Does Surgeon Experience Matter? A Bunion Surgeon's Honest Answer

I’m going to say something that I wish more patients heard before they scheduled foot surgery anywhere: the name of the procedure matters less than who’s performing it.

I see this play out constantly. A patient comes in for a second opinion after a bunion surgery that didn’t go well. They had the right procedure on paper. The surgeon was credentialed. But the case volume wasn’t there, and the small judgment calls that separate a good outcome from a mediocre one weren’t made. So now we’re talking about revision surgery a year after the original.

Here’s what surgeon experience actually does for an outcome, and what questions you should ask before you let anyone operate on your foot.

What the research says about volume and outcomes

The volume-outcome relationship in surgery is one of the most consistent findings in medical research. Across virtually every surgical specialty studied — cardiac surgery, orthopedics, oncology, and yes, foot and ankle surgery — higher-volume surgeons produce better outcomes, lower complication rates, and fewer revisions. This isn’t a marketing claim. It’s decades of peer-reviewed data.

For bunion surgery specifically, recurrence rates and patient satisfaction both correlate with surgeon volume. The surgeon who does five Lapiplasty procedures a year and the surgeon who does five a month are not interchangeable.

What experience changes in the operating room

It’s not that low-volume surgeons can’t do the procedure. They can. What changes with experience is the small stuff that nobody talks about until it matters.

How much rotational correction to apply. When to address a coexisting hammertoe in the same operation versus when to stage it. How to handle an unexpected anatomic variation that shows up only after the incision is open. Whether the soft tissue release needs to be more aggressive on this particular foot. Whether to choose a slightly different fixation pattern based on bone quality you can only assess in real time.

Those are the judgment calls that determine whether a patient walks out with a great foot or an okay foot. And those calls get better with repetition.

What questions to ask a foot surgeon

If you’re considering surgery, here’s what I’d ask:

• How many of this specific procedure have you done? Not foot surgeries in general — the exact procedure being proposed for you. If the answer is vague or evasive, that’s information.
• Are you board-certified in foot surgery? In reconstructive rearfoot/ankle surgery? These are two separate certifications from the American Board of Foot and Ankle Surgery. The second is significantly harder to obtain.
• What’s your revision rate? A surgeon who tracks their outcomes will be able to answer this. A surgeon who doesn’t track outcomes is operating without data.
• What happens if something goes wrong? Will I see you, or will I see a partner or PA? How quickly can I be seen if I have concerns?
• Will you do surgery on me, or will a resident or trainee do it? In academic centers, this is a legitimate question. The attending surgeon is responsible for the outcome, but the hands doing the actual work matter.

The Elite Centurion designation, explained

For Lapiplasty^® 3D Bunion Correction specifically, Treace Medical Concepts — the company that developed the procedure — tracks surgeons by case volume. The Elite Centurion designation is awarded to surgeons who’ve completed more than 500 Lapiplasty procedures with strong outcomes. It’s the highest volume tier they award. I’m one of a small number of surgeons in the Mountain West region to hold this designation.

I don’t mention that to brag. I mention it because it’s the kind of credential patients should know exists, and should look for, when they’re evaluating a bunion surgeon. Not all credentials are equal.

Frequently asked questions about choosing a foot surgeon

Is it okay to have foot surgery done by an orthopedic surgeon instead of a podiatric surgeon?

It depends on the orthopedist’s subspecialty. A fellowship-trained foot and ankle orthopedic surgeon is a strong choice. A general orthopedist who occasionally does foot cases is not. The same logic applies to podiatrists: a board-certified, high-volume foot and ankle surgeon is a strong choice; a generalist who occasionally operates is not.

How many procedures should a surgeon have done before I trust them?

There’s no single magic number, but I’d be cautious of any surgeon proposing a complex procedure they’ve done fewer than 50 times. For something like Lapiplasty, I’d look for surgeons in the hundreds.

Does a second opinion offend the first surgeon?

It shouldn’t. Any surgeon worth seeing will support you getting a second opinion on a significant operation. I welcome surgical second opinions in my practice routinely.

Considering surgery? Get more than one opinion.

If you’re weighing foot or ankle surgery, take the time to evaluate the surgeon as carefully as you evaluate the procedure. Call our Twin Falls office at (208) 731-6321 to schedule a consultation or second opinion.