Brazilian butt lift represent one of the most popular cosmetic procedures today. The number of people requesting BBL vs Butt Implants has been increasing year after year for the past several years.
The procedure involves removing fat via liposuction from the places you do not want it, the muscle belly and then re-injecting that fat into the places you do want it, such as the butt and the hips.
The procedure offers the benefit of liposuction in addition to the advantages of fat transfer. The end result is usually a smaller waist with perky butt and rounder hips.
Unfortunately, the infamous BBL procedure has been getting a bad rap as one of the most dangerous cosmetic procedures in the press over the past several years.
It has been called “the most dangerous cosmetic procedures”. There have also been recent Internet clips from a well-known Hollywood plastic surgeon claiming that this cosmetic procedure is so deadly that it should not be performed.
The backlash over this procedure stems from a study that was performed in 2017. This study showed that there was a significant death risk when having a BBL procedure performed.
However, this is certainly not the case and evaluation of the actual data shows that BBL deaths are not a common occurrence, and this procedure is safer than a tummy tuck.
The 2017 Study
The study was published in 2017 using data from surveys to plastic surgeons. The data study showed there was a 1 in 3000 Brazilian butt lift death rate. This is certainly an extremely high death risk and understandably, this caused great concern amongst plastic surgeons as well as the general public.
There are no board certified plastic surgeons who would ever advocate for procedure that carries a 1 in 3000 chance of BBL death rate in USA. Those of us who have been performing BBL procedures for a very long time and specialize in this procedure, immediately knew that this number just didn’t make sense.
When experts in fat grafting and BBLs as well as people knowledgeable about scientific studies looked at the results of the survey, it became apparent that the study was just simply flawed on many levels. There were errors in statistical analysis and study design. But the damage was already done.
Global media picked up on this reported BBL death rate of 1 in 3000, and there was an immediate call to ban the BBL.
There were some countries in Europe that went so far as to actually prohibit plastic surgeons from for performing this procedure. Additionally, there were some hospitals in the United States that placed this procedure on the list of prohibited operations.
During this period of public uproar, there was also criticism of this procedure from other plastic surgeons who, quite frankly, never even performed this operation. It became a very hot topic within the plastic surgery community and caused a great division within plastic surgery societies.
The 2019 Study
Luckily, a better designed study was performed in 2019. This study did not have the flaws seen in the original 2017 survey. The results of this 2019 study show that the actual BBL mortality rate is 1 in 15,000. This was quite different from the 1 in 3000 BBL surgery death rate that was originally reported. And shows that this procedure is actually quite safe when performed correctly.
In fact, for comparison when we are looking at the tummy tuck death rate 2023, a different image emerges. A tummy tuck procedure carries a death risk of 1 in 14,000. This means that tummy tuck risks of death are actually greater and, the BBL is actually statistically safer than a tummy tuck.
Fat Embolisms
Obviously, there are risks with any surgical procedure. In addition to the usual risks of infection, bleeding, anesthetic reaction, and scarring, the Brazilian butt lift fat grafting procedure carries a unique risk because of the procedure itself. The fat grafting procedure relies on injection of fat to fill up areas such as the butt and hips. Injecting fat into the body (fat grafting) carries the potential risk of what is called a fat embolism. A fat embolism is when droplets of fat travel through a blood vessel to the heart lung and brain.
This is a potentially fatal complication. So how does a fat embolism occur during a BBL? In order for fat to travel through a blood vessel to other organs, fat needs to get into the blood vessel to begin with.
When fat grafting occurs by excess fat being injected into the buttock, the surgeon needs to be very aware of the location of normal blood vessels in that area as to avoid accidental injection of excess fat into these vessels.
It is these instance of fat embolism’s that are responsible for the majority of unfortunate deaths associated with a BBL
Ways to Minimize BBL Death Rate
Ways to Minimize BBL Death RateRegardless of whether or not reported data was flawed, it became quite obvious that the BBL procedure is a procedure growing in popularity and that we need to focus strongly on safety surrounding this procedure. This meant that plastic surgeons created guidelines to help minimize the death rate with a BBL.
These guidelines were extremely important given the increasing popularity this procedure, as well as the increasing number of board certified plastic surgeons who are starting to perform this procedure and may not have many years of experience that the experts have.
The majority of the guidelines focused around techniques during fat injections to minimize the risk of fat injections into blood vessels. This included:
- improved knowledge of the anatomy of the area so that blood vessels can be avoided
- patient positioning during the surgery
- surgical instruments used to inject the fat
- injecting the fat over the muscle as opposed to in the muscle or below the muscle
- Rapid recognition of a potential fat embolism
Any plastic surgeon performing Brazilian butt lift procedures needs to be intimately aware of these guidelines in order to keep their Brazilian butt lift patients safe.
How to keep yourself safe during your Brazilian Butt Lift Procedure
In addition to aesthetic plastic surgeons being aware of techniques to reduce your risk during a BBL, there are also things you can do as a patient to reduce your risk. These include appropriately selecting your surgeon who is performing your procedure, and appropriately selecting the facility in which your procedure is going to be performed.
- Choosing your surgeon
As you are probably familiar, you should always select a board-certified plastic surgeon for your aesthetic plastic surgery procedure. More importantly though, you want to make sure that your board-certified plastic surgeon is experienced in plastic surgery trends as the BBL. This BBL procedure is very specialized and carries unique risks as described earlier.
You want to make sure that they are an expert at the BBL procedure. This means that you should ask your surgeon how many of these BBL procedures they perform per month or per year. You also want to specifically ask what techniques they will use during this procedure.
This is because you want to make sure that they are following all safety guidelines in order to reduce your risk of potentially fatal complications. And experience board-certified plastic surgeon will not be offended by these questions. They will recognize that this is a potentially risky operation and they should appreciate your involvement and concern for your safety. If they get offended, then that may be an indication that they are not the right surgeon for you.
- Choosing your facility
All aesthetic plastic surgery procedures should be performed in accredited operating facility. This means that it could be a hospital, an ambulatory surgery setting, or an accredited office operating room. You want to make sure that wherever you are having the surgery is up-to-date with all safety standards and there is a board-certified anesthesiologist who will be administering your anesthesia and monitoring you throughout the procedure and stay in the recovery room.
As someone who has performed over 5000 Brazilian butt lift procedures safely, I never perform this operation under local anesthesia. I find that general anesthesia is safer, more comfortable for you, and allows me to provide you with a better surgical result.
Questions and Answers
What is the risk of death in BBL?
As with any surgical procedure, there are major risks are associated with BBL, including the risk of death.
According to a study published in the Aesthetic Surgery Journal in 2019, the mortality rate for BBL was estimated to be 1 in 3,000 cases. This is higher than the mortality rate for most other cosmetic aesthetic plastic surgery and procedures.
The main cause of death in BBL is fat embolism, which is a complication of fat grafting. It occurs when fat is injected into the muscle and then travels to the bloodstream, blocking vessels and causing damage to organs. To reduce the risk of fat embolism and other fat grafting complications, it is important to choose a qualified and experienced surgeon, follow all pre- and post-operative instructions, and disclose any medical conditions or medications that could increase the risk of complications.
What is the biggest risk of Brazilian Butt Lift Surgery?
The biggest risk associated with Brazilian Butt Lift surgery is the development of fat embolism, which is when fat enters the bloodstream and blocks vessels, potentially leading to serious complications including death.
During a BBL, fat grafting from one area of the body (usually the abdomen, hips, or thighs) and transferred to the buttocks through injection. If the fat graft itself is injected into the deep muscle tissue instead of the subcutaneous fat layer, it can enter the bloodstream and travel to the lungs, brain, or heart, causing serious harm.
Other risks of BBL surgery include infection, bleeding, scarring, asymmetry, nerve damage, skin irregularities, and dissatisfaction with the results. However, fat embolism related to problems with the fat grafting is the most significant risk associated with BBL surgery and can be life-threatening if not recognized and treated promptly.
What causes BBL death?
Back in 2017, it was discovered that Brazilian Butt Lift (BBL) procedures carried the risk of mortalities resulting from pulmonary fat embolisms (PFE). These embolisms can occur when fat is injected into or beneath the buttock muscles. If the fat enters the veins and reaches the pulmonary circulation, it can lead to immediate and potentially fatal consequences.
What is the riskiest cosmetic surgery?
Body Lift, Liposuction and Facial Reconstruction and a few other cosmetic surgery procedures.
Why is BBL so dangerous?
The primary reason why is BBL so dangerous is a fat embolism. A fat embolism occurs when fat enters the bloodstream, travels within the blood vessels, and becomes lodged, resulting in a blockage. This blockage disrupts the blood supply, leading to potentially fatal consequences.
What is the death rate BBL after 10 years?
A sum of 692 surgeons, constituting 14.3% of the total, responded regarding 198,857 cases. The survey inquired whether members were informed about any fatalities related to Brazilian Butt Lifts (BBLs). Based on their responses, the estimated mortality rate ranged from 1 in 2351 to 1 in 6241 cases, thus earning BBLs a reputation as the most fatal procedure in plastic surgery.
Contact us Today
If you would like to learn more about the Brazilian butt lift procedure and how you can get this cosmetic surgery done safely, you can contact New York City board certified plastic surgeons Dr. Matthew Schulman.
Dr. Schulman is considered an expert BBL surgeon having performed more Brazilian butt lift BBL procedures in his career than most other plastic surgeons. See before and after BBL photos.
