Foot Fat Pad Augmentation

Based in the heart of NY, Advance Foot and Ankle Solutions offers the best facility for performing foot fat pad augmentation, while catering to all other various foot and ankle problems. Look no further when you can have direct access to the globally acclaimed specialist team of foot and ankle surgeons, supervising & managing your foot fat pad augmentation with diligence and dedication.

Advance Foot and Ankle Solutions support team is absolutely attentive to your requirements related to foot fat pad augmentation. Call & book an appointment right away for professionally diagnosed, treated and empathetically cured foot and ankle issues, to lead a wholesome, enviable lifestyle.

Basic Anatomy & Pathophysiology Of Foot Fat Pad

The Basic Anatomy

The fat pad is the thick pad of fatty connective tissue that runs under the ball in the forefoot and heel of the hind foot, forming the lower aspect of foot. The plantar fat pad serves as a bolster and a means of absorbing shock while landing sharply and forcefully over the ground. The fat pad mainly serves the following purpose:

  • Provide effective cushioning to minimize the effect of friction, pressure and gravitational forces on the foot musculoskeletal structure
  • Serve as a mechanical anchor that helps in shifting and distributing the body weight appropriately without over-pressurizing connective tissue elements

The Basic Pathophysiology

Fat pad atrophy is the thinning and gradual loss of the fat pad in the ball or heel of the foot. In other words, it is the thinning of the pad that exposes the delicate connective tissue elements to strain and pressure, creating inflammation and minor injuries. Conditions like these are more common in aging population and usually presents with severe foot pain and discomfort during walking.

During gait, there is a pressure equal to nearly 2.5 times the body weight on the heel during heel strike on the ground. This can lead to heel pain with an increase in pressure strike and load forces due to anterior displacement, as one would see in the Cavus foot type with some of the fat pad shifting under the digital sulcus. This can subsequently lead to stress fractures of the calcaneus.

Fat pad atrophy affects men and women equally and becomes more intense with age. Over the years podiatric scientists and researchers have tried to devise a way to replace the fat pads in the foot. This has been very difficult owing to the weight-bearing nature of the foot.

Causes Of Foot Fat Pad Atrophy

Certain factors may aggravate the risk of developing fat pad atrophy. These are listed beneath:

  • Footwear selection can cause as well as aggravate the risk of foot pad atrophy like wearing thin soles, high heels, and ill-fitting or exceedingly tight footgear.
  • Walking Barefoot is one of the factors of fat pad atrophy that is often overlooked and ignored.
  • Age poses a direct risk factor for developing degenerative foot conditions with its progression in years, since new cartilage and fat tissue formation decreases, turning the bones weaker and more prone to damage.
  • Injury caused by significant trauma by landing heel-first that leads to multiple fractures or surgeries can also increase the risk of developing fat pad atrophy.
  • High Arch, Scleroderma & Lupus may also cause changes in the fat pad by applying direct pressure on the connective tissue architecture.
  • Excessive Pronation where the feet roll inward can cause the foot fat pad to weaken and, thus, atrophy.
  • Arthritis Or Rheumatoid Arthritis aggravates the risk of fat pad atrophy as the bones become more vulnerable to damage or breakage as a result of ongoing inflammation
  • Collapsed Bone, as a result of degeneration or damage to the long bones of the foot is able to exert undue pressure over the fat pad, leading to increased wear and tear damage.
  • High-Pressure Area Under The Foot due to deformities like claw toe, rocker bottom foot, and problems in ankle alignment lead to fat pad depletion.
  • Surgery On Other Podiatric Parts can lead to fat pad atrophy.
  • Diabetes Patients are vulnerable to develop peripheral or autonomic neuropathy which leads to numbness and loss of sensation in the foot, elevating the propensity of developing pressure-induced atrophic changes that leads to fat pad atrophy.
  • Body Mass Index (BMI), which is the ratio between your weight and height, can produce an impact on the fat pad wellbeing.
  • Hormonal Shifts caused as a result of pregnancy, menopause, hysterectomy and chemotherapy can produce the atrophic condition.
  • Medications that include the chronic intake of steroids and statins are also known to cause fat pad atrophy in adolescents.
  • Steroid Injections in the foot on a frequent basis to treat the heel pain of plantar fasciitis can cause fat pad atrophy.
  • Family History Or Genetics plays a very important role in the development of atrophic and degenerative conditions.

The Associated Symptoms Of Fat Pad Atrophy

Common symptoms of fat pad atrophy include:

  • Pain In The Feet While Walking, especially on hard and flat surfaces
  • Discomfort While Standing for extended periods of time
  • Feeling A Mass Or Swelling in the foot front or heel
  • Thick Callus Formations on the ball of the foot
  • Worsening Pain on wearing high heeled footwear

The Diagnostic Process

The process comprises of the below-mentioned steps:

  • Taking down your symptoms, their duration and general health history
  • Doing complete, thorough physical examination of the affected foot
  • Carrying out the following imaging tests to accurately characterize the loss of foot fat pad presented:
  • Plain X-ray Films
  • Ultrasound Scans
  • CT Scans
  • MRI Scans
  • Ambulatory Pressure Pads

The Treatment Procedures

The foot fat pad atrophy may be treated utilizing conventional, conservative means as well as the surgical ones in the case of the former’s failure or inconsistency.

The Conservative Method

  • Activities which put excessive pressure on the foot such as walking barefoot on hard, flat or uneven surfaces should be restricted or better avoided.
  • Wearing high heels should be refrained from while switching to comfortable footwear.
  • Low impact weight bearing exercises should be opted for to optimize healing and regeneration processes.
  • Extrinsic paddings or insoles should be used to allow even distribution of weight to minimize the direct impact of pressure.
  • Such a footwear be chosen that supports the foot (especially the heel and arches) to provide cushioning and shock absorbing features.
  • Treatment of fat pad atrophy via regenerative medicines such as Platelet Rich Plasma injections and Stem Cell Therapy carries significant potential.

The Surgical Method

When conventional methods fail, healthcare providers may recommend surgical treatment as a last resort. Surgical augmentation of the plantar fat pad can be divided into 3 categories:

  • Injectable Fillers that offer a swift and easy moderate-term solution with minimal side effects and downtime, along with immediate weight bearing
  • Auto Lipotransplantation that utilizes patient’s own fat cells with slightly extended recovery period and immediate weight bearing in a surgical shoe
  • Allografting that is an injectable graft matrix sheet with the longest recovery period as well as the longest effective procedure

The Risks Involved

As is true with any surgical procedure, the following complications may pop up in the postsurgical phase:

  • Bacterial Infection In The Wound
  • Damage To Nerves & Blood Vessels
  • Excessive Bleeding
  • Blood Clot Formation
  • A Bad Reaction To The Anesthesia
  • Stiffness & Numbness Near The Incision Due To Nerve Injury
  • Delayed Wound Healing