Bunions are not life and death surgery. It really is a matter of how much discomfort and pain it is causing you, and how much deformity there is.
The deformity can be that of just the big toe, or sometimes it may affect the other toes as the bunion gets progressively worse.
Bunions usually progress with time, and it is a 3D deformity. The big toe usually starts pointing outwards, and this is coupled with a rotational deformity. The big toe will then start squeezing the second toe, and may start to either over-ride (it goes above the second toe), or under-rides (goes below the second toe).
No matter how severe the deformity, bunions can usually be corrected. But the point to note is, a mild to moderate deformity can be corrected via keyhole/ MIS surgery.
A severe deformity has to be done via an open method, and not ameanable to keyhole correction. If other toes start becoming affected, keyhole surgery will not be suitable as well. And it makes surgery longer and more tedious, as I would have to correct the other toes involved as well, in addition to the bunion. This increases surgery time and effort, increases the risks, increases the post-surgical pain and discomfort etc.
For older patients, delaying surgery would also mean increased risks of surgery and anaesthesia, as they are now older and hence, a corresponding increased risk. So looking at the big picture, there is really no reason to delay unnececessarily, if the bunion causes pain and the deformity is starting to progress.
