Information from Podiatry Today, April 2011, “Emerging Concepts In Cosmetic foot Surgery” by Allan Grossman, DPM lead author.

Fat pad injections are another practice gaining momentum. The plantar fat pad absorbs much of the pressure that our feet must endure. Over time, this fat pad wears down and atrophies resulting in painful callouses and in some patients ulcerations. Some of the conservative treatments to approaching this situation include orthotics, gel cushion inserts and changes in shoe gear.

Attempts have been made to inject silicone into these atrophied areas with some success. Research studies have shown a reduction in pressure in areas injected with silicone but the results do not last long and the patient requires multiple injections. Other similar treatments with products called dermal fillers ( Restylane and Sculptra) have shown similar results but also require multiple treatments.

Autologous fat can augment fat pad atrophy with some relative success. Working with a cosmetic surgeon, fat removed during liposuction can then be transplanted into areas of fat pad atrophy on the foot. Another technique of fat pad augmentation is the use of acellular human dermal allograft, human tissue grown in a lab. A 2009 a study performed to measure the success of this technique showed reduced pressures and according to the lead author solves the problem “permanently and practically”.

As always one should weigh the risks versus the benefits when considering a surgical procedure, especially an elective cosmetic procedure versus non-elective procedure. You should discuss you specific condition and treatment options with a trained Podiatrist so that you can make the best, well informed decision that will give you the best long term result.