What is the difference between aesthetic and cosmetic foot surgery? In each case, we are making to foot more visually appealing but there is still a big difference. Cosmetic surgery is performed with the sole intention of making your feet look better. Aesthetic surgery is performed to fix a painful condition but also leave the foot looking better than before. In each case, the result is the same. An example would be a person with one toe longer than another. For some this might cause pain and we would perform an aesthetic surgery to get rid of the pain and make it look nice in a sandal. For some, this condition might not be painful, just unappealing, so we would shorten it just for looks, and this would be considered a cosmetic surgery.