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What is Fat Pad Cushion Restoration?

The fat pad beneath the heel serves as a natural cushion for the foot and helps to absorb shock during walking or running. Individuals who lose the shock absorbent ability of the heel often experience significant pain and discomfort at the bottom of the heel with prolonged walking or standing. The thinning or reduction in the size of the natural fat pad in the foot is known as fat pad atrophy. The condition may occur as a result of aging, traumatic injuries, prolonged standing, overweight, diabetes, genetics, and inflammatory diseases such as rheumatoid arthritis.

Fat pad cushion restoration is a minimally invasive injection procedure for the treatment of fat pad atrophy in which dermal fillers are placed in the affected areas of the foot such as the toes, heel, and ball of the foot to restore natural cushioning to the bottom of the foot. The procedure offers instant cushioning and reduces pain in the foot while walking barefoot or in shoes. The effects of the procedure can last anywhere from 8 months to 2 years depending upon the degree of fat pad atrophy, the filler used, and patient activity.

Indications for Fat Pad Cushion Restoration

Fat pad cushion restoration with fillers can be used to treat various foot conditions such as:

  • Corns
  • Calluses
  • Hammertoes
  • Bunions
  • Metatarsalgia
  • Plantar fasciitis
  • Diabetic ulcerations

Who is a Good Candidate for Fat Pad Cushion Restoration?

You may be a good candidate for fat pad cushion restoration if:

  • You are an elderly person
  • You have chronic heel or foot pain
  • You are a person who wears high heels frequently
  • You are a runner whose feet are impacting hard surfaces often
  • You are in a profession that requires prolonged standing
  • You have painful foot conditions that have not responded to other treatment modalities

Preparation for Fat Pad Cushion Restoration

In general, pre-procedure preparation for fat pad cushion restoration will involve the following steps:

  • You will be asked if you have allergies to medications, anesthesia, or latex.
  • You should inform your doctor of any medications, vitamins, or supplements that you are taking.
  • You may need to refrain from vitamins and supplements or certain medications.
  • It is also important to inform your doctor if you are pregnant or might be pregnant, diabetic, asthmatic, or have any other medical conditions.
  • You should refrain from alcohol or tobacco at least a few days prior to the procedure.
  • You should not consume any solids at least 6 hours prior to the procedure. A small quantity of clear liquids is okay up to 2 hours before the procedure.
  • A written consent will be obtained from you after the procedure has been explained in detail.

Procedure for Fat Pad Cushion Restoration

Fat pad cushion restoration is a simple in-office procedure in which FDA-approved dermal fillers are injected into the skin of the affected foot area to increase the volume of that region. Dermal fillers are made up of several types of natural, synthetic or man-made substances and work by providing extra cushioning into the heels and balls of the feet. They deliver a plumping effect in the region it is injected. Some dermal fillers also assist the body to produce more of its own collagen for a long-term effect.

During this minimally invasive pain-free procedure, you will lie on the procedure table on your back. Your physician will administer an injection containing dermal fillers (hyaluronic acid or poly-L-lactic-acid) and a local anesthetic (lidocaine) into the fat atrophied area of your foot. Sometimes, regional anesthesia may be utilized if the individual is already in pain. Your physician will meticulously examine the foot to inspect the volume of filler required in each area before inserting the needle into the sole of the foot. More than one filler injection may be required depending on the location and extent of fat pad atrophy.

Post-Procedure Care and Recovery

After the filler has been administered, your physician will cover the region with a couple of bandages and offload pads. There is little to no recovery time for this injection procedure as compared to other treatment alternatives. You may leave the clinic within an hour after receiving the injection. The pain relief is immediate, and you can weight-bear right away. You will be instructed to wear supportive shoes, do foot exercises, take pain and anti-inflammatory medications, and engage in low-impact activities for a specified period of time.

Risks and Complications

Short-term complications of the fat pad cushion reconstruction procedure include:

  • Swelling
  • Bruising
  • Infection
  • Tenderness
  • Inflammation