FOR many women, the spate of Christmas parties this weekend means the return of an annual dilemma: wear unflattering flat shoes, or dance the night away in stilettos and suffer crippling pain afterwards?
But an increasing number of partygoers have found a drastic solution — having a combination of Botox and dermal fillers injected into the balls of their feet, which is claimed to make high stilettos as comfortable as flats.
Once the preserve of celebrities wanting to sashay effortlessly down the red carpet, the procedure is soaring in popularity among professional women who want to wear smart heels to work, but still feel comfortable in the evening when they go out with friends or colleagues.
And the festive season means an annual rush of requests for the treatment, known as a ‘stiletto lift’.
‘My clients can be anyone from high-powered City executives to retired women with a busy social life,’ says cosmetic doctor Tijion Esho, who performs the procedure at the Esho Clinics in London and Newcastle. ‘The one thing they all have in common is a diary thick with Christmas events and parties from November onwards.’
Emma English
Emma English, 30, knew her festive schedule would be packed, and had a stiletto lift at the end of November.
Like many petite women, 5ft 4in Emma is something of a high heel obsessive and wears 4in heels to her sales job every day, even though she is on her feet for hours at a time.
She walks to collect her three-year-old son, Mason, from nursery in the same high heels — and even at the weekend, she prefers to wear boots with a small heel as she runs around after her little boy.
Last month, her mother bought her an early Christmas present and paid £600 for Emma to have the stiletto lift.
The procedure is a drastic — and expensive — alternative to the popular cheap gel inserts that women often buy to slip into their shoes during the party season, which can be picked up for less than £5 from any pharmacy.
Just like the gel inserts, injectable fillers help to relieve pressure on the fat pads on the balls of your feet, which bear most of the weight when you walk in heels. Meanwhile, Botox injections in the same area prevent swelling and sweating.
Dr Esho says 223 women have had the procedure at his clinics this year, up from 185 last year. Many are mature career women who are dismayed to find they can no longer wear their heels without pain.
‘Around 60 per cent of clients for this procedure are in the 45-to-60 age group,’ says Dr Esho. ‘The extra cushioning makes a particular difference for older women, because the fat pad on the ball of the foot decreases as you age.’
Just as the collagen in facial skin declines with the years, the firm cushion of fat on the bottom of the foot becomes thinner and less supportive over time.
‘When you walk normally in flat shoes, this side-effect of ageing isn’t so noticeable, because your weight is evenly distributed across your feet,’ explains Dr Esho.
‘But when you’re wearing high heels, a lot of weight is forced onto the ball of the foot, which can be very painful.
‘The injection of filler — I use hyaluronic acid, a form of which is found naturally in the body — acts to fill the space and add another layer. Then Botox is injected in areas of the soles of the feet.’
As we get older, the joints in our feet may start to show the first signs of changes linked to arthritis, swelling and leaving less space for the nerves that connect to our toes to pass through — which increases the chance that wearing tight shoes will put pressure on these nerves.
Meanwhile, women of all ages are forcing their feet into ever-higher heels to keep up with fashion trends — and searching for an answer to the resulting pain.
The stiletto lift treatment has even been nicknamed the ‘Loub job’ after high-end footwear designer Christian Louboutin, who created the first 8in stilettos and is credited with being the driving force behind the craze for teetering heels.
Emma, who lives in Newcastle, has worn high heels for years. But she had started to feel burning pain each evening, and feared she would soon be unable to walk in her favourite pairs.
‘Last year, I had to leave my office Christmas party at 10.30pm because my feet were so sore,’ she says. ‘I’ve got two parties this week and I really didn’t want the same thing to happen again.’
So she booked an appointment for the 20-minute procedure, which busy professional women can have done during their lunch break.
‘He gave me two or three injections into my feet and I barely felt a thing,’ recalls Emma. ‘Afterwards, my feet felt a bit numb, but there was no pain and I could drive and walk without any problem.’
After 48 hours, she realised her feet were no longer throbbing at the end of the day.
‘I’d done lots of walking around in my usual heels, then picked up my son Mason from nursery. By the end of the day, my feet are usually burning and sore, and I have to soak them in warm water. But two days after the stiletto lift, they didn’t hurt at all. It was incredible.
‘My boyfriend Richard is pretty pleased, too, because it means he won’t be left on his own this year at all our Christmas parties.’
