The Loub Job (named after the famous shoe designer Christian Louboutin) was born a few years ago in England and is now becoming more and more popular in France, especially in Paris. Doctor Vincent Masson is one of the few French cosmetic surgeons in Paris trained in the Loub job technique (technically described as the injection of filling into the plantar pads).
This is a procedure which injects hyaluronic acid or fat at the level of the plantar pads in order to thicken the panicle of the support areas of the foot and thus reduce pain when wearing high heels. Many women experience pain in certain areas of the foot (forefoot, metatarsals, toes, heel) when they wear high heel shoes.
Before the procedure:
A static foot examination is essential in order to detect any postural anomaly. Your cosmetic surgeon will refer you to a specialized podiatrist who will perform a podometry. The foot is a very complex anatomical structure. It is composed of 26 bones, 16 joints, 20 muscles, and over a hundred ligaments. In a normal physiological situation (walking on flat ground without heels), the body weight is distributed 75% on the heel (talus and calcaneus) and 25% on the forefoot (metatarsal heads and toe pulp). When wearing heels of 8 cm or more however, the ratio is reversed (75% of the weight passes over the forefoot and only 25% over the heel). This reversal of the support ratio between the heel and forefoot is the cause of pain.
There are only two techniques that are reliable and recognized. Injection of hyaluronic acid and lipofilling (fat transfer). In both cases the principle is identical: strengthen the thickness of the subcutaneous tissues at the support points and modify the distribution of the support points by filling in the areas that should normally provide support but do not. In other words, an injection of hyaluronic acid or fat is carried out in order to create a quilting effect on the weight bearing areas and to modify the support areas of the foot.
Hyaluronic acid is the same product that is used on the face to fill in small wrinkles, dark circles or hollows, and augment the cheekbones or lips. It is a product naturally present in the human body and absorbable after 6 to 9 months. Silicone or collagen injections are not recommended in France (synthetic allergens and non-absorbable products).
Lipofilling can be described in several different ways: fat transfer, fat graft, liposculpture, lipomodelling and Coleman’s technique. The principle, however, is always the same whatever the name used. Using micro-incisions, fat is taken somewhere on the body where it is in excess (flanks, stomach, hips, inner thighs, knees etc.), it is then purified and reinjected into the desired location. This is a classic plastic surgery technique that has the advantage of being gentle, non-traumatic, natural and, above all, permanent. In fact, the transferred fat remains in place for the rest of the patient’s life, unlike hyaluronic acid which is absorbable.
In practice :
After consulting your surgeon who will have explained the principles of the procedure and carried out a podometric examination in cooperation with a specialized podiatrist, two options are possible.
Injecting hyaluronic acid is the gentler of the two methods. Local anesthesia is performed in the surgeon’s office and hyaluronic acid is injected using microcannulas in the areas to be treated. The pain during local anesthesia is similar to that of a blood test (a stinging sensation). The session lasts for an average of 15 to 30 minutes depending on the case. Walking is authorized (with or without high heels) after a 30-minute rest without support. Some pain (tightness, discomfort) may be present for a few days as well as redness and a slight swelling in the injected areas but no social life disruption is necessary. The result will be visible around the fifth day. The disappearance of pain is never 100%, however, you can expect a reduction in foot pain ranging from 50 to 75% and which is proportional to the height of the heel and the quality of the shoe. The duration of the effects of hyaluronic acid (an absorbable product) on the foot is from a minimum of four months (this includes walking a lot, wearing heels over 10 cm, stilettos, running etc.) to a maximum of nine months.
The second possibility is the transfer of fat. Unlike injecting hyaluronic acid, the advantage of this method is that it has a definitive effect and can be associated with liposuction. A short hospital stay (entry in the morning and exit in the afternoon) is essential. Anesthesia is local, combined with sedation (you remain awake but in a state of relaxation). The fat is removed in small quantities from a part of the body where it is in excess, purified, and then reinjected at the level of the plantar pads in the support areas of the foot. Walking is authorized the same day and the effects and results are the same as with as the injection of hyaluronic acid. The swelling and redness may, however, take a little longer to subside than with hyaluronic acid. The amount of fat removed is small (40 cc on average) and some patients therefore wish to associate a Loub Job with more extensive liposuction, which is entirely possible. The postoperative follow-up is the same as for conventional liposuction but it’s important to know that an initial discomfort when walking can exist for a few days, weeks, or sometimes even longer periods.
Generally, patients start with hyaluronic acid injections and then, after having experienced the benefits when wearing high heels, opt for lipofilling where the results, unlike with hyaluronic acid, are definitive. This is particularly the case with patients who want associated liposuction.
How much does a Loub Job cost ?
The cost is variable depending on the technique used (hyaluronic acid, lipofilling, associated procedures) and the anatomy of your foot (the amount of hyaluronic acid required, number of injections). A quote indicating the price will be given to you after consultation with Doctor Masson. Prices range from 600 euros for hyaluronic acid and 3000 euros for lipofilling.