In recent years, the Brazilian butt lift (BBL) – formally known as gluteal fat grafting has attracted global attention, not just for its popularity but also for its risks. For a time, the procedure was considered one of the most dangerous cosmetic surgeries, with survey data suggesting a mortality rate as high as one in 3,000. This alarming figure placed the BBL under intense scrutiny, even among people outside the field of plastic surgery.
According to Dr. J. Peter Rubin, President of the American Society of Plastic Surgeons (ASPS), those numbers prompted significant concern. But in the last five years, education campaigns, improved techniques, and research-driven changes have helped reduce risks. Today, when performed by a qualified surgeon, the BBL can be much safer, though it is still not without danger.
What Exactly Is a BBL?
Despite its name, the BBL is neither Brazilian nor a traditional “lift.” Instead, it is a type of buttock augmentation using a patient’s own fat. The process has two stages: first, liposuction is performed on areas such as the abdomen, thighs, flanks, or back to remove excess fat. That fat is then purified and injected into the buttocks and hips to enhance contour and projection.
Why the Procedure Is Risky
The risk of the BBL surgery comes not from fat grafting itself – which is a common and generally safe technique – but from where the fat is injected. When fat is placed too deep, near or inside the gluteal muscles, it may enter large blood vessels and travel to the lungs or heart, causing a fat embolism. This complication can be fatal.
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The International BBL Safety Task Force
In response to early mortality data, ASPS and other global plastic surgery organizations formed an international task force to address the risks. Their research confirmed that fat embolism was the most serious threat. To reduce this risk, new safety guidelines were issued: surgeons should avoid injecting fat into or below the gluteal muscle. Instead, the fat must remain above the muscle, where the risk of vessel injury is significantly lower.
Thanks to widespread adoption of these recommendations, the mortality rate of BBLs has improved dramatically. Current estimates place it closer to that of a tummy tuck – roughly one in 15,000 procedures – making it safer than before, though still more complex than many other cosmetic surgeries.
Possible Complications
Most serious complications, such as fat embolism, occur during or within hours after surgery. Other risks include infection, bleeding, or fat necrosis (death of fat tissue). Long-term risks are less common but can involve contour irregularities or asymmetry.
Patients should also understand that not all transferred fat survives. On average, 20–40% of the injected fat is reabsorbed by the body. To preserve results, surgeons advise avoiding prolonged sitting and minimizing pressure on the buttocks during the initial healing phase. By three months, the remaining fat is usually stable, with final shaping continuing up to six months.
What Recovery Looks Like
A Brazilian butt lift recovery resembles that of liposuction. Patients can expect bruising, swelling, and mild to moderate discomfort. Wearing compression garments is standard, as is avoiding sitting directly on the buttocks for extended periods. Specialized pillows or padding can help relieve pressure. Both Dr. Rubin and Dr. Steven Williams stress that protecting the newly grafted fat is key to achieving the best long-term results.
-The Bottom Line
The Brazilian butt lift has evolved from a controversial procedure with high risk into one that can be performed more safely when strict safety protocols are followed. Even so, it remains a complex surgery with potential complications. Prospective patients should carefully select board-certified surgeons, ask thorough questions, and understand both the risks and realistic outcomes.
With improved techniques and better awareness, the BBL can deliver transformative results. But like any surgical procedure, it requires caution, preparation, and a commitment to safe practices above all else.
Resources: https://www.aronowitzmd.com/