For Emma, it was a simple solution that has allowed her to keep wearing the shoes she loves. But is it really sensible to spend hundreds of pounds just to appear more fashionable?
Experts warn that injecting Botox and fillers into the balls of one’s feet may not be a risk-free solution.
Podiatrist Margaret Dabbs, whose clients include A-listers and royals, warns that patients may exchange one form of discomfort for another.
‘I would be concerned if a lot of filler is used, as this tends to migrate and could cause pain somewhere else in the foot,’ she says.
This could lead to unsightly bumps or, if the filler has not been injected correctly, unnecessary pressure being placed on joints and nerves.
‘As with filler injections in other areas of the body, there is always the potential for complications,’ says Reza Nassab, a consultant plastic surgeon from the British Association of Aesthetic Plastic Surgeons.
‘Patients who are considering this treatment should know exactly what filler is being used.
‘Hyaluronic acid fillers, for example, have long been used for facial treatments. They are temporary and have the benefit of being able to dissolve safely inside the body, but there are other fillers on the market that can’t do this.
‘The foot is a complex structure and the injector should have a good knowledge of anatomy, as the sole of the foot has several layers and structures within it. You need to know that you’re injecting in the right place.’
If too much filler is used, or if the filler is too thick or firm, it may make walking uncomfortable.
In the most extreme cases, says Mr Nassab, the risks of fillers ‘may include infection, skin necrosis [death of the skin] and allergic reactions. Some fillers can even cause granulomas, a reaction in which the body treats the filler as a foreign substance’.
He adds: ‘Any injection into the joints of the foot could also cause nerve or blood vessel injury.’
Dr Esho recognises that there are risks to the stiletto lift. ‘It is a surgical intervention and there may be a risk of infection, an allergic reaction or even bruising and bleeding from the needle,’ he says. ‘But in careful hands, the risks are minimal.’
Even if the fillers and Botox cause no adverse reaction, they are not a long-term solution to the pain of high heels.
After all, the effects of the procedure she had last month will only just see Emma through the party season.
Dr Nick Milojevic, of London’s Harley Medical Group, says: ‘Facial fillers last for three months and Botox lasts up to six months, but on the foot area, fillers will often only provide cushioning for two to three months.
‘We do say to patients that the results are not long-lasting because of the high impact on this area of the body, so they should think twice before spending the money.’
Then, of course, there is the risk of doing your feet serious harm because you spend more time wearing shoes that force them into an unnatural position.
There is a reason why six-inch heels are so uncomfortable — they dramatically alter your posture. Wearing them every day can cause permanent problems, including shortening of the calf muscles, which may eventually make even walking in flats uncomfortable.
Heels that are too high can also be to blame for a host of problems that a stiletto lift may do nothing to prevent, from bunions and corns to painful tendonitis in your Achilles tendon.
Severe pain may be a sign of a torn ligament or other serious health problem, which could require surgical intervention.
But this formidable list of potential problems does not discourage women desperate for relief from aching feet, but determined to keep their party shoes on.
Rubey Lalia is a make-up artist who spends hours on her feet in the run-up to the Christmas party season, working eight-hour shifts to help her clients get ready for big events.
The 26-year-old had a stiletto lift in November last year. ‘I love a strappy sandal and will wear heels at least five inches high if I’m going to a party,’ she says.
‘But for years, I’ve always ended up in a taxi before midnight, heels in my hands and the balls of my feet burning and aching — so when I heard about the treatment, I didn’t hesitate.
‘The injections were fine — my feet felt a bit tingly afterwards, but that was it.
‘Two days later, I was partying and dancing the night away without feeling the slightest twinge or ache.
‘I really felt as though I was wearing gel insoles in my shoes.
‘I was also on my feet a lot working on clients into the New Year and didn’t feel any of the usual pain in my feet at the end of the day.’
Rubey adds: ‘Women don’t tend to talk about the pain of wearing high heels. Usually, we will just soldier on.
‘But now, if any of my clients talk to me about having aching feet, I tell them about this procedure because, for me — someone who works standing on her feet most days — it has been revolutionary.’
While many women return to their surgeon every November or December for a little lift before the party season, Dr Esho warns that the stiletto lift is a short-term measure and should not be performed more than twice a year at most.
‘If you start feeling pain in your feet, this is a message that something is wrong,’ he says.
In which case, there is usually only one cure: whipping out a pair of trusty flats.
© Daily Mail