A Board Certified Plastic Surgeon Advises Against the BBL—Here’s Why

A woman looks at her bum in the mirror following a Brazilian Butt Lift (BBL)

Are you considering getting an enhanced backside contour with the popular Brazilian butt lift, or BBL, procedure? As common as this surgery seems to be, it is actually quite dangerous—and board certified plastic surgeon Dr. Christopher Hess advises his patients to think twice before seeking it out. Below, we explain why.

The technique required to perform a BBL can be deadly

A Brazilian butt lift—technically “gluteal fat grafting”— is a two part procedure: first, a surgeon uses liposuction to strategically remove fat from the waist, hips, flank, or thighs. This harvested fat is then purified, placed in a syringe, and re-injected into the buttocks to create the desired appearance.

The reason that a Brazilian butt lift, or BBL, is dangerous is that a surgeon can easily and accidentally inject fat into a blood vessel, causing blood clots or pulmonary fat embolism in the blood vessels of the lungs. To avoid potentially deadly complications, injected fat should be placed just below the skin (in the subcutaneous plane) using a thick, blunt-tipped cannula to avoid injecting into a blood vessel or into the muscle; if the fat is injected into the gluteus maximus muscle (deeper than the layers of skin and fat), there is an increased risk of the fat reaching a blood vessel.

A surgeon can easily and accidentally inject fat into a blood vessel, causing blood clots or pulmonary fat embolism in the blood vessels of the lungs.

A 2017 task force found that numerous doctors were using the dangerous technique of injecting into the muscle

In response to an alarmingly high percentage of patient deaths after the Brazilian butt lift, various plastic surgery professional organizations created a task force to study the issue. Their 2017 report made it clear why the BBL was so deadly: numerous surgeons were injecting fat into the muscles of the buttocks, thinking that this technique led to a better, more natural-looking outcome. In fact, this method led to patient deaths and other life-altering complications.

From 2017-2020, surgeon education initiatives helped to reduce the number of surgeons utilizing this technique. But, even with our increased collective knowledge, the risks of receiving enhanced buttocks through this method outweigh the benefits, and plastic surgeons who limit their practice to only the safest procedures do not offer BBL.

Watch for unethical BBL providers

As Brazilian butt lift remains extremely popular, reports continue to surface of doctors who offer this procedure in less-than-hygienic conditions, performing numerous discount procedures a day in order to capitalize on demand. This “BBL factory” or “chop shop” type of operation is highly dangerous, and should be avoided at all costs. Red flags to look for include:

  • The doctor does not hold board certification from the American Board of Plastic Surgery.
  • The price quoted for a BBL seems lower than that charged by qualified, experienced, medically-respected plastic surgeons.
  • The surgeon does not have glowing reviews from their previous patients on sites with verifiable patient reviews such as Real Patient Ratings.
  • The surgeon does not hold privileges at a trusted local hospital.
  • The surgeon does not take time to hear about and discuss your health history, goals, and desired outcome.

When considering any plastic surgery procedure, you should have a face-to-face meeting with your surgeon in which they answer all of your questions and discuss all of the procedure options to meet your goals. Surgeons should also provide you with a personalized, comprehensive fee quote based on your procedure details. If anything about their credentials, experience, or compassion for you as a patient seems “off,” walk away.

If anything about their credentials, experience, or compassion for you as a patient seems “off,” walk away.

Alternatives to the BBL

The apparent size of your buttocks can often be enhanced by sculpting nearby areas of the body. A plastic surgeon with extensive experience can help you learn about all of the available safe options for creating an hourglass figure, including tummy tuck, CoolSculpting, and waist and flank liposuction. Plastic surgeons work with numerous patients of all shapes and sizes, and are able to offer highly customized advice for you.

For patients intent on increasing the projection and size of their buttocks, gluteal implants may be the safest option—but buttock implants still carry risks. To safely reach your appearance goals, schedule a consultation with a board certified plastic surgeon who is experienced in body contouring procedures.

About board-certified plastic surgeon Dr. Christopher Hess of Fairfax, VA

Board certified plastic surgeon Dr. Christopher Hess has served patients in the Fairfax, Virginia area for over 20 years. He is certified by the American Board of Plastic Surgery and is a Fellow of the American College of Surgeons. Dr. Hess prioritizes learning about each patient’s goals in an in-depth consultation, and he helps you to learn about all of your options and their safety to empower you to make an informed decision about your plastic surgery. To schedule a consultation today, call 703.752.6608 or contact us online today.

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