The specialized fat pad on the bottom of our feet, which act as shock absorbing cushions, can begin to shrink and shift with age and use. The collagen and elastin are lost beneath the surface of the skin. The change in anatomy will make walking, staying active and standing extremely painful.

Coined by Dr. Abraham Wagner (an expert in non-invasive functional & aesthetic treatments) the Brazilian Foot Lift serves as a long-term alternative to help improve the shape and integrity of the bottom of your feet. These fat pads protect the feet’s bones, tendons, ligaments, blood vessels and nerves.


The fat pad is regenerated using your own fat, also known as an autologous fat transfer or autolipotransplantation (fat from your own body). The fat is harvested from one of a number of locations. The amount is small (usually a small syringe worth) and will not leave any noticeable defect. The procedure is designed to provide an alternative to surgery, to restore quality of life and to eliminate pain once and for all.

Dr. Wagner and the JAWS Podiatry team will determine if you are a candidate for the Brazilian Foot Lift procedure.


  • Age
  • Collapsed long bones in the balls of the feet or prominent metatarsal heads
  • Wearing high heels
  • Extremely high arches
  • Extremely flat feet
  • Previous Injury
  • Previous surgery or fractures
  • Genetics
  • Rheumatoid arthritis
  • Some patients with Diabetes Mellitus
  • Chronic or local use of corticosteroids
  • Orthopedic deformities
  • Abnormal foot mechanics
  • Autoimmune conditions


  • Supportive or accommodative orthotics to provide adequate shock absorption and comfort
  • Over-the-counter Pads / padding devices
  • Supportive foot wear
  • Change in shoe gear
  • Temporary Dermal Fillers
  • Avoiding certain activities that places pressures on the affected areas


Can fat pad atrophy lead to other problems?

The atrophy of the fat pads can lead to other foot health problems. The change in anatomy predisposes individuals to develop other problems such as neuromas, metatarsalgia, capsulitis and bursitis. These conditions can amplify the pain experienced and may lead to the need for additional conservative or surgical care.

What type of symptoms can I expect with fat pad atrophy?

  • Pain in the ball of the foot or heel
  • Pain when barefoot, in high-heels or thinned soled shoes.
  • Pain which is worse when standing and relieved when sitting.
  • The feeling of having a small ‘pebble’ in the shoe.
  • Painful Calluses may appear and become very thick on the ball or heel of the foot.

Who can benefit from the procedure?

  • Women who wear high-heels
  • Men
  • Women
  • Athletes
  • Essentially anyone who suffers with fat pad atrophy

Indications for the procedure:

  • Fat pad atrophy
  • Pain from structural or biomechanical abnormalities such as a high-arched or flat feet
  • Metatarsalgia or ‘stilleto-tarsalgia’ (burning on the ball of the foot)
  • Nerve pain secondary to atrophied fat pads
  • Scarred and traumatically damage skin and surrounding tissue
  • Heel Fat Pad Syndrome or ‘sore heel’
  • Patients with previous pedal ulcerations

How is plantar fat pad atrophy currently treated?

  • Avoiding certain activities that places pressures on the affected areas
  • Supportive or accommodative orthotics to provide adequate shock absorption and comfort
  • Over-the-counter Pads / padding devices
  • Supportive foot wear
  • Change in shoe gear


The Brazilian Foot Lift, fat grafting to the foot, is a revolutionary and innovative procedure that will serve as a permanent treatment option to help alleviate pain in the foot due to fat pad atrophy. Fat grafting involves using your own fat cells from the abdomen or thighs and transferring it into the painful area in the foot that has lost its cushion. Since your own fat cells are being used, there is minimal chance of an allergic reaction or rejection of the tissue. Fat grafting is a minimally invasive procedure performed in the office that has been widely used by plastic surgeons for many years and has now become standard practice.

The fat grafting technique (lipoaspiration) is performed in two steps. The patient and plastic surgeon, Gabriel Salloum MD, determine the location. This area will be anesthetized with local anesthesia and a small amount of fat will be extracted with a liposuction-like cannula. The graft will then be refined, mixed with platelet-rich plasma and prepared for reinjection to the foot. The small holes (1-2 mm) are dressed for clean healing.

Possible Complications:

Regardless of the simplicity of the procedure, there are some possible complications that may change your post-procedure experience from what we expect. Some of the possible complications for this procedure may include, but are not limited to:

  • Allergy to anesthesia
  • Discomfort after the procedure for several days
  • Recurrence of the original complaint
  • Total absorption of the fat
  • Bruising or discoloration that usually subside after several days
  • Infection of soft tissue or bone
  • Chronic swelling of the foot after the procedure for up to 6 months in duration
  • Damage to nerves (tingling, burning, stinging, numbness)
  • Significant or permanent pain (CRPS, RSD)

Alternatives to Surgery:

Fat Pad augmentation is an elective procedure. This means that it is not medically necessary to perform this surgery. It is important to understand that there are alternatives to this procedure. They include but are not limited to:

  • Accommodative shoes (Orthopedic or custom)
  • Over the counter gel pads
  • Custom molded orthotics
  • Anti-inflammatory pain medication


It is not self evident that all feet and all foot surgeons are created equally. The cosmetic and functional procedures we perform require mastery over an extensive set of skills that take years to develop. 

So when you need to keep your best foot forward, make sure that it goes in that direction only and contact our caring, experienced and thoroughly prepared staff at Jaws Podiatry.

Final thought about feet: The human foot  is a masterpiece of engineering and a work of art- Leonardo Da Vinci