Dream or Disaster? The Hidden Dangers Lurking Behind the Brazilian Butt Lift (BBL)

In the current digital era, social media has a tremendous impact on how we perceive beauty and the rising popularity of cosmetic surgery, especially among women. One notable instance is the Brazilian Butt Lift (BBL), a procedure many pursue without fully comprehending its possible risks. The attractiveness of the hourglass figure vividly portrayed across numerous social media platforms frequently overshadows the risks connected with the operation.

• What is the origin of this procedure, then?
• When did people start wanting this hourglass so strongly, and why?
• Why is it considered dangerous, how long will it take to recover, and how can we reduce the risks?

So buckle up as we dive into the world of Brazilian Butt Lifts!

Over the past 2 decades, the BBL has become significantly more popular, with the number of surgeries rising by over 800% in the last decade alone. 61,387 BBL treatments were carried out in 2021, according to current data from the American Society for Aesthetic Plastic Surgery. This astounding statistic emphasizes the significant number of people who seek to acquire their desired curves using this method. In the 1960s, Brazilian plastic surgeon Ivo Pitanguy emerged as the mastermind of the Brazilian butt lift. His technique, influenced by years of surgical developments, intended to tighten and tone the buttocks by removing the excess skin to eliminate sagging. However, it couldn’t add volume (Pitanguy, 1987:292-298). 

In 1969, Dr. RJ Bartels performed the first-ever surgical technique for enlarging the buttocks, which involved deploying a silicone breast implant to address the decrease of volume in a one buttock.  This attempt did not produce satisfying results due to the considerable differences between butt and breast implants, including look, texture, and movement. A more durable implant is necessary since the buttocks are used for many different activities, including sitting, walking, running, and more (Bartels et al., 1969). Later, as liposuction gained popularity in the 1980s and 1990s, doctors discovered that it was possible to deliberately remove undesirable fat from one area of the body and reinject it into the buttocks. The BBL, as we know it today, developed thanks to this creative strategy (Bellini et al., 2017:53-60).

Photo retrieved from: https://www.thepmfajournal.com/features/features/post/plastic-surgery-founding-father-ivo-pitanguy-on-life-learning-and-legends-remembering-a-giant

So, the BBL procedure entails the following phases in modern practice: First, liposuction removes extra fat from certain locations, such as the belly, thighs, hips, lower back, and hips. The fat is then purified and made ready for transmission after extraction. Finally, the buttocks are carefully injected with pure fat by a plastic surgeon to add volume and improve shape. Here’s the thing: not all the fat injected remains (Cherney, ‘’Brazilian butt lift procedure, benefits, side effects, and cost’’. 2019). The body may absorb 20–50% of the total amount. The majority of the injected fat, however, blends in nicely and improves the look of the buttocks.

For a booty-licious transformation, it’s crucial to follow specific post-operative care guidelines after the BBL operation. No more lying on your back to sleep or sitting for at least two weeks. Also, welcome to your BBL pillow, who will be by your side for six weeks! Remember to treat yourself to those much-needed massages as well. And if you are impatient to hit the gym again, you must wait 8 weeks (Clark, Six things you need to know about recovering from a Brazilian butt lift 2022).

So why is this bum-tastic surgery considered one of the most dangerous ones?

While this procedure seems like a dream to have the desirable curves, doctors today warn that it has the highest death risk, as high as 1 in 3,000 surgeries  (Mofid et al., 2017:7-9). Why so? Well, the answer is actually simple. There are many blood vessels in the buttocks, some of which are the size of drinking straws. Especially the inferior gluteal vein has a distinctive anatomy. It is larger and less flexible than others, making it challenging to avoid when doing procedures. Meaning it doesn’t keep out of the surgeon’s way during the operation; it is stable. And the risk starts exactly at this point; watch out!

Because of this vein, surgeons may have trouble correctly injecting fat into the buttocks when using a cannula to transfer it there. Incorrect placement of the fat can cause it to enter the bloodstream, which can have serious negative effects on health or, in the worst cases, even death (Turin et al., 2019)

Fat injection into this vein has consistently been seen in post-mortem investigations of BBL-related deaths, leading to an often deadly fat embolism (Pazmiño & Garcia, 2022:162-178).

Minimizing the risks: How can we achieve our big booty dreams safely?

BBL includes risks just like any other procedure, yet despite this, it is one of the most popular and widely performed treatments worldwide. People obviously do not want to avoid this procedure at all, but how can you stay safe and still achieve your dream booty? The ASERF’s executives formed a task force in 2017, and based on their findings, they published a warning and suggestions to lower procedure-related risks. Skilled plastic surgeons who drafted these guidelines emphasize that when performed with intense focus and concentration, the procedure can be safe due to our understanding of potential dangers and how to avoid them.

Gulsultan Dogan, the founder of MCAN Health, a prestigious medical tourism company, states that certain precautions must be taken to reduce risks during BBL surgery. She emphasizes the importance of proper fat grafting techniques employed by the surgeon during the surgery; therefore, selecting a skilled and experienced surgeon and accredited institutions is crucial. To achieve this end, it holds national and international accreditations while also evaluating contracted surgeons every six months with the assistance of an independent medical committee. She further highlights the significance of a thorough medical evaluation prior to the procedure, allowing for an assessment of overall health and identification of potential risks. ‘’Honest disclosure of the patient’s medical history is essential in this regard. Moreover, the importance of post-operative care cannot be overstated because it plays a critical role in the quick recovery from surgery. A skilled patient experience team makes this possible by carefully monitoring and assisting patients at each stage of the healing process.’’ the founder adds.

Sources:

• Aesthetic Surgery Journal, Volume 42, Issue Supplement_1, July 2022, Pages 1–18,

• BARTELS, R. J., OʼMALLEY, J. E., DOUGLAS, W. M., & WILSON, R. G. (1969). An unusual use of the Cronin breast prosthesis. Plastic and Reconstructive Surgery, 44(5), 500. https://doi.org/10.1097/00006534-196944050-0002

• Bellini E, Grieco MP, Raposio E. A journey through liposuction and liposculture: Review. Ann Med Surg (Lond). 2017 Nov 6;24:53-60. doi: 10.1016/j.amsu.2017.10.024. PMID: 29158895; PMCID: PMC5681335.

• Cherney, K. (2019, July 15). Brazilian butt lift procedure, benefits, side effects, and cost. Healthline. https://www.healthline.com/health/brazilian-butt-lift#procedure  

• Clark, K. (2022, August 11). Six things you need to know about recovering from a Brazilian butt lift. American Society of Plastic Surgeons. https://www.plasticsurgery.org/news/articles/six-things-you-need-to-know-about-recovering-from-a-brazilian-butt-lift

• Mofid MM, Teitelbaum S, Suissa D, Ramirez-Montañana A, Astarita DC, Mendieta C, Singer R. Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force. Aesthet Surg J. 2017 Jul 1;37(7):796-806. doi: 10.1093/asj/sjx004. PMID: 28369293; PMCID: PMC5846701.

• Pat Pazmiño, Onelio Garcia, Brazilian Butt Lift–Associated Mortality: The South Florida Experience, Aesthetic Surgery Journal, Volume 43, Issue 2, February 2023, Pages 162–178,

• Pitanguy, I. (1987). Body contour. The American Journal of Cosmetic Surgery, 4(4), 283–298. https://doi.org/10.1177/074880688700400407

• Singer, N. (2016, August 8). Ivo Pitanguy, plastic surgeon to the stars and a celebrity himself, dies at 93. The New York Times. https://www.nytimes.com/2016/08/08/obituaries/dr-ivo-pitanguy-pioneering-brazilian-plastic-surgeon-dies-at-93.html

• Turin, S. Y., Fracol, M., Keller, E., Markl, M., Collins, J., Krochmal, D., & Kim, J. Y. (2019). Gluteal vein anatomy: Location, caliber, impact of patient positioning, and implications for Fat Grafting. Aesthetic Surgery Journal, 40(6), 642–649. https://doi.org/10.1093/asj/sjz260

• Urgent warning to surgeons performing fat grafting to the buttocks. (n.d.). https://www.plasticsurgery.org/documents/Patient-Safety/BBL/Gluteal-Fat-Grafting-Safety-Advisory_Jul18.pdf