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10-13-18 | Posted by

Although J-Lo, Pippa, and KKW have been credited with making big butts a thing, it was actually the Brazilians who cornered this rising aesthetic trend a few decades ago.

The popular Brazilian butt lift or BBL, as it is more commonly known, comes with some risks, especially if you aren’t careful about the doctor you choose.  According to the American Society for Aesthetic Plastic Surgeons (ASAPS), the BBL procedure has been shown to have the highest rate of complication and even death in extreme cases.  In fact, as many as 1 in 3,000 people who undergo the procedure die, or 0.033 percent, compared with 0.002 percent for all office-based cosmetic procedures, according to a 2016 study published in Aesthetic Surgery Journal. In 2017, there were three deaths in Florida alone from the BBL procedure.

Although no surgery is without risk, that is an alarming rate. Patients who died from this procedure have had specific findings in common, according to ASAPS, including:

  1. Fat in the gluteal muscles
  2. Fat beneath the muscles
  3. Damage to the superior or inferior gluteal vein
  4. Massive fat emboli in the heart and/or lungs

According to Shreveport, LA plastic surgeon Simeon Wall, of The Wall Center for Plastic Surgery, “BBL is the fastest growing cosmetic surgical procedure in the US, with high demand from patients but with relatively few surgeons who are highly experienced in this procedure. BBL is actually a combination of several procedures, including reduction of the abdomen, flanks, back, entire waist, and sometimes other areas, while also placing fat back into the buttock region in specific locations to achieve a harmonious and more dramatic silhouette. The desired results are typically a more muscular, higher, rounder, and more athletic buttock shape that is complemented by a drastically reduced waistline.”

“Unfortunately, many surgeons are still using outdated instrumentation and techniques that involve placing fat into the gluteal muscles under high pressure. There have been alarming reports of deaths caused by fat traveling to the lungs causing a pulmonary embolism,” says Dr. Wall.

New York City plastic surgeon Dr. Alan Matarasso, president of the American Society of Plastic Surgeons, explains; “The procedure enlarges the buttock area through the injection of fat that is usually taken from the abdomen and thighs to add volume and contour the buttock region. Patients like the idea of using their own fat for augmentation and to enhance their body shape.”

According to Dr. Matarasso, variations include the amount of fat that is injected, the angle at which it’s injected and the choice of instruments used. Your weight and the length of the procedure can also factor into the risks. The BBL can have a number of non-life-threatening complications, including bleeding, infection, and issues with skin healing. Patients can experience fat necrosis where the injected fat cells die, resulting in firm lumps that can lead to nasty complications.

“The operation can be risky in the hands of doctors who are not well trained in the procedure,” said Dr. Matarasso. But a Brazilian butt lift isn’t the only option available. “Buttock implants are also commonly used for patients looking to increase the size of the area permanently. Fat injections can also be combined with implants in some cases. There is also a surgical buttock lift, which is more commonly performed after massive weight loss,” he said. However, injecting permanent substances like silicone into the buttocks can be extremely dangerous.

Non-surgical options are also available, with the most popular being the Sculptra Aesthetic (Galderma) buttock augmentation. Injecting the buttock area with this poly-l-lactic acid dermal filler stimulates the body to produce its own collagen which increases firming and plumping. It generally takes a few injection sessions over several months to achieve the best results, and although results are not permanent, it can last for a few years in some cases. EmSculpt, a non-invasive technology that uses electric muscle stimulation to help build muscle mass and reduce fat, is another popular new option for those who want a better looking butt.

In response to the high mortality rate associated with the BBL procedure, the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, the International Society of Aesthetic Plastic Surgery, the International Society of Plastic Regenerative Surgeons and the International Federation for Adipose Therapeutics and Science have formed a task force to develop safety guidelines for the procedure. As of October 10, 2018, the British Association for Aesthetic Plastic Surgery (BAAPS) has advised its members to “refrain from performing BBLs through fat transfer until more proven data is released.

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