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Anne Betts was sassy and confident strolling down New York's Fifth Avenue in her strappy, 5-inch platform heels. Until, that is, she stepped off a curb and fell to the ground.

"I felt it immediately," says the New York ad-sales manager, referring to the pain that shot up from her just-sprained ankle. Although her doctor admonished her to give up the skyscraper shoes and imposed a 3-inch-heel maximum, Ms. Betts admits she can't resist the allure of tall shoes. "I love to dance in them," she says. While standing still, she notes, "they improve your posture."

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AFP/Getty Images Gold leather sandals from the Salvatore Ferragamo Spring 2009 collection. See more towering heels.

Not so long ago, high heels were defined as 3 or 4 inches -- a footnote to give a little height and a more appealing silhouette to the wearer. But this fall, shoes have been supersized with the proliferation of 5-, 6- and even 7-inch heels and platforms. The über-heels range from $100 versions sold by Steve Madden to deluxe pairs costing between $600 and $1,500 from designers such as Yves Saint Laurent, Marni, Manolo Blahnik and Christian Louboutin. They come in an array of shapes, including spiky stilettos, tapered cones, sloping wedges and thick wooden posts. Exaggerated platforms have thick, elevated soles, as well as high heels, making for a superhero, rather than a Barbie-doll, look.

"These are the highest heels that I've ever seen sold on a commercial level," notes Roseanne Morrison, fashion director for Doneger Group, a retail consultant for more than 200 stores. And they're selling. At Bergdorf Goodman, senior vice president Edwin Burstell says they represent "a large piece of the business this fall."

Mr. Blahnik, who for more than 20 years topped out at 5-inch heels, pushed the envelope this year, adding a 6-inch style to his line. "These are still sexy, pretty shoes," he says. The designer -- who doesn't do platforms -- says that 6-inch heels already account for about 30% of his company's business.

The heels are proving treacherous to many. At Prada's spring 2009 fashion show in Milan last month, two models fell down on the runway; others stumbled as they walked in mile-high shoes designed by Miuccia Prada. "I was having a panic attack, my hands were shaking. The heels were so high," one of the models told reporters after the show. "Some of the girls were crying backstage they were so scared."

But instead of rejecting the extreme heels, many women can't seem to get enough of them.

Posted Image Bergdorf Goodman A platform sandal for Fall 2008 by Versace.

Claudia Chan, a 33-year-old owner of an event-marketing business, partly blames her super high heels for back problems and a herniated disc. And yet she wears 4- or 5-inch high heels to business meetings and for most social occasions.

"I look taller, my legs look longer, and I feel more slender," says the 5-foot-2-inch New Yorker. "About half of the clothes I wear only look good in high heels. There is a price to pay for beauty, and high heels is one of them," she says.

Mr. Louboutin, the Parisian shoe designer known for his slick red soles, says that his new 6- and 7-inch stilettos are selling so well right now that he plans to introduce 8-inch platform shoes next fall. "I hear they can be painful," Mr. Louboutin says, "but women keep asking for them."

Women's shoes with heels 3 inches or higher represented 25% of all women's fashion footwear sold at shoe retail chains for the 12 months ended August 2008 compared with 21% in 2006, according to NPD Group Inc. At the same time, moderate heels, between 1½ inches and 27/8 inches, saw their market share fall to 26% from 34% in 2006.

Whether the trend has legs is yet to be seen. New York-based designer Warren Edwards, who participated in the heel hype this summer, has since backed down. "I think they have become vulgar and unwalkable," he says. "They are figments of runway imagination -- it's like, how high can they go? They've become cartoony."

Stacy Lastrina, executive vice president of marketing for retailer Nine West, acknowledges that "the majority of women do not wear shoes that are so extreme." But due to all the runway exposure, the company has adapted some of the looks -- with more "walkable" styles that top out at 4½ inches.

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Associated Press Supporters watched as Republican vice-presidential Sarah Palin, high on heels, addressed a crowd in Allentown, Pa., earlier this week.

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The shoes, which often feature peep-toe cutouts and bulbous round toes, have been popularized by red-carpet warriors such as Victoria Beckham, Jennifer Lopez and Jessica Simpson.

The contemporary stiletto was invented in the 1950s by Italian shoe designer Salvatore Ferragamo, who made his first pair for Marilyn Monroe in alligator skin. The models back then were tame by today's standards, with heels no higher than about 3 inches.

In the 1970s, high-heeled platform shoes caught on with hip, young women (and a few brave men) who clomped around in heavy cork-soled platform shoes that were up to 4- or 5-inches thick.

Lofty heels re-emerged in the mid 1990s, as millions of women adopted TV's "Sex and the City" standard: pointy-toed, 3- and 4-inch stilettos (often worn year-round with bare legs or jeans) that seemed to have an elongating effect.

Today's megaheels, among the season's few strong fashion trends, have a historical precedent. High platform shoes date back to the 15th century in Europe when upper-class women and courtesans teetered on 11-inch-high blocky platforms, called Chopines. They were so impractical that wearers "required a servant or a chivalrous man to help them walk," says Elizabeth Semmelhack, curator of the Bata Shoe Museum in Toronto. Paintings of the period, she adds, depict women "towering over other people, which was a way of elevating one's self above one's peers."

Women who lack attendants -- or curbside limousine service -- have found a way to zap the discomfort of today's extreme heels. They get injections of a cosmetic filler such as Restylane or Juvederm to plump up the balls of feet. These "pillows" last for six to nine months.

Suzanne Levine, a New York podiatric surgeon who teaches the $500 to $1,500 procedure to other doctors, says she's been getting calls from patients, especially women over 40, who want to put the cushioning back in their feet so they can wear higher heels.

Making ultrahigh shoes more wearable doesn't necessarily make them any safer. Joshua Kaye, a Los Angeles podiatrist, describes what happens to the feet in high-heeled platform shoes. "It's like you're walking on stilts," he says. "The ball of your foot is up a couple of inches off the ground in platform shoes. That puts more pressure on the ligaments and soft tissue, instead of the bones." Elevating the heel more than 3 inches off the ground, he says, increases the odds of suffering a sprained or broken ankle.

Ms. Betts, who is now healing from her shoe incident, is undeterred -- and almost ready to slip back into her super stilettos. "The only flats I wear," she says, "are sneakers."

Corrections and Amplifications: In an early version of this article, Claudia Chan's last name was misspelled as "Chen." The article has been updated to correct the error.

Write to Teri Agins at teri.agins@wsj.com

Hello, :wave: my name is Hoverfly. I’m a high heel addict…. Weeeeeeeeeee!  👠1998 to 2022!

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Just some food for thought: If heels are getting so high that some women are afraid to wear them, and men can't wait to wear them, do you think this might move the trend toward men wearing high heels, women's styles or otherwise?

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