Infographic explaining key facts about Brazilian Butt Lift (BBL) surgery, including safety and procedure details
For several years, the Brazilian butt lift (BBL), technically known as gluteal fat grafting, has been a subject of intense discussion, especially regarding its safety. Initial reports raised alarms, even among those outside the cosmetic surgery field, due to concerning statistics.
Dr. J. Peter Rubin, President of the American Society of Plastic Surgeons (ASPS) and a distinguished professor and chair of Plastic Surgery at the University of Pittsburgh Medical Center, noted, “Survey data highlighted a disturbingly high mortality rate. It appeared to be as high as one in 3,000, which is exceptionally high.”
However, the landscape of gluteal fat grafting has evolved significantly in the last five years. Thanks to extensive education for both patients and surgeons, refined surgical techniques, and insightful research, the procedure has become considerably safer, particularly when performed by a board-certified plastic surgeon.
Despite these advancements, Dr. Rubin emphasizes a crucial point for anyone considering a BBL: “Patients must understand that this procedure has been linked to fatal outcomes.” He stresses the importance of being informed about critical safety aspects before undergoing a BBL.
To guide individuals in making informed decisions and finding qualified surgeons, Dr. Rubin, along with Dr. Steven Williams, a board-certified plastic surgeon based in California and fellow member of ASPS, have provided essential facts about the BBL procedure.
Defining a BBL: More Than Just a “Butt Lift”
Dr. Rubin clarifies a common misconception: “It’s called a Brazilian butt lift, but it’s neither inherently Brazilian nor a lift in the traditional sense.” He explains, “It’s essentially a buttock augmentation achieved by using the patient’s own fat tissue.”
Dr. Williams elaborates on the two-step nature of the procedure. It begins with liposuction to remove fat from areas like the abdomen, flanks, thighs, or back. This harvested fat is then carefully prepared and strategically injected into the hips and buttocks to enhance their shape and projection.
Understanding the Risks Associated with BBLs
The BBL procedure employs autologous fat transfer, or fat grafting, a technique generally considered safe for volume enhancement in various body areas, as Dr. Rubin points out. The specific risk associated with BBL arises from the injection site—the buttocks. “When transferring fat to the buttock area,” he explains, “surgeons navigate anatomical danger zones rich in blood vessels. It’s possible for fat to enter the bloodstream and obstruct major blood vessels.” This blockage is known as a fat embolism, a severe complication.
International Collaboration for BBL Safety
The alarming mortality rate data prompted immediate action. The ASPS collaborated with global plastic surgery organizations to establish an international task force dedicated to investigating and mitigating the safety concerns surrounding BBL.
Dr. Williams explains the task force’s findings: “They discovered a relatively high incidence of complications, notably fat embolism.” Fat embolism occurs when fat intended for the buttocks inadvertently enters the venous system. This triggers a dangerous chain reaction within the body, potentially leading to fatal consequences.
“Recent surveys indicate that many surgeons have modified their techniques based on the task force’s recommendations,” Dr. Rubin states. “Consequently, the mortality rate is now estimated to be closer to that of a tummy tuck, approximately one in 15,000.”
Dr. Williams details the crucial technique modifications: “A key change is avoiding fat injection into the muscle itself, where large blood vessels are concentrated.”
Instead, the refined technique emphasizes injecting fat tissue above the gluteal muscle. Dr. Rubin underscores the importance of this approach for BBL safety: “The muscle layer acts as a protective barrier, separating the blood vessels from the cannula, the instrument used for fat extraction and injection.”
Dr. Williams affirms the task force’s positive impact, stating that their efforts have resulted in “significant success,” making BBL procedures “much, much safer.”
The Immediate Nature of Serious BBL Complications
“Severe, life-threatening complications tend to manifest either during surgery or in the hours immediately following,” Dr. Rubin clarifies. While post-operative issues like infection or fat necrosis (fat cell death) can occur later, “serious, systemic complications are less likely to arise a week after the procedure.”
Managing Post-BBL Volume Loss Expectations
It’s important to understand that, similar to all fat grafting procedures, not all injected fat will survive long-term. Dr. Rubin estimates that patients can expect to lose between 20% and 40% of the transferred fat as the body naturally absorbs it during the healing process.
To optimize fat retention, Dr. Williams advises patients to “minimize prolonged sitting or direct pressure on the grafted fat during the initial recovery phase.”
Around the three-month mark, the risk of significant fat loss diminishes. Dr. Rubin notes that the buttock’s appearance at this stage provides “a reliable indication of the long-term outcome.” Dr. Williams adds that between months three and six, the shape will continue to “refine, and the enhanced curve will become more defined.”
Padding: Your Essential Recovery Companion
BBL recovery shares similarities with liposuction recovery, according to Dr. Williams. “Patients should anticipate wearing a compression garment and experiencing mild to moderate pain, along with bruising and swelling during the recovery period.” He emphasizes that avoiding prolonged sitting is crucial for successful BBL recovery.
“Minimizing pressure on the treated area is paramount,” cautions Dr. Rubin. His key recommendation for pressure relief? “Padding, padding, padding. Utilizing foam padding and egg crate padding significantly helps alleviate pressure on the buttocks.”
Ideal BBL Candidates: Specific Criteria
Due to the elevated risk profile compared to other plastic surgery procedures, stringent patient selection is essential for BBL. “An ideal candidate has realistic expectations regarding the achievable results,” says Dr. Williams. “They should be reasonably close to their ideal body weight, in good overall health, and a non-smoker.”
To locate a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. ASPS members are board certified by the American Board of Plastic Surgery, have completed accredited training, operate in accredited facilities, and adhere to rigorous safety and ethical standards. Find an ASPS member in your area.
