What is the price of beauty? If you think that beauty includes a well-shaped rear end, the answer may be your life. According to the statistics, the Brazilian Butt Lift (BBL), a form of gluteoplasty also known as gluteal fat grafting, is the most dangerous operation. While breast augmentation has a death rate of about one in 72,000, BBL has one death in every 3,000 or 4,000 procedures. Despite a number of suggested changes to make the procedure safer, it has proved very resistant with death rates remaining unacceptably high.
Image of trochar and cannula used in BBL procedures.
The BBL is performed by taking fat from one part of the patient’s body (liposuction) and injecting it into the buttocks in a series of injections intended to spread it out and sculpt the shape of the buttocks.
The BBL presents all of the problems of other cosmetic procedures. The patient may have an unrealistic expectation about the outcome. The body “sculpting” may not be even and may leave lumps or bumps. There may be scarring, infection, blood clots, excessive blood loss and anesthesia problems. However, bigger problems also exist.
Grave risk arises if the fat injection is too deep or at the wrong angle. Fat globules can be injected into a blood vessel and block circulation or can be injected into a vein and carried to the heart or lungs. These fat emboli, as the fat globules in the bloodstream are called, can cause tissue death, pulmonary embolism, respiratory failure, and death.
Florida is the epicenter of the BBL industry. The problem is made worse there by the proliferation of low budget, high volume medical clinics in South Florida which do many BBL’s each day. Some of them use doctors who are not board certified plastic surgeons. Even those which employ board certified plastic surgeons may also employ less well-trained doctors or non-physician employees to perform some of the tasks required for a BBL. While a patient should always opt for a well-trained, board certified plastic surgeon for any cosmetic procedure, when it comes to BBL’s the statistics show that even these doctors have unacceptably high rates of complications and fatalities.
The belief among those studying the situation is that high volume practices are inconsistent with the kind of good care that will lessen the chance of a major complication. Experienced plastic surgeons claim that they can safely do at most three BBL’s a day. They say safe and effective fat injections require great attention to detail. Some of the doctors at the low budget, high volume clinics are doing 8 to 10 procedures a day. Some doctors are even doing multiple BBL’s at one time and rotating from room to room in the process. In response, the Florida Medical Board has recently passed an emergency rule prohibiting surgeons from doing more than three BBL’s in a day and requiring ultrasound guidance for fat injections. Whether this will reduce the number of deaths and major complications remains to be seen.
As always, if you are considering cosmetic surgery, take your time and do your homework. Check out the credentials of the surgeon you are considering. Ask about complication rates. Do your best to make sure that your expectations are realistic. And when it comes to BBL’s, remember the words of a well-respected plastic surgeon addressing the issue, “No one ever died of a skinny buttocks.”
