Ask The Experts
Is there a procedure to add back one's own adipose tissue to aging, thinning feet? Is it safe?
Thank you for contacting IPFH. We do not endorse or recommend treatments, procedures or remedies on line. Obviously you are already familiar with the fact that, as we age, the fat pads of our feet tend to get thinner and less protective. You can read more about this phenomenon at this link: http://www.ipfh.org/foot-care-essentials/fat-pads-what-you-need-to-know.
The use of “prosthetics” to replace lost fat pad tissue in the feet can be done in several ways: 1) the use of “replacement” pads (using dermal fillers such as Sculptra®); 2) the introduction of adipose tissue from a donor (an allograft); and 3) the introduction of a person’s own adipose tissue from another bodily location (an autograft). At IPFH, we rely heavily on peer reviewed research to lead us to conclusions about good practices for effective foot health. We are aware of some articles that chronicle benefits of all three of these techniques, although most of this research deals with their use in injured feet:
This review of the use of liquid silicone injections to address loss of plantar fat pads addresses some of the benefits and risks of that procedure: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909515/.
This article from the journal Wounds describes the successful use of an allograft (transplant of tissue from a donor to a patient) to treat injured plantar fat pads:
http://www.woundsresearch.com/article/tissue-augmentation-and-replacement-heel-fat-pad-decellularized-sterile-human-dermal-matrix.
This article from the journal The Foot details the successful use of an autograft (a procedure called “lipofilling”) in injured feet (specifically, post-traumatic loss of soft tissue): http://www.thefootjournal.com/article/S0958-2592(14)00005-4/fulltext.
Regarding the use of one’s own adipose tissue for replacing worn plantar fat pads, we assume that the feet are otherwise healthy. We are not, however, aware of the extensive use of this method in practice today, although we are aware of the fairly extensive use of plastic and reconstructive surgery in people whose feet have suffered cumulative damage from poorly designed and fitted footwear, and/or years of use (and often abuse). Therefore, we would recommend, if you are considering such a procedure, that you consult a Doctor of Podiatric Medicine (DPM), with whom you can discuss the feasibility of this procedure. There are other alternative measures you can take to help offset the loss of plantar fat pads. Specially designed footwear, including padded socks, orthotics or inserts, and accommodative shoes, can help cushion your feet and reduce the pain from lost fat pads, and we would encourage you to try these less invasive methods before you seriously consider surgery. As we always recommend, both invasive and non-invasive treatments should be discussed with a medical professional who is familiar with your situation and your medical history, and we recommend that you pursue your options with the consultation of a DPM. If you are not under the care of a DPM, you can get a referral from your primary care physician, or you can find one near you by visiting this web site: http://www.apma.org/Directory/FindAPodiatrist.cfm.
Last, here is an article entitled "Expert Insights On Therapies For Plantar Fat Pad Atrophy": http://www.podiatrytoday.com/expert-insights-therapies-plantar-fat-pad-atrophy. It is written for medical professionals and is several years old, but it gives a pretty good assessment of options for treating the loss of plantar fat pads.
We hope that this information is helpful, and that you will consult a medical professional, and possibly even get a second opinion, before deciding on any invasive procedures. We wish you the best.