The dangers of improper Brazilian butt lifts

Brazilian butt lifts, also known as BBLs, have historically been viewed negatively because of the risk of death associated with improperly performed procedures. Nevertheless, this procedure has continued to be popular for improving the shape and size of the butt, as well as providing balance and contour.

It's easy to be turned off by this life-changing procedure because of fatalities linked to BBL gone wrong. As a result, plastic surgeons and lawmakers have taken crucial steps in recent years to combat complications associated with improperly performed BBLs.

So, what are the risks historically associated with a BBL? What steps have been taken to protect patients from these potentially fatal complications? To learn more about the risks associated with BBL procedures and how surgeons have been diligently working to counter them, we reached out to ASPS Member Surgeons Orlando Llorente, MD, and Johnny Franco, MD.

The historical risks of Brazilian butt lift procedures

While BBLs have historically been considered risky procedures for even the healthiest patients, this is no longer necessarily true due to changes in procedural standards. There has also been a shift in aesthetic preference among patients that has contributed to this change, as patients are currently more focused on shape than size.

"Up to 2018, I would say that this procedure involved injecting fat not only above the muscle but also into the muscle itself," said Dr. Llorente. "After 2018, many of the [medical] societies put out a recommendation that fat no longer be injected under the muscle. This recommendation came from many reports and some studies showing that injecting under the muscle increased the risk of injecting into a large vein, which would lead directly to a fat embolism."

A fat embolism occurs when fat enters the bloodstream, which can cause blockages and can ultimately result in death.

"Many of the issues from BBL safety come from just a few years ago – essentially, it was a misunderstanding of what we were trying to do," said Dr. Franco. "In the past, we were trying to inject the fat into the muscle because there was better fat uptake. Upon understanding the danger involved here, this has been a huge positive change."

New protections in place for BBL patients

Now that there is a better understanding and awareness of the dangers associated with improperly performed BBLs, there are more protections in place for patients undergoing this procedure.

"The use of ultrasound has been an immensely positive contribution, helping to make the procedure easier and more accessible," said Dr. Franco. "This actually helps make the results better, and the procedures are dramatically safer than they have been. This is priceless from a safety and appearance platform."

New techniques, technologies, and even legislation have emerged in the last several years to improve safety for BBL patients.

"In South Florida, there was a recent recommendation made that surgeons are mandated to use an ultrasound to confirm that they are in the right plane prior to injecting, not injecting into or under the muscle," said Dr. Llorente. "They (doctors) have to document that they are using an ultrasound to avoid the dangers of intramuscular or submuscular injection."

Any patient interested in a BBL should discuss the risks, complications and safety measures with their surgeon before the procedure.

"From a patient perspective, they should be educated in how the surgeon is injecting the fat to avoid the muscles," said Dr. Llorente. "They should also ask that the surgeon uses ultrasound to confirm where they're injecting the fat."

Best practices for BBL patients

There are a few crucial steps that patients can take to protect themselves and ensure the best result. For a BBL, it's important to not only find a board-certified plastic surgeon, but also one who specializes in the procedure.

"Look out for the training and experience that the physician has," said Dr. Llorente. "Do they do this procedure often? What is their complication rate? What are the components of fat grafting and liposuction procedures?"

Some doctors offer a lower price point. That might be tempting, but it's important to avoid facilities that seemingly churn out BBLs to keep yourself safe.

"There are often a lot of corners being cut by large centers," said Dr. Llorente. "They are probably performing operations on patients who should not be having this procedure. You also cannot know who is performing the procedure. Is it a surgeon or their unlicensed assistant? These things are really impossible for patients to know at these locations."

Just a few years ago, the goal of BBLs was to inject as much volume as possible. Nowadays, with the shift in aesthetic preference and procedural guidelines, this focus has evolved to emphasize shape over size.

"Patients want something that gives them a little bit of shape," said Dr. Franco. "This is where the ultrasound and targeted fat transfer have been priceless – we can make shape changes without injecting as much fat as possible to increase size."

BBLs can be a life-changing procedure that helps patients achieve the shape and size of their dreams, and they are low-risk when performed following proper protocol. However, it's important to remember that there are potentially fatal risks that can come with an improperly performed BBL. By working with a board-certified plastic surgeon who follows updated guidelines, patients can help protect themselves from complications and achieve the butt size and shape of their dreams.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.