If you have chronic foot pain, you\u2019ve probably tried a variety of treatments and medications. If those approaches have provided little to no improvement, you may be losing hope.\n\u201cPlease don\u2019t give up,\u201d advises Jeffrey Gusenoff, MD, a plastic surgeon at UPMC. He and his wife, podiatrist Beth Gusenoff, DPM, a researcher at the University of Pittsburgh, are offering a new treatment that\u2019s showing remarkable success in treating certain types of foot pain. It\u2019s called foot fat grafting.\nThe Pain of Atrophy\nYou may not think of the foot as a fatty part of the body, but the ball and heel have specialized fat pads that act like the body\u2019s shock absorbers. Fat pad atrophy occurs when these pads deteriorate, usually through repetitive use or injury.\n\u201cNearly one in three adults over age 60 has this problem,\u201d explains Dr. Jeffrey Gusenoff. \u201cAthletes, people who stand for long periods each day, and those who\u2019ve had fractures, surgery, or repeated steroid injections also are likely to have fat pad atrophy.\u201d\nDr. Beth Gusenoff notes that the atrophy can be caused by other issues, including systemic diseases such as rheumatoid arthritis and diabetes. People who have high arches or habitually wear high heels, those with jobs that require standing for a long time, or those who over-train athletically may lose foot pad fat. The two doctors also are developing a novel treatment for people with chronic plantar fasciitis through the use of the person\u2019s own fat.\n\u201cThere\u2019s a great deal of pressure when the fat is gone, so you\u2019re in a lot of pain,\u201d says Dr. Jeffrey Gusenoff. \u201cIt can be debilitating. We\u2019ve seen people on crutches, people who tell us they\u2019re basically crawling around the house because they can\u2019t put pressure on their feet.\u201d\nWhen people lose mobility, they often get depressed and become housebound, adds Dr. Beth Gusenoff. \u201cWe see retired people who can\u2019t entertain, can\u2019t play with their grandchildren, can\u2019t take trips. They are suffering, and their function is gone.\u201d\nCollaborating on a Solution\nThe two doctors came up with the idea for foot pad grafting together. \u201cWe were talking during dinner one night, and it struck us: We do a lot with fat injections elsewhere \u2014 why can\u2019t we put them in the foot?\u201d explains Dr. Jeffrey Gusenoff.\nThey began a two-year clinical trial in 2013 at the University of Pittsburgh Department of Plastic Surgery. The results, published in the December 2018 issue of Plastic and Reconstructive Surgery, showed that people experienced pain relief and improved quality of life for up to two years after the fat injections. In fact, they improved more with foot fat grafting than with traditional treatments like orthotic insoles or steroid injections.\n\u201cWe\u2019ve had people come in from as far away as Australia and California to have the procedure done,\u201d says Dr.\u00a0 Beth Gusenoff. \u201cThis procedure has provided relief from foot pad atrophy to many people.\u201d\nHow Foot Fat Grafting Works\nFoot fat grafting is a minimally invasive procedure that doesn\u2019t require a hospital stay. \u201cWe perform the procedure in the office using local anesthesia,\u201d says Dr. Jeffrey Gusenoff. A small portion of fat is removed from a fatty area like the belly or thighs using liposuction. The fat is then cleaned in a centrifuge and injected into the foot.\n\u201cBecause it\u2019s your own fat, the body doesn\u2019t reject it,\u201d explains Dr. Jeffrey Gusenoff. \u201cFoot fat grafting is a simple, quick procedure. We bandage the foot, then modify the patient\u2019s shoe and\/or insole to reduce pressure on the grafted area. Typically, patients can walk out of the office.\u201d The doctors and staff are in regular communication with patients throughout the six- to eight-week recovery period.\nThe procedure is best for people who don\u2019t smoke, don\u2019t have an active infection, and don\u2019t have uncontrolled diabetes.\nFoot fat grafting is currently available through Regenerative Cell and Tissue Therapies at UPMC, a specialized center in the UPMC Department of Plastic Surgery. To make an appointment or for more information, call 412-641-3960.