A Brazilian Butt Lift (BBL) is a cosmetic procedure involving two primary steps: liposuction removes fat from areas like the abdomen or flanks, and this harvested fat is purified and injected into the buttocks to enhance shape and volume. The term “botched BBL” describes a result that is either physically unsafe, leading to significant health issues, or aesthetically unsatisfactory, requiring corrective measures.
Immediate Severe Medical Complications
The most serious and potentially fatal complication associated with a BBL is a fat embolism, which occurs when injected fat enters the bloodstream. This happens when fat is mistakenly injected into the deep gluteal muscle layer, accessing large, underlying veins. Once fat particles enter the venous system, they can travel to the lungs, heart, or brain, blocking blood flow and leading to organ failure. The mortality rate for the BBL procedure is reported to be higher than for any other cosmetic surgery, estimated around one in every 3,000 procedures.
Patients may also face serious infections at the liposuction or fat grafting sites, which can become systemic and compromise overall health. Poor sterile technique or inadequate postoperative care can lead to severe bacterial infections, including resistant strains like MRSA or Pseudomonas. Another significant risk is tissue necrosis, the death of transferred fat cells that fail to establish a new blood supply. This dead tissue can become infected or require surgical removal.
Immediate surgical complications include excessive bleeding and the formation of a hematoma, which is a collection of blood pooling under the skin. A large or painful hematoma may require medical intervention to drain the blood. Extensive liposuction and grafting also increase the risk of shock or adverse reactions related to the anesthesia.
Unwanted Aesthetic Outcomes
A common sign of a botched procedure is noticeable asymmetry, where one side of the buttocks is visibly larger, differently shaped, or positioned unevenly compared to the other. This unevenness results from non-uniform fat harvesting or unequal fat distribution during the injection phase. Such a result fails to provide the balanced and harmonious contour the patient sought.
Irregularities on the skin surface are a frequent complaint, including the development of hard lumps, bumps, or calcifications. These nodules manifest as fat necrosis, where transferred fat cells have died but were not fully reabsorbed by the body. The resulting hard spots can be painful and create an unnatural texture or dimpling.
The overall shape of the buttocks may also be aesthetically unsatisfactory, often described as poor contour. This can include a “shelf deformity,” characterized by excessive fullness in the upper portion that creates a squared or unnatural projection. Conversely, some patients end up with a disproportionately large or wide lower region, sometimes called “diaper booty.” These outcomes indicate a failure to sculpt the body into a smooth, proportional silhouette.
Factors Contributing to Poor Results
The single most consequential factor leading to severe medical complications is the depth of the fat injection. Surgeons are trained to place harvested fat only into the subcutaneous layer, the fat layer situated just beneath the skin. The danger arises when fat is injected beyond this layer and into the deep gluteal muscle, allowing it to enter large blood vessels.
Many unsatisfactory outcomes are directly linked to the qualifications and experience of the practitioner. Utilizing non-board-certified surgeons or undergoing the BBL in unaccredited facilities drastically increases the risk of complications. These settings often lack the stringent safety protocols and necessary emergency equipment required to manage a serious surgical event.
Technical errors in the procedure itself, such as inadequate purification of transferred fat or poor harvesting techniques, also contribute to poor results. Improper patient screening can lead to complications if the patient has insufficient donor fat or underlying health conditions that make them a poor surgical candidate. A lack of clear communication regarding the patient’s desired outcome can also contribute to a result that is technically sound but fails to meet the patient’s specific aesthetic goals.
Options for Revision and Correction
Patients dissatisfied with their initial results often seek surgical revision. This corrective surgery is typically more complex than the first operation, requiring the surgeon to work through scar tissue and existing contour irregularities. Revision may involve targeted liposuction, sometimes using specialized tools like ultrasound-assisted devices, to remove excess fat or soften hard scar tissue and lumps.
To address asymmetry or insufficient volume, a secondary fat grafting procedure can be performed to balance the shape. In cases where lumps from fat necrosis are present, the surgeon may need to excise, or surgically remove, the hard, non-viable masses. The goal of surgical revision is to create the smooth, natural contour missed in the initial attempt.
Non-surgical treatments are sometimes employed for minor issues, particularly small, soft lumps caused by fat necrosis. Steroid injections can be used to reduce inflammation and shrink these masses. It is advisable to consult a board-certified plastic surgeon who specializes in revision BBL procedures, as their expertise is necessary for achieving a safer and more successful final outcome.