American Society of Plastic Surgeons
For Medical Professionals

The media loves to talk about them, but what do you really need to know about BBLs?

Buttock augmentation, BBL, gluteal fat grafting – no matter what you call it, all these terms mean the same thing. "Harvesting fat from other places in your body, typically the abdomen, the flanks, the back, and then transferring that fat to the hips and the buttocks," said ASPS President-Elect Steven Williams, MD, who adds that autologous fat grafting is the more medically correct term.

When it comes to procedures like Brazilian butt lifts that have been dragged in the media for the dangers and risks, it's essential to do your research and know what you are going into prior to having the surgery.

Follow along as Kaitlin Clark touches on all of the "need to know" of Brazilian butt lifts with board-certified plastic surgeons Jerry Chidester, MD, Steven Williams, MD, and Ryan Neinstein, MD.

Advances in technology are aimed at making BBLs safer

"Patient safety for all of us is one of the primary things we think about," said Williams. "There have been a number of modifications and studies that have come out to make the procedure more safe."

One of the most recent advances in BBL technology is the use of ultrasound in combination with the fat grafting portion of the procedure. This ensures that the cannula, the device where surgeons deposit the fat, is in the right space and not near the blood vessels. While this may be a new use in relation to gluteal augmentation, surgeons have been using ultrasound-assisted liposuction in other areas of plastic surgery for years.

The danger that has been associated with BBLs comes in part when a surgeon accidentally hits a blood vessel. While the complications for hitting a blood vessel can be minimal, like extra bruising, Williams emphasizes that "the thing that we really are concerned about for our patients and for the safety of our patients is fat embolism, because that is potentially fatal."

Surgeons agree, less is more

What started out as a desire for exaggerated proportions has now turned into a cultural phenomenon that even celebrities are trying to emulate. But with surgical procedures, especially ones that are as difficult to perform as BBLs, it's essential to start conservatively and ask yourself if you are doing a procedure for you, for someone else or to fit into a societal trend.

"I think it's important when you're talking to patients about any type of procedure to take a 30,000-foot view," said Neinstein. "What's the ultimate goal? Is it to get rid of stubborn fat, or is it to totally recreate the shape of their body? I think when anything comes out new, just like in most dimensions in life, there's a pendulum that swings way too far in one way."

And given that the Brazilian butt lift is a fairly new procedure in the world of plastic surgery, it will continue to change as body trends do.

"The other part of this that I think is actually a big misconception is that a Brazilian butt lift does not have to be extreme," said Chidester. "When we do liposuction around the buttock area, you can really create some really nice defining contours and shape. Using even a minimal amount of fat in a safe amount can really create a nice shape. That's a lot of times what I'm telling patients."

Steps needed to get a BBL safely

The first and most important step when you are considering any plastic surgery procedure is making sure you go to a board-certified plastic surgeon "because you have to start with an individual that's well trained, that has the appropriate equipment, the appropriate location to do the surgery, and has an ethical code that we're required to follow," said Williams.

It's also essential that you go to a surgeon who has performed these procedures before. With any newer surgical procedure, there can be a learning curve, Williams suggests. That's why it's so important to have in-depth conversations with your physician on "what your expectations are, what the complications may be and then what the process itself looks like," said Williams. "Again, those consultations should be made with a physician, not with the front desk or your best friend. You need to ask your physician those things."

Another less-talked-about fact is that this surgery does not have to be a one-and-done procedure.

"I think one thing to consider as well is sometimes also, patients, you may need to do this in several stages or rounds. It may not be safe to do all at once," states Chidester. "If there's a certain look that that patient is going for, again setting expectations and just saying, 'This may take two sessions, maybe three, to get to where you want to be.' I think helping patients realize that in the beginning, that helps set the stage for the next several months as they're healing and seeing their results."

What does recovery look like

"Patients want immediate results, but there's an evolution here," said Neinstein. "Initially, there's going to be swelling, which some people love because they get a lot of volume, and then things dissipate and it's almost like the body regenerates and rejuvenates. It can take six months to a year."

Like any surgical procedure, recovery and results look different for everyone. Not only do your lifestyle and genetics impact your results, but following your surgeon's aftercare instructions can as well.

"I think every plastic surgery procedure requires people to follow those operating results. These are generally elective procedures," said Williams. "At our office in San Francisco, we really emphasize that people find not only the right medical time for them to be healthy enough with the procedure and the right physician partner, but they find the right time in their lives to do that procedure because the recovery is important. Family support is important. Being able to financially afford it, so that that's not an additional stressor. All those things are really important, and I think that's true really for all cosmetic surgery."

As new procedures come to light and plastic surgery progresses, there are a few things to remember, the most important being to always visit a board-certified plastic surgeon who is experienced in the type of procedure you want to get done.

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.


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