bunion surgery issaquah

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austin bunionectomy

Bunion surgery is one of the most common surgical procedures in the United States.  It is usually performed in an outpatient setting and no overnight stay is required.  The majority of bunion surgeries take less than 2 hours and have great long term outcomes.  The most common bunion surgery is an Austin bunionectomy as it is called. It has been utilized for almost 100 years and is a powerful tool in bunion correction. 

The Austin bunionectomy traditionally involved a cut in the 1st metatarsal head.  It was cut from medial to lateral in a chevron type fashion.  This allows for correction of the abnormally aligned joint and removal of the bunion.  It usually involves some sort of fixation to hold the bone in place like a screw or a pin.  Some surgeons require a period of non-weight bearing and typically 3 months before back to normal activities.`

I personally have performed this type of bunion surgery 1000’s of times.  I like to make a longer arm with my but on the bottom of the bone as opposed to a chevron style cut.  This allows for a more rigid fixation and faster recovery.  The typical patient can return to activities at 6 weeks. 

If you have a bunion that is causing pain and want to have minimal downtime give me a call and I can review all your options.  Remember I have an onsite surgery center that saves thousands as compared to having your procedure at a hospital or ASC.


Dr Brandon Nelson

austin bunionectomy

Bunion surgery continues to be one of the most common surgical procedures performed in the United States.  In the United States approximately 150,000 are operated on annually.  The satisfaction and success rate are high, and most patients are happy with their outcomes.

It is important be well prepared for bunion surgery and I will discuss a few tips that will make the process easier.

1.     Make sure you are prepared before the day of surgery and have somebody to help for the first 24 hours

2.     Set up a central command, ie a bed downstairs that you have all your necessary items near.  Your medications, a bathroom, and some entertainment.

3.     Bathroom - you may want to investigate a booster seat for your toilet. It can be difficult if it is too low to stand up once seated.

4.     Shower, consider a shower chair or stool

5.     Cast cover of something to keep your leg dry

6.     Vitamin supplements, I like collagen and bone healing supplements

7.     Understand your post-operative course

8.     Icing - do not underestimate the importance of icing and elevation for the first 72 hours. 

9.     Exercise to prevent blood clot, ankle rotations, leg lifts.

I hope you find some of these tips helpful. If you are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online


Dr Brandon Nelson


Bunion surgery
is one of the most performed surgical procedures in the United States.  The bunion can be corrected with many different types of procedure from osteotomies (the cutting of bone) to arthrodesis (the fusion of bones).  Lapiplasty procedure is relatively new but utilizes a technique that has been around for years.  The procedure is based on a Lapidus bunion surgery. 

This procedure was named after a Dr Lapidus.  It involves fusion of a tarsometatarsal joint to stabilize the foot and fix the bunion.  The Lapiplasty allows for surgeons to have reproducible results utilizing special equipment and cutting jigs.  I find Lapiplasty to be a reliable tool for bunion correction.  Especially useful in large bunion cases and with people that have had long standing bunions.  If you have a large bunion and would like to speak with a Lapiplasty Surgeon please contact my office and we can see if you are a candidate. Give us a call at 425-391-8666 or make an appointment online today. 


Dr. Brandon Nelson

austin bunionectomy

can be quite painful for many people.  They can begin to interfere with activities and make exercising difficult.  Additionally, it can become difficult to find shoe gear that fits properly.  Most bunions are a genetic condition that is inherited and develops with time and loading of the foot.  Many bunions get bigger as time goes on and eventually require surgical repair.  Surgery for a bunion can be broken down into two categories what are called head procedures and base procedures.  Today I will only discuss a base procedure as this seems to be the most common question lately.

Base procedures are often used for large bunions and can be a powerful tool to correct the foot.  The base procedure is usually further divided into joint sparing procedures and joint destructive procedures.  The most asked about procedure currently is the Lapiplasty.  The Lapiplasty is a procedure based off a technique described by Paul Lapidus.  It involves removing a joint in the foot that is the apex of the bunion deformity.  The reason this procedure is so effective is it eliminates the primary cause of the bunion, the hypermobile joint that initiated the development of the bunion.

Lapiplasty is a tool set that is provided to make the Lapidus bunion surgery easier.  This is a technique that has been utilized for years however this instrument set is the first of its kind and has helped make this procedure more reproducible.  This is the most common bunion procedure I execute as it has great correction and great long-term outcomes.  If you have a bunion and would like a consultation, make an appointment today and I can help.

Give us a call at 425-391-8666 or make an appointment online. 


Brandon Nelson

Board Certified Physician and Surgeon

austin bunionectomy

Bunion surgery
takes years to master and hundreds of procedures to become proficient. Experience is one of the best outcome predictors in addition to ongoing training and learning. As a physician part of our job is to constantly evaluate our own outcomes and explore techniques to improve our results. I continue to monitor my outcomes and satisfaction from patients. This has helped me to have a unique perspective on long term bunion surgery outcomes.

I have found that two bunion surgeries seem to be the most predictable procedures that have favorable results. They both have been around for years and have been utilized on hundreds of thousands of patients. These two procedures are the Austin and Lapidus bunionectomy.

The Austin is a procedure that is preformed on the head of the first metatarsal. It involves the release of some soft tissue around the bone and then cutting and sliding the bone back into position. This procedure works very well on smaller bunions with no foot instability. It has a quick recovery and can be done in under 1 hr.

The second is procedure the Lapidus or Lapiplasty is the work horse of bunion surgery. It utilized on larger bunions, people with foot instability or juveniles. It provides great correction and incredible long-term results. It involves release of some soft tissue structures around the head of the first metatarsal, then realignment of the first metatarsal and a tarsometatarsal fusion. It can take about 2 hours and has a longer recovery.

If you have a bunion, I would be glad to help you evaluate it and weigh your options between conservative and surgical correction. Give us a call at 425-391-8666 or make an appointment online today. 

Dr. Brandon Nelson

Board Certified Foot & Ankle Surgeon

austin bunionectomy

Bunion surgery
is by far the most common foot surgery in the United States. The number of bunion surgeries performed per year in the U.S. is about 150,000. The majority of these bunion surgeries are done in an outpatient setting and take less than 1.5 hours.

What is a bunion?

Please watch the following video for more information on a bunion;


So, what is the most common bunionectomy to date? The answer is a distal osteotomy or cutting of the bone towards the head of the metatarsal. This procedure is called an Austin bunionectomy.

Please watch the following video to learn more about bunion procedures; https://www.youtube.com/watch?v=U_D0NhTZOyY

Bunion surgery does not need to be scary or overwhelming we are here to help.

Give us a call today at 425-391-8666 or make an appointment online. 


Most bunion surgeries require screws or plates (or a combination). It’s important during bunion surgery, in order to get full correction and realign the bones and joints, the bone is typically resected or effusions are done to realign the first metatarsal.  This requires hardware such as plates and screws. Once the hardware has done his job and the bone has healed and maintained the new corrected alignment and position, many of our patients elect to have hardware removed. The hardware can be medical grade stainless steel or titanium. These are the most common metal/metallic implants used. 

Sometimes the head of the screw causes minor irritation or part of the threads protrudes enough that there is irritation with some of the adjacent soft tissue. 

In other instances some patients seem to be sensitive to having a foreign body or a non-human item in the body. Some patients have minor skin manifestations although this isn’t common.  In general patients feel better once the hardware is out. 

If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today. 


Complications from foot surgery are not common and many of them can be avoided with careful planning and following your doctor’s recommendations. Keeping your foot dry after surgery and until after your sutures are removed is recommended. During the first few days after surgery the incision site will still create a pathway for bacteria to get into the deeper tissue layers.

Sutures also penetrate a deeper layer and if they get wet or are contaminated they could create a direct pathway for bacteria to travel deep and cause an infection. We do not recommend allowing the incision site to get wet with bathing until after sutures are removed. Use a special cast protector for bathing and make sure that it is on correctly. A garbage bag with rubber bands may leak and fill with water-not good! Follow your doctor’s advice on wound care. At our clinic, after surgery we change our patient's dressings at our clinic to make sure it is done using sterile technique, for example a postop infection is certainly going to be more of a risk if you have an open wound or one that still has sutures and you get your foot wet such as bathing.

If you have questions about bunion surgery, and would like a consultation please let us know.

Give us a call today at 425-391-8666 or make an appointment online. 

Bunion xray

are painful enlargements around one’s big toe joint. They can be uncomfortable in shoes and with exercise. The majority of pain is usually associated with swelling, throbbing and sometimes redness. Most people with a bunion will have a family history of foot disorders and have a parent with a bunion. Commonly patients will have tried larger shoes or wider shoes and most will continue to have pain despite these measures. I get a lot of questions about the timing of bunion surgery and when to fix the bunion deformity. I will answer some of the most common questions to help others make this decision.

1. When should I have bunion surgery?

The majority of patients I see already have bunion pain and that is why they are in the office. I always have the discussion with patients about whether the bunion is causing pain daily or interfering with the activities they want to enjoy. If these are occurring it is time to fix the bunion. This deformity can make life challenging especially from a physical activity standpoint. If your bunion is preventing you from exercising, it is time to fix it.

2. How long is my recovery?

It depends on the bunion procedure that is utilized. The majority of bunion surgeries patients can begin to walk when they can tolerate it. Surgery will cause some pain and swelling. I like to have my patients aggressively treat the swelling as this will create a quicker return to activities. I also like my patients that are athletic to maintain some sort of activity, like riding a stationary bike. Runners will most likely need about 2-3 months before they can return.

If you are suffering from a bunion and need a consultation to discover what conservative or surgical options are available schedule an appointment online or give us a call at 425-391-8666 today.


Don’t forget that if you take narcotic pain medication, it may have Tylenol in it. Medication such as Percocet and Vicodin may have Tylenol in it and there’s a maximum daily dose of Tylenol, approximately 3000 mg per day. This is why it’s important to keep a log of your medications. If you’re not comfortable with this then make sure to ask your doctor for narcotic pain medication that is a stand-alone item such as pure oxycodone instead of Percocet.

It’s recommended to have a family member help you keep track of these pain medications with a log. Set your clock or phone so that you have a schedule because you want to stay on top of the pain. 

If you are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online. 

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