I own 8 pairs of Alden modified last shoes. I have what my shoemaker calls a "sickle" shaped foot that requires a non-standard last, and very few manufactures make a last which accommodates this shape. Luckily for me, Alden does, and this is called the "modified last" as you mention. Vass of Budapest offers a similar RTW last called the "banana last" (though all of Vass' lasts are essentially RTW, but I digress). The quality/finishing on the modified last shoes is not as high as Alden's regular stuff though (stitching is not as neat, only half-lined sole, etc). However, on some of the cordovan shoes I've purchased, the quality is as good as Alden's mainline stuff. I know the styling isn't so sexy, but if they're comfortable for you, go for it. I purchased all of mine through Moulded Shoe, and they are excellent people to work with. But, photographers they are not. So the shoes are definitely better looking in person than on the website. As an aside, the Japanese are ape-shit over the modified last, and they command a significantly higher price in JP. You can see some of the porn at: http://www.lakota.co.jp/catalog_alden_dress.htm
for the cordovan shoes, and http://www.lakota.co.jp/topic_9.htm
for some seasonal shoes. A shoemaker I use tells me that the Japanese often have "sickle" shaped feet which is why they are so popular in JP.