Sesamoid Injury: Email Advice

This is a comment to one of my posts several months ago. 

Thank you for the information Dr. Blake.  I saw the podiatrist this week and he suggested removing the bone all together. Dr Blake"s comment: The sesamoid bones are two in number and dwell under the first                              metatarsal at the ball of the foot.  He mentioned using an incision on the top of the foot and the bottom of the foot. Dr Blake's comment: I favor a medial or side incision if it the tibial or medial sesamoid, and                             a plantar incision if it is the fibular or lateral sesamoid.  He prefers the top so there is not a scar on the weight bearing part of the foot. Dr Blake's comment: If the plantar incision is in the wrinkle just lateral to the weight bearing                             surface, the visualization and ease of removal is worth the scar risk.  Do you have information of which would be the better way to go? Dr Blake's comment: This is definitely surgeon's preference, and since I do not do surgery, I am                              a little out of touch if recent research is involved.  Do you have pictures of the actual procedure? Dr Blake's comment: Sorry, but I do not.  I think I am coming to terms with having surgery.  Is there a specific amount of time to wait that is suggested before surgery? Dr Blake's comment: Most wait 6 months to see if improvement is noted with the MRI scans                             conservative care.  I know you mentioned it would be acceptable after three months, but is there a golden time frame? Dr Blake's comment: No golden time frame. These things must be individualized. Top                             athletes may have surgery several weeks after injury, you and I years if                             treatment and testing showed initial improvement.  Thank you again for the information your blog offers