The heel is the first point of contact with the ground when walking and contains a specialized fat pad to absorb pressure. Loss of fat in the heel reduces the shock absorption and causes pain with every step. Heel fat pad atrophy is most commonly seen in a high arch foot that does not collapse when standing, exposing the heel bone to significant amounts of pressure on heel strike and weight bearing. Pain can get worse throughout the day and with prolonged standing. The number one cause of heel pain is plantar fasciitis, but heel fat pad atrophy is common as well and sometimes found in patients with plantar fasciitis. Plantar fasciitis pain improves throughout the day with activity and flexibility, whereas pain from fat pad atrophy gets worse. Steroid injections are a common treatment option for plantar fasciitis, but if the steroid spreads, it can dissolve the fat and cause heel fat pad atrophy. Often patients will note a discoloration of the heel or even a depression of the skin. Many have wrinkly skin like a raisin.
Fat grafting uses your own natural fat to replace the missing fat in your feet. No foreign material and no rejection. We take fat from one part of your body where you do not need it (like your hips, thighs, or belly) using small liposuction tubes and transplant it to the heel. This is a safe, minimally invasive procedure done under local anesthesia, with no sutures. Fat is injected into the specialized fat compartment, thereby improving shock absorption.