More than 520,000 people in 2021 got some type of buttock augmentation, including the BBL or Brazilian butt lift, yet the procedure has the highest mortality rate of any aesthetic surgery.
Dr. Rubinstein said there are large veins around the muscles of the buttocks that can be injured during a BBL if the fat injections are placed in those muscles. "If that happens, there’s a high risk of fat entering the injured veins and being carried by the bloodstream to the lungs, causing a fat embolism," he said.
Alexandra of Arizona traveled to San Francisco for her BBL surgery."I was never trying to get a big butt, really — it was mainly just about removing my fat and replacing it to fill out my curves a little more." In 2017, the Aesthetic Surgery Education and Research Foundation sent an anonymous survey to 4,843 plastic surgeons worldwide to try to determine how often fat embolisms occurred. Around 7% of the surgeons who responded said they had seen at least one pulmonary fat embolism during their careers, with a total of 32 fatalities reported.In June 2021, the Florida Medical Association announced in a press release on its website that intramuscular or submuscular fat injections were prohibited. The release also stated that"[w]hen performing gluteal fat grafting procedures, fat may only be injected into the subcutaneous space and must never cross the gluteal fascia." Depending on the individual patient’s anatomy and fat composition, the fat can be extracted from the abdomen, thighs, hips, lower back or other areas of the body., hypertension, anemia, obesity and malnutrition," Dr. Samuel Lin, an associate professor of surgery at Harvard Medical School, told Fox News Digital. Patients who smoke or drink excessively should stop doing so before surgery, said Dr. Lin. Those with chronic lung, heart or kidney disease also face a higher risk of complications, he warned."Being overweight greatly increases the risks of complications, including infection and wound healing problems," he said. The BBL is a fat-grafting process in which fat is removed from other areas via liposuction — and injected into the buttocks. "On the flip side, a very thin patient has less fat in the buttocks to begin with and could be at a higher risk for fat being accidentally placed into and around the muscles." For those considering a BBL, it’s important they choose an experienced surgeon who is certified by the American Board of Plastic Surgery. "It’s not enough to ask a doctor if he or she is board certified," said Dr. Rubinstein."You must look for the American Board of Plastic Surgery, since that is the only Board that certifies plastic surgeons. A doctor can be certified by the American Board of Pediatrics and still be offering BBL surgery services."Additionally, Dr. Zuriarrain recommends choosing a surgeon who uses a wireless ultrasound device that helps ensure the injection doesn’t go too deep into the muscle, which is"a recipe for fat embolism and possible death.""You probably shouldn’t be the seventh operation your surgeon is performing that day," said one board-certified plastic surgeon about the process and precautions."Make sure you’re not getting a tired surgeon at the end of the day." "You probably shouldn’t be the seventh operation your surgeon is performing that day," said Dr. Rubinstein. "The state of Florida has now limited the total number of operations a surgeon can perform in a day. More than three procedures in one day can be a lot for one doctor. Make sure you’re not getting a tired surgeon at the end of the day." Dr. Rubinstein added that the best way to avoid a bad outcome is to make careful choices in procedures, surgeons and facilities.Melissa Rudy is health editor and a member of the lifestyle team at Fox News Digital.
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