What is a Brazilian Butt Lift (BBL)?
A Brazilian butt lift, also known as BBL surgery, is a sought-after cosmetic procedure that utilises the patient's own fat to sculpt a rounder, fuller, and more elevated butt.
This outpatient treatment starts with liposuction, a procedure performed by a plastic surgeon. The excess fat is skillfully extracted from various trouble areas such as the thighs, back, stomach, and love handles. Once obtained, the fat undergoes purification before being injected via gluteal fat augmentation. This method involves injecting a portion of the purified fat into the buttock cheeks, and sometimes the hips, to enhance their size and shape.
The Brazilian buttock lift stands out as a favourite among individuals due to its dual benefits. By eliminating unwanted fat, you not only achieve a leaner physique but also reshape your buttocks and hips without resorting to synthetic injections or implants. This unique combination delivers astonishing body contouring results, ultimately crafting a coveted hourglass figure.
What are the Pros & Cons of getting a BBL?
- Skilled plastic surgeons can achieve remarkably natural-looking results with a Brazilian butt lift procedure.
- The liposuction from a BBL can also effectively shape multiple areas of the body, including the stomach, waist, love handles, thighs, and back, where excess fat resides.
- The transferred fat that weathers the procedure stays permanently, ensuring long-lasting results as long as your weight does not fluctuate.
- When the fat is injected above the muscle and fascia, Brazilian butt lift surgery is regarded as a safe procedure (further details below).
- Since the patient's own fat is used, there is no possibility of an allergic reaction. A BBL also has a lower risk of infection compared to butt implants.
- There is minimal scarring with a BBL, thanks to small, discreet incisions made for the liposuction tube.
- Patients typically express satisfaction with their results and the procedure is overall rated higher than silicone butt implants.
- Brazilian butt lifts have gained prominence for being one of the most dangerous plastic surgery procedures due to the use of certain risky methods by some surgeons.
- The immediate recovery period after a BBL typically lasts a minimum of 2 weeks and can be uncomfortable, even with pain medication. Patients must avoid sitting or applying weight to the buttocks for several weeks to protect the transferred fat.
- Approximately 40 per cent of the grafted fat may be reabsorbed by the body during the first 4 months after the procedure, resulting in varying outcomes among patients.
- Patients who were unsatisfied with the buttock augmentation procedure often cited wanting a more significant change or experienced issues such as dents, bumps, or slipping that required additional revision surgery.
How much does a Brazilian butt lift cost?
Average Cost: $10,500
Range: $7,250 - $17,500
The price of a Brazilian butt lift (BBL) is influenced by several crucial factors, including the qualifications of your surgeon, their geographical location, the extent of liposuction performed, the anesthesia used, and other considerations.
Surgeons often provide flexible payment options, including payment plans or the acceptance of Buy Now Pay Later providers like Afterpay, making a BBL more accessible to a wider range of individuals.
Why are BBLs so dangerous and what are the risks?
Despite its controversial reputation, Brazilian Butt Lift (BBL) surgery, when executed correctly, is far less risky than anticipated. Its perceived danger is largely attributed to a series of unfortunate fatalities in previous years, when ill-informed surgeons injected fat into and beneath the gluteal muscle, leading to deadly blood clots.
The BBL surgery was further stigmatised due to a flawed 2017 study - later challenged by BBL thought leaders - that overestimated the mortality risk from a BBL to be between 1 in 6,214 to 1 in 2,351.
Subsequent research painted a more accurate picture, aligning the BBL mortality rate of 1 in 14,952 patients to that of an abdominoplasty (tummy tuck), as long as a board-certified plastic surgeon adheres to the latest safety standards.
The Aesthetic Surgery Journal (ASJ) highlighted in its May 2023 publication that the safety of subcutaneous gluteal lipofilling is continually improving, thanks largely to innovations in technology, surgical techniques, and professional training that avoid dangerous intramuscular fat injection. However, patients who undergo BBLs at unlicensed facilities or through medical tourism are at a higher risk of encountering serious complications.
A recent study explored the higher BBL fatality rates in South Florida, identified by the researchers as having the highest BBL mortality in America. The study - conducted by plastic surgeons specialising in BBL - analysed 11 BBL autopsies and found that all had fat injected into their gluteal muscles. The majority of these patients (92%) had surgery at high-volume, discount clinics in South Florida, where surgeries typically lasted just 90 minutes, leading some surgeons to label these clinics as "assembly lines".
While the BBL does have the highest post-operative complications among plastic surgeries, most issues are cosmetic and can be corrected, such as irregular shapes, indentations, or lumps.
The above ASJ study remarks that more serious risks and complications included: hypothermia, sepsis, skin necrosis, subpar aesthetic results, and fat embolism.
A pulmonary fat embolism can usually be avoided if the surgeon operates above the gluteal muscle and avoids veins. However, the risk emerges if the surgeon penetrates the fascia or injects into the muscle to gain more volume, but compromises patient safety.
An embolism can happen if an injection cannula damages a vein, permitting the injected fat to enter. The gluteal region is highly vascular, with an abundance of blood vessels in and below the gluteal muscle.
If fat enters a vein, it can travel to the heart or lungs, obstructing vital vessels, which can quickly lead to fatal consequences, even during surgery.
Nonetheless, despite its infamous reputation, plastic surgeons continue to scrutinise BBL risk factors and enhance techniques to improve the procedure's safety.
In an effort to further mitigate the risk of complications, medical professionals recommend undergoing surgery in an accredited ambulatory facility, or a hospital.
Who is a good candidate for a Brazilian butt lift?
A Brazilian butt lift (BBL) surgery candidate should have:
- Good Health: Candidates should be in overall good health. In certain cases, blood tests may be required by the provider to ensure suitability for the operation.
- Skin Tone: Candidates should exhibit favourable skin tone in the buttocks and hips. For individuals with lax or sagging skin, surgeons may suggest alternative options such as nonsurgical skin tightening treatments or traditional buttock lift surgery (commonly known as a butt tuck) to address firmness or remove excess skin.
- Stable Weight: Candidates should maintain a stable weight and have sufficient fat reserves in other areas of the body for extraction and transfer.
Some surgeons offer a specialised "skinny BBL" procedure for individuals with a BMI below 21. During this procedure, the utilisation of BeautiFill for fat extraction and processing has shown an exceptional average fat cell viability rate of over 95 per cent.
It is important for slimmer patients to manage their expectations as the skinny surgery involves a smaller volume of fat grafting compared to a traditional BBL, ensuring natural results and optimal fat viability.
Prospective candidates should undergo an in-person or virtual consultation with a qualified surgeon. This consultation typically includes a physical examination to assess candidacy, thorough discussion of medical history, and setting realistic expectations regarding the anticipated results.
Melon Hint: