Fat pad atrophy treatment: restoring the cushion under your feet.

What it is

Why the padding under the foot thins.

Fat pad atrophy means the natural cushioning under the ball of the foot or the heel has become thinner or has shifted forward. It is common with age. Years in high heels, a high arch, toe deformities such as hammertoes, some arthritis conditions, and repeated cortisone injections can all add to it.

Thinning padding can look like other problems, including metatarsalgia, a neuroma or plantar fasciitis. An exam, sometimes with ultrasound, shows how much padding is left and where it hurts.

Fillers

Fillers add cushioning in one office visit.

An injectable filler is placed under the skin of the ball of the foot or the heel to add padding over the bones. The visit is short, a local anesthetic may be used, and most people walk out in their own shoes.

The result is temporary, and the filler gradually breaks down, so treatment may need to be repeated. Using fillers in the feet is an off-label use, and it is usually not covered by insurance. The office will tell you the cost before treatment.

Liposana

Liposana uses donor fat tissue to rebuild the pad.

Liposana is human fat tissue from screened donors, processed by a tissue bank. It is injected where the padding has thinned, to replace lost cushioning with fat tissue rather than a gel. No liposuction or fat removal from your own body is needed.

You may have some soreness, swelling or bruising for a few days, and you may be asked to limit high-impact activity for a short time. How long the result lasts varies from person to person and is not guaranteed. Liposana is usually not covered by insurance.

• Exam first to confirm the padding is the problem
• Cost explained before treatment
• Orthotics and shoe advice alongside any injection