You can’t help but wonder where it will end—when women, with a strong assist from the media, will stop comparing themselves to some impossible ideal and electing ever-stranger cosmetic procedures to achieve it. And when physicians will stop transforming themselves from doctors who address medical issues into aestheticians, capitalizing on this lucrative trend and enabling women to continue their endless quest for perfection.

It’s hard to put blame exclusively on the shoulders of any party in this mix—it’s a self-perpetuating vicious circle with everyone contributing. Media organizations compete to publish the most sensational stories they can find to capture ratings, and cosmetic surgery is of huge interest these days. Women succumb to increasing pressure to look thin enough, feminine enough and young enough to be acceptable in today’s society. And gynecologists, dermatologists and even general practitioners add cosmetic procedures like breast augmentation and liposuction to their practices—or even convert to the field of cosmetic surgery altogether—to make money.

As the vicious circle keeps turning and widening, cosmetic procedures are starting to show up in still other areas of medicine. Some of the newer procedures you can elect allow you to beautify your feet. Yes, podiatrists are adding a variety of aesthetic treatments to their practices to help you look your best in sandals and sport the most uncomfortable—but fashionable—footwear on the planet, sky high heels.

One of the leaders of this movement is Dr. Ali Sadreih, DPM, with his Beverly Hills Aesthetic Foot Surgery center. In a visit to Sadreih, you can sign up for “aesthetic toe shortening.” As a photo caption on his website notes, “When toes are too long, they can bunch up when wearing heels.” Dr. Sadreih’s toe surgery can help you avoid another foot fashion faux pas, when toes “hang off the edge” when the occasion calls for revealing footwear. You don’t want that.

Other treatments offered at the Aesthetic Foot Center include toe lengthening, which, to be fair, can be a relief to those with congenitally deformed toes or those who have had hammertoe surgery go wrong. But you can also get bunions shaved so you can fit in narrower shoes, in an operation Dr. Sadrieh has trademarked the “Cinderella Procedure.” And, in a breakthrough application for the trendy fat transfer process usually connected with shaping up faces and breasts, you can have your own fat injected into the balls of your feet so you’ll be more comfortable in high heels.

So, now that aesthetic procedures are an option for doctors of podiatry and women who are unhappy with their feet—what could be next? Neurosurgeons offering skull-smoothing surgery for people who think their heads are too bumpy? An orthopedic surgeon trademarking “Knobby Knee Reduction?”

According to Sadreih’s own awkwardly-worded justification for ever-escalating aesthetics, society is to blame:

“It seems incredible that we live in a society that we do procedures to wear certain shoes, but until we can change the societal pressures of the high heeled shoe being the standard professional shoe gear for a woman, simple, safe solutions like the Foot-Tuck [toe shortening] can relieve the pain that women have to deal with.” (See www.beverlyhillsfootsurgery.com)

One thing seems patently clear: the media will not stop sensationalizing, and practitioners like Sadrieh will not stop responding to demand. That’s the heart of the vicious circle, the mechanism that keeps it forever turning: demand. The only way to bring about moderation in aesthetic medicine is for women to come to their senses and draw the line somewhere reasonable. How about it?

Where do you draw the line? Is cosmetic foot surgery going too far?