spurs & other common foot, ankle & knee injuries
- The Pinnacle plantar fasciitis insoles offer superior heel cushioning and arch support. The dual-layer cushioning is designed to reduce stress and fatigue, while PowerStep premium arch support is designed for plantar fasciitis relief.
- The PowerStep Pinnacle arch support inserts for men & women can be worn in a variety of shoe types such as; athletic, walking, running, work & some casual shoes. Orthotic Inserts are ordered by shoe size, no trimming required.
- Made in the USA & backed by a 30-day money-back guarantee. PowerStep orthotic inserts for men & women are designed for shoes where the factory insole can be removed. HSA & FSA Eligible
PowerStep arch support — realigns foot mechanics that drive bunion progression.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
A bunion is a progressive joint deformity — padding and splints reduce pain but don’t reverse the bone shift. If the big toe angle is worsening, shoes no longer fit, or pain is disrupting sleep or activity, schedule a consult at Balance Foot & Ankle. Our surgeons perform minimally-invasive bunion correction with faster recovery than traditional osteotomy. We’ll review X-rays with you and explain exactly what the joint needs.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Watch: Dr. Tom explains
Podiatrist-recommended products
As an Amazon Associate, Dr. Tom earns from qualifying purchases.
Post-Lapiplasty immobilization boot for early weight-bearing.
View on Amazon →Long-term arch support to protect bunion correction.
View on Amazon →Cryotherapy for post-Lapiplasty swelling.
View on Amazon →Topical comfort during Lapiplasty recovery.
View on Amazon →Related resources
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When conservative care isn’t enough, Dr. Tom Biernacki and the team at Balance Foot & Ankle offer advanced, same-day options — including Hammertoe Correction Michigan at our Howell and Bloomfield Hills clinics.
Same-day appointments available. Call (810) 206-1402 or book online.
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
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