The term foot sculpture describes self amputation of the toes and relates to the practice of body modification, common among modern primitives. There are several sites on the World Wide Web where authors claim to be multiple toe amputees. Whilst there is no way to confirm their claims there is are photographs available. Amputations are reportedly undertaken under the strictest conditions with big toes or smaller digits amputated.
Apotemnophilia describes a psychological pre-occupation, not necessarily sexual driven, where a person wants one less limb to become complete. Apotemnophilia was first described in 1977 by psychologist John Money who published the first modern case history of "apotemnophilia". The condition was referred to as a paraphilia of the stigmatic/eligibilic type in which sexual-erotic arousal and facilitation or attainment of orgasm is dependent upon being an amputee, or an attraction to the idea of being an amputee. He distinguished apotemnophilia from "acrotomophilia", a sexual attraction to amputees. Apotemnophilia relates not to a sadistic nor masochistic intention instead to the idea of self-fulfilment brought about by being an amputee. Apotemnophilia is now classified as a Body integrity identity disorder (BIID), often referred to as amputee identity disorder. The compulsion to have an amputation is similar to the angst suffered by transgender people who may be relieved only when their transgender relocation is complete by surgical intervention.
The cause of ampotemnophilia remains a mystery but no treatment involving counselling and or pharmacy has been found to reduce the anxiety. Many apotemnophiliacs go undiagnosed and more importantly untreated. Frustration and desperation drives many to self-amputation with tragic consequences. There are cases cited where orthopaedic surgeons have amputated healthy limbs at the request of their patients. Although small in number and obviously controversial the procedures are only conducted once all other forms of treatment have been exhausted. Like gender relocation surgery the protocols are strict and patients screened very carefully. Opposition to this type of cosmetic surgery is fierce and centres where these procedures are undertaken are few and far between.
Many experts believe the increase of apotemnophilia is due at least in part to the internet and networks of would-be self-amputators sharing their experiences combined with a growing number of sympathetic medical professionals willing to perform amputations for them. On a lesser but no less significant scale a number of people attend podiatry services, convinced they have a misshapen, smelly, or otherwise defective foot and will submit to all manner of cosmetic and surgical programs with the practitioner unaware the person is suffering a form of body dysmorphic disorder. Following a reported increase in requests to have healthy limbs, or parts there off, amputated the subject has become an interest to medical and social research. Findings are complex with the motivation to have an amputation surprisingly varied.