A Brazilian Butt Lift (BBL) is a cosmetic procedure that reshapes the buttocks by transferring fat from one part of the body to another. It involves removing unwanted fat deposits, typically from the abdomen, hips, lower back, or thighs, through liposuction. This harvested fat is then purified and injected into the buttocks to enhance their size and shape, creating a more contoured appearance. While a BBL focuses on volume augmentation rather than addressing sagging skin, it carries significant dangers.
Underlying Risks of the Procedure
The BBL procedure introduces risks due to the gluteal area’s anatomical characteristics. The process begins with liposuction, where fat is removed using a cannula, a thin, hollow tube. This fat is then processed to separate viable fat cells before being re-injected into the buttocks. The gluteal region contains numerous blood vessels and nerves, making precise injection depth a concern.
The risk arises from the fat transfer’s method and injection location. To achieve desired volume, fat must be injected into viable tissue. However, injecting fat too deeply, particularly into or beneath the gluteal muscle where large veins are present, increases serious complications. This anatomical proximity to major blood vessels is a factor that makes the BBL more dangerous than some other cosmetic procedures.
Life-Threatening Complications
Pulmonary fat embolism (PFE) is the leading cause of death from BBL surgery. PFE occurs when fat droplets inadvertently enter the bloodstream, often during injection, and travel to the lungs, blocking blood vessels. This can happen if the injection cannula punctures a vein, allowing the injected fat to enter the circulatory system. The consequences of PFE include difficulty breathing, respiratory failure, and cardiac arrest, with a reported fatality rate of 7–10%.
The risk of PFE is higher when fat is injected into the deep muscle layers, where major blood vessels are abundant, compared to injection into the subcutaneous fat layer (just beneath the skin). Historically, the estimated death rate from gluteal fat grafting, primarily due to fat embolisms, has been as high as 1 in 3,000. This mortality rate is higher than for many other cosmetic procedures. While PFE is the primary life-threatening complication, other severe risks include extensive infections like sepsis, hemorrhage, and tissue necrosis (fat tissue death from lack of oxygen).
Contributing Factors to Danger
Several external factors can amplify the dangers of a BBL. The surgeon’s skill and experience are important, as improper surgical technique, such as injecting fat too deeply into muscle tissue, is linked to fatal complications like PFE. A lack of specialized training in BBLs among some practitioners can lead to unsafe practices. Adhering to guidelines, such as injecting fat only in the subcutaneous plane using larger, blunt-tip cannulas and potentially using ultrasound guidance, can reduce risks.
The safety and accreditation of the facility where the procedure is performed also play a role. Procedures conducted in unaccredited or non-surgical environments may lack emergency equipment, sterile conditions, and qualified support staff, increasing the risk of complications. Accredited facilities meet strict national standards for equipment, safety, and personnel.
Patient selection and overall health are also important considerations. Pre-existing health conditions, such as diabetes or heart disease, can complicate recovery and worsen surgical risks. Proper screening of candidates, including assessing their body mass index and ensuring they are non-smokers, is important for minimizing risks. Finally, general anesthesia, often used for BBLs, carries its own set of risks, including potential reactions to medications and breathing problems. While local anesthesia can be an option for smaller fat transfers, larger procedures typically require general anesthesia, which necessitates careful monitoring by qualified professionals.