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Brazilian Butt Lift (BBL)

Is a procedure which is getting popular but I do not perform this procedure due to the high risk of death.

I still do small corrections of irregularities in the bum and I still do reduction of the butts by Liposuction.

Further reading on our Butt Reduction procedure.

The article below about BBL is the official position of the ACCS and can be found in the college website as well.

Brazilian Butt Lift:  Advice to patients – Don’t do it!

  • BBL is the cosmetic procedure with the highest risk of death.
  • The risk is about 1 in 3000 compared with the risk of death from liposuction of about 1 in 30,000.
  • At least 44 patients have died worldwide.
  • The cause of death is fat globules entering veins, reaching the heart and causing cardiac arrest.
  • Although techniques to reduce the risk exist they do not eliminate it.
  • Some clinics are heavily promoting BBLs but the ACCS advises patients not to do it.

What is a Brazilian Butt Lift (BBL)?

A BBL enhances the projection of the buttocks giving a larger, more rounded look. Fat is removed from another area of the body, typically the outer thighs or abdomen, and then injected into the buttocks. Paradoxically it does not provide much lifting of the buttocks beyond the immediate post-operative period when the area is swollen. According to The American Society of Aesthetic Plastic Surgery, BBLs increased by 26% in the US in the year 2016/17. At a single US consumer website RealSelf, 3.8 million visitors researched BBLs in the 12 months to July 2018.

Why is it dangerous?

The veins beneath the buttock muscles (gluteal veins) are fragile and can tear easily. Once damaged the injected fat globules can enter the veins. Anatomically, the buttock veins are a short distance from, and drain blood into, the large vena cava blood vessel which returns blood to the heart. Once it reaches the heart, the fat globules can block circulation and cause cardiac arrest.

How can the risks be reduced?

The gluteal veins lie deep to the buttock muscles. If fat is injected only superficially under the skin, the veins should not be damaged. In all cases of death from a BBL, fat was found in the muscle layer at autopsy. However, some surgeons believe that better results are obtained by injecting fat into the muscle. This is not certain and most surgeons performing BBLs do only inject fat superficially.

Nevertheless, the anatomy in patients varies and even the best trained surgeons sometimes make mistakes. Some mistakes have little consequence. Other may cause distressing complications or a poor cosmetic outcome. This would be bad enough however, if the consequence of the mistake dramatically increases the risk of death as in the case of BBLs, the ACCS believes the risk is not worth it.  We therefore advise patients NOT to undergo a BBL and advises its surgeons not to offer this procedure.

What if I want to go ahead anyway?

Firstly, you should consider alternatives such as buttock implants. Secondly you should find a cosmetic or plastic surgeon experienced in BBLs. You should ask if the fat is to be injected only under the skin and not into the muscle. You should ask what, if any, techniques the surgeon uses to ensure no fat is injected into the muscle layer.

Are there likely to be any advances in the BBL technique to make it safer?

Currently an international task force of surgeons has been set up to investigate the risks of BBLs further and to develop protocols to reduce these risks. Until and if such protocols are proven to be safe, the ACCS will continue to warn patients against having a BBL.