It is a great challenge for a plastic surgeon to reconstruct the plantar foot. The heel is located at the lowest point of the vertical axis of the human body and plays a crucial role in body weight bearing, standing and walking. That makes the reconstruction of the heel pad even more important. Of all the camplications after heel pad reconstruction, foot ulceration presents a serious problem-the occurrence is frequent and the treatment is difficult. In this article we analyze the mechanisms of foot ulceration based on our experience of heel pad reconstruction. We also developed a principle of surgical reconstruction to reconstruct the heel pad as a unit. We apply this principle on 5 patients with large defects of the heel pads as a result of trauma or after tumor surgery, and the result is excellent. There were neither foot ulcers, wound infection nor dehiscence. Time before ambulation was 5.4 months in average alter reconstruction. There was no problem in wearing sport shoes or even leather shoes. The eventual function was good while tested with gait analysis, in both static and dynamic aspects.