what you need to know about a Brazilian butt lift
The Brazilian Butt Lift, often referred to as a BBL, has gained significant attention in cosmetic surgery discussions over recent years. While the term itself might be widely recognized, the procedure’s true nature, associated risks, and safety advancements are crucial for anyone considering it. Once surrounded by controversy due to alarming safety statistics, gluteal fat grafting, the more accurate term for a BBL, has evolved thanks to dedicated efforts in patient and surgeon education, refined surgical techniques, and ongoing research. This article will delve into what a BBL truly is, addressing the key safety facts every prospective patient should understand, guided by insights from experts in the field.
Defining the BBL: More Than Just a “Butt Lift”
To begin, it’s important to clarify what a BBL actually entails. As Dr. J. Peter Rubin, President of the American Society of Plastic Surgeons (ASPS), explains, the term “Brazilian Butt Lift” is somewhat misleading. “It’s neither Brazilian, nor is it a butt lift in the traditional sense,” he states. Instead, a BBL is more accurately described as a buttock augmentation procedure that utilizes a patient’s own fat tissue to enhance the area. The goal is to reshape and add volume to the buttocks and hips, creating a more sculpted and projected appearance.
The procedure itself is a two-part process, as outlined by Dr. Steven Williams, a plastic surgeon based in California and also a member of the ASPS. It starts with liposuction, where fat is removed from another area of the body. Common donor sites include the abdomen, flanks, thighs, or back. This harvested fat is then carefully processed and strategically injected into the buttocks and hips to achieve the desired shape and volume enhancement. Therefore, a BBL is fundamentally a fat transfer procedure designed to augment the buttocks.
Why Was BBL Considered Dangerous? Understanding the Risks
The concern surrounding BBL procedures stemmed from the specific technique used – autologous fat transfer, or fat grafting. While fat grafting itself is generally a safe procedure in many areas of the body, the buttock region presents unique risks. Dr. Rubin emphasizes that the danger associated with BBLs is directly related to the anatomical area where the fat is injected. The buttocks contain a dense network of blood vessels, and injecting fat into this region carries the risk of fat entering the bloodstream.
This occurrence, known as fat embolism, is the primary concern. As Dr. Rubin explains, when fat is inadvertently injected into the venous system, it can “literally clog major blood vessels.” This blockage can trigger a cascade of severe and potentially life-threatening complications.
The International Safety Task Force and Improved Safety Measures
The initial reports of high mortality rates associated with BBLs prompted immediate action within the plastic surgery community. The ASPS, along with other plastic surgery organizations worldwide, formed an international task force to thoroughly investigate these safety concerns. Dr. Williams highlights the task force’s crucial findings, noting that they discovered a “relatively high incidence of complications, the most serious of which included fat embolism.”
The task force’s recommendations have been instrumental in improving BBL safety. Dr. Rubin notes encouraging data indicating that “many, many surgeons are changing their technique based on the recommendations of the task force, and that the mortality rate is now approximately that of the tummy tuck, one in about 15,000.” This represents a significant improvement from the previously reported higher rates.
A key modification in surgical technique, as Dr. Williams explains, is to “avoid placing fat in the muscle itself where these large blood vessels are at risk.” The current best practice is to inject the fat tissue above the gluteal muscle. Dr. Rubin stresses the importance of this technique, explaining that “that muscle layer is really a barrier that separates the blood vessels from the cannula” – the instrument used for fat extraction and injection. By injecting fat above the muscle, surgeons significantly reduce the risk of fat entering the bloodstream and causing a fat embolism. Dr. Williams concludes that the task force’s efforts have led to “significant success” in making the BBL procedure “much, much safer.”
Understanding Potential Complications
While safety has improved, it’s essential to be aware of potential complications associated with BBL surgery. Dr. Rubin clarifies that “the really severe, life-threatening complications, when they happen, tend to happen either during the surgery or within hours following the procedure.” These immediate risks are primarily related to fat embolism.
Beyond the immediate postoperative period, other complications can occur, although they are typically less severe. These can include infection or fat necrosis, which is the death of fat tissue. However, Dr. Rubin reassures patients that “if you’re a week out, it is less likely that you’re going to have a serious, systemic complication.” This highlights the importance of careful monitoring and adherence to post-operative care instructions, particularly in the initial days following the procedure.
Managing Expectations: Fat Volume and Longevity
It’s crucial for patients to have realistic expectations regarding the long-term results of a BBL. Like all fat grafting procedures, not all of the injected fat will survive. Dr. Rubin estimates that patients can expect to lose “anywhere from 20 to 40% of the injected fat” as it is absorbed by the body during the healing process. This is a natural part of the fat grafting process and should be considered when discussing desired outcomes with your surgeon.
To maximize fat survival, Dr. Williams advises patients to “minimize the amount of time that they sit or put pressure directly on the grafted fat during the recovery period.” Following post-operative instructions carefully is essential for optimizing the longevity of the BBL results. Dr. Rubin notes that by around month three post-surgery, the appearance of the buttocks will be a “pretty good indicator of what’s going to stay there.” Dr. Williams further adds that during months three to six, the shape “should further refine and the curve should become more apparent,” as the remaining fat settles and integrates into the surrounding tissue.
Recovery and Aftercare: What to Expect
The recovery process after a BBL is comparable to that of liposuction, as described by Dr. Williams. Patients should anticipate wearing a compression garment to support the treated areas and minimize swelling. The recovery period typically involves “mild to moderate pain with some bruising and swelling.” Managing discomfort with prescribed pain medication and following your surgeon’s instructions for wound care are crucial aspects of recovery.
A key element for a successful BBL recovery is avoiding prolonged sitting or direct pressure on the buttocks. Dr. Rubin emphasizes the importance of “keeping pressure off of that area.” To facilitate this, both doctors recommend using padding. Dr. Rubin specifically advises, “Padding, padding, padding… Foam padding and egg crate padding will help relieve pressure” on the buttocks and sit bones during the crucial initial recovery phase. Following these guidelines will aid in fat survival and contribute to optimal healing.
Are You a Good Candidate for BBL? Ideal Patient Profile
Given the inherent risks associated with BBL procedures, even with improved safety measures, careful patient selection is paramount. Surgeons should adhere to stricter criteria when determining candidacy for a BBL. Dr. Williams states that “an ideal candidate is a patient who has realistic expectations about the results.” Understanding the limitations of the procedure and having achievable goals is essential.
Furthermore, optimal candidates are generally “relatively close to their ideal body weight and be in good health and a nonsmoker.” Being in good overall health minimizes surgical risks and promotes better healing. Smoking can significantly impair healing and increase complication risks, making it a crucial factor in patient selection.
To ensure your safety and achieve the best possible outcome, it is vital to choose a qualified and experienced plastic surgeon for a BBL or any cosmetic procedure. The American Society of Plastic Surgeons (ASPS) is a valuable resource for finding board-certified plastic surgeons. ASPS members have completed rigorous training, practice in accredited facilities, and adhere to strict safety and ethical standards. You can find an ASPS member in your area through their online referral service.
