Adding Fat Pad Injections to Your Practice

Do you have patients with painful fat pad atrophy who aren’t improving with pads and orthotics?

In this episode, Don shares his first experience using Leneva (fat pad replacement injectable) for a patient with severe forefoot fat pad atrophy. After hearing about it at a recent conference, he implemented the treatment in-office—complete with consent workflow, storage protocol, injection technique, post-op plan, pricing strategy, and marketing rollout.

This is a practical breakdown of how to evaluate, introduce, and operationalize a new regenerative-style offering—from patient selection to filming a YouTube explainer. If you’re considering adding higher-value procedures to better serve chronic pain patients, this gives you a real-world starting point.

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Timestamps (Total: 5:48)

[00:00] Why Consider Fat Pad Replacement?

Managing painful calluses and fat pad atrophy when orthotics and pads fail.

[00:45] Discovering Leneva at Conference

Initial exposure, hesitation with similar products, and deciding to trial it.

[01:30] Office Setup and Financial Workflow

$500 deposit, ordering and freezing protocol, consent forms, and tissue documentation.

[02:10] Injection Technique Step-by-Step

V-block anesthesia, thawing and drawing with 18-gauge needle (noting 20-gauge may offer better control), retrograde injection technique, and even distribution under the metatarsal head.

[03:40] Post-Procedure Protocol

Sterile strip closure, offloading padding, surgical shoe, 3 days heel weight bearing, 2 weeks protected weight bearing, gradual transition back to shoes.

[04:30] Pricing and Case Selection

$1,500 per 1.5cc syringe; typically one per metatarsal head depending on severity.

[05:05] Marketing the Procedure

Recording a YouTube video using CapCut, uploading via Google Drive, adding subtitles, and educating patients through email outreach.

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Key Takeaway

If conservative care isn’t enough for fat pad atrophy, adding a structured, well-priced in-office injectable option—supported by proper workflow and marketing—can improve outcomes and elevate revenue per case.

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Conclusion

If you’re evaluating whether to introduce regenerative or specialty injectables, start with one diagnosis, build your consent and pricing structure carefully, and document the process.

Have you added fat pad replacement or similar procedures to your practice? Share your experience—what worked, what didn’t, and how patients responded.