Bunion surgery involves cutting and realigning the bone at the base of your big toe, then holding it in place with small screws or plates while it heals. The procedure typically takes an hour or less, and you’re usually awake for it with just your foot numbed. What your foot looks like during and after depends on which technique your surgeon uses, but the basic goal is always the same: straighten the big toe and remove the bony bump.
What Happens During the Procedure
You’ll typically receive a nerve block that numbs your foot and the area around it rather than being put fully to sleep. Some people get sedation so they’re relaxed but not unconscious. A tourniquet is placed around your ankle to limit bleeding, and the surgical area is cleaned and draped so you won’t see much of what’s happening even if you’re awake.
The surgeon makes an incision along the inside of your foot near the big toe joint. In traditional open surgery, this cut runs a few centimeters long, giving the surgeon direct access to the bone. The bony bump itself is shaved down, and then the real work begins: the surgeon cuts through the first metatarsal bone (the long bone behind your big toe) in a precise, angled line. This is called an osteotomy. The bone is then shifted into a straighter position and secured with titanium screws, pins, or small plates. These implants are typically permanent and don’t need to be removed later.
For more severe bunions, the correction may happen at the joint where the metatarsal meets the midfoot bones, rather than near the toe. This approach, sometimes called a Lapidus procedure, fuses that joint entirely to prevent the bunion from coming back. The bone is locked into its new alignment with titanium plates and screws.
How Minimally Invasive Surgery Differs
Instead of one long incision, minimally invasive techniques use two or three tiny cuts, each about one centimeter (roughly the size of a pea). A small camera is passed through one incision to guide the surgeon in real time, while a low-speed drill cuts through the bone through the other openings. Screws are placed through the same small incisions to hold the corrected bone in position.
Because fewer soft tissues are disrupted, the foot tends to be less swollen and painful afterward, and the cosmetic result is better. The tradeoff is that open surgery remains a more powerful correction for very severe deformities, so not everyone is a candidate for the minimally invasive approach.
What Your Foot Looks Like Right After
You won’t see your foot immediately after surgery. It will be wrapped in a bulky surgical dressing or placed in a cast or stiff-soled surgical shoe. Underneath that bandaging, the incision site is closed with stitches or surgical tape, and the toe is positioned in its new, straighter alignment. Bruising and swelling are significant in the first few days, often extending beyond the surgical area into the midfoot and sometimes the ankle.
For the first two weeks, you’ll need to keep your foot elevated 50% to 80% of your waking hours to control swelling and let the wounds close properly. Some numbness around the incisions is common and typically fades over three to six months. The deeper swelling can linger for 6 to 12 months, which may limit what shoes you can comfortably wear during that time.
Pain After Surgery
Most surgeons now use a nerve block at the ankle in addition to whatever anesthesia is given during the procedure. This makes a major difference in the early hours. Patients who receive a nerve block don’t typically need pain medication for about 11 hours after surgery, compared to roughly one hour for those who don’t get one. The block works by interrupting pain signals from the surgical site before they reach the spinal cord, which also reduces the overall sensitivity of the nervous system in the days that follow. Once the block wears off, oral pain medication manages the discomfort, which is most intense during the first few days and gradually eases.
Recovery Timeline
You won’t be able to put weight on your foot initially. A cast or special surgical shoe protects the toe and keeps it in the correct position for at least 3 to 6 weeks, though some procedures require this protection for a few months. Weight-bearing is gradually introduced, usually starting with heel-walking in a stiff boot before transitioning to regular shoes.
The bone itself takes roughly 6 to 8 weeks to heal enough for light activity, but full recovery, including the resolution of swelling and a return to all footwear, often takes closer to a year. During that time, the scar matures from a raised, pink line into a flatter, lighter mark. Minimally invasive scars are much smaller and less noticeable, sometimes just a few dots along the inner foot.
How Often Bunions Come Back
Recurrence depends on how you define it. A meta-analysis of 17 studies found that 5% of patients developed a bunion severe enough to look and feel like the original problem (a toe angle greater than 25 degrees). About 10% had a moderate return of the deformity. Using the strictest measurement, where any angle above 15 degrees counts, the number jumped to 64%, but many of those patients had no symptoms and didn’t need further treatment. The surgical technique used didn’t significantly change these rates. Factors like foot structure, footwear habits, and whether the correction addressed the root cause of the misalignment all influence whether the bunion gradually drifts back over the years.