The standard claim on surgery is that you get the best outcome if you find a specialist who does your surgery A LOT.

I had bunionette surgery (little toe structure, no big toe) a few months before doing my first AT hike, after being out of backpacking for 25 years. I did a lot of reading and research on the web, and found out about the various options....

Shoe fit, minimal surgery, major reconstructive surgery.

The doctor that I selected happened to also be the one who would see me right away. Several others wanted me to wait one, two or even three months before they could see me.

The surgeon was sensitive to the time needs and presented the minimal surgery and the major reconstructive surgery as options. The major reconstruction would have me off my feet for quite a few months. With luck, the minimal surgery would heal fast enough in the February to April timeframe that I could do the hike. Long term, he cautioned, I may have to have the major reconstructive surgery anyway.

The minimal surgery healed in time. I did the hike with antiinflamation pain pills and a compression sock. Just Springer Mountain, GA, to Damascus, VA.

I became very sensitive to getting shoes that fit properly around the bunionette area... mainly the toebox and the width of the shoe.

The few times I incorrectly picked shoe fit, I noticed both pain and swelling in the bunionette area. I discarded such shoes.

Most of the shoes I buy now are Wide Width, even though the shoe fit gauge in the store indicates a D width is the "proper fit".

The foot is still functional, and I have hiked several hundred more miles on The Superior Hiking Trail and another section of the Appalachian Trail.

There is a technique sometimes called "Broomsticking" that can be used with leather footwear to stretch local areas. The rounded end of a broomstick and "shoe stretch" liquid (or isopropyl alcohol) are used with considerable force to do the localized stretching. Doesn't work on synthetic materials which fail to soften and stretch.

Do your research and good luck in finding a competent, skilled and understanding surgeon.