Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
Foot surgery has undergone a revolution. Techniques that once required large incisions, prolonged non-weight-bearing, and months of recovery can now be performed through tiny puncture incisions with specialized instruments — dramatically reducing pain, recovery time, and surgical risk. At Balance Foot & Ankle, Dr. Tom Biernacki is a skilled minimally invasive foot surgeon offering Michigan patients the most advanced, least invasive surgical options available.
What Is Minimally Invasive Foot Surgery?
Minimally invasive foot surgery (MIFS) uses 2–5mm percutaneous incisions rather than traditional 3–8cm open incisions. Specialized rotary burrs, micro-osteotomes, and precision instruments allow bone correction, tendon release, and deformity correction without exposing large amounts of tissue. Fluoroscopic (live X-ray) or ultrasound guidance provides the surgeon real-time imaging to ensure precise cuts and alignment. Because no significant tissue dissection is required, swelling, post-operative pain, and recovery time are substantially reduced.
Conditions Treated with Minimally Invasive Techniques
Bunions (MICA procedure) — The Minimally Invasive Chevron and Akin (MICA) osteotomy corrects bunion deformity through three tiny stab incisions. The metatarsal bone is cut and repositioned using a specialized burr under fluoroscopic guidance, then fixed with tiny titanium screws. Patients walk in a surgical shoe the same day. Studies show MICA produces equivalent or superior alignment correction compared to traditional open bunionectomy with significantly faster recovery and less post-operative swelling.
Hammer toes — Minimally invasive hammer toe correction releases the contracted tendons and reshapes the bent joint through a single 2–3mm incision per toe. No large surgical scar, no pin sticking out of the toe. Walking in a surgical shoe immediately. Return to regular shoes in 4–6 weeks.
Plantar fascia release (endoscopic) — Endoscopic plantar fascia release is performed through a single 5mm portal, visualizing the fascia with a small camera and dividing it precisely. Far less soft tissue trauma than open plantar fasciotomy. Return to shoes in 2–3 weeks rather than 4–6 with open surgery.
Heel spur / bone prominence removal — Retrocalcaneal exostosis (Haglund’s deformity), calcaneal spurs, and dorsal bone spurs on the midfoot or ankle are removed percutaneously using a motorized burr through a single tiny incision. Outpatient procedure, minimal downtime.
Metatarsal osteotomies for metatarsalgia — Prominent or elongated metatarsals causing ball-of-foot pain are shortened or elevated through minimally invasive percutaneous osteotomy. Walking allowed same day in a surgical shoe.
Benefits of Minimally Invasive Foot Surgery
Reduced surgical trauma means less post-operative swelling and pain; reduced infection risk (smaller incisions have lower contamination exposure); faster return to activities and footwear; minimal visible scarring; outpatient same-day procedures in most cases; general or regional anesthesia options; and equivalent or superior outcomes compared to traditional open surgery in appropriate cases.
Is Minimally Invasive Surgery Right for You?
Not every foot condition is appropriate for a minimally invasive approach — deformity severity, bone quality, and surgical goals all factor into technique selection. Dr. Biernacki evaluates each patient individually and recommends the approach most likely to produce the best long-term result, whether minimally invasive or traditional. Second opinions are always welcome.
Call Balance Foot & Ankle at (734) 479-6200 to discuss your foot condition and whether minimally invasive surgery is an option at our southeast Michigan offices.
Frequently Asked Questions
Is minimally invasive bunion surgery as effective as traditional bunion surgery?
Yes. Multiple randomized controlled trials and systematic reviews have shown the MICA minimally invasive bunion procedure achieves correction equivalent or superior to traditional open bunionectomy, with significantly faster recovery, less post-operative swelling, and equivalent patient satisfaction at 1-year follow-up. The technique requires specialized training — patient selection and surgeon experience are critical to outcomes.
How soon can I walk after minimally invasive foot surgery?
Most patients walk in a flat surgical shoe or protective boot within 24 hours of minimally invasive procedures. The ability to immediately bear weight — even on a corrected bunion or hammer toe — is one of the major advantages of these techniques. Return to regular shoes typically occurs at 4–8 weeks depending on the procedure.
Does insurance cover minimally invasive foot surgery?
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Yes — when surgery is medically indicated for a painful foot condition, insurance covers the procedure regardless of whether a minimally invasive or traditional open technique is used. The insurance decision is based on medical necessity, not surgical technique. Our team verifies your benefits and obtains prior authorization before scheduling any surgical procedure.
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Dr. Biernacki and our team at Balance Foot & Ankle are accepting new patients in Howell and Bloomfield Hills, MI. Most insurances accepted.
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Medically Reviewed by: Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists
Minimally Invasive Foot Surgery Experts
Smaller incisions, less pain, faster recovery. Our surgeons specialize in the latest minimally invasive techniques for bunions, hammertoes, heel spurs, and more — often allowing same-day walking.
Clinical References
- Vernois J, Redfern DJ. “Percutaneous surgery for severe hallux valgus.” Foot Ankle Clin. 2016;21(3):479-493.
- Maffulli N, et al. “Minimally invasive surgery of the foot and ankle.” Foot Ankle Surg. 2019;25(6):727-728.
- Redfern DJ, Vernois J. “Percutaneous Chevron and Akin osteotomy for hallux valgus correction.” Orthop Clin North Am. 2014;45(3):375-387.
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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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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.
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
- Hallux Valgus (Bunions): Evaluation and Management (PubMed)
- Bunions (Mayo Clinic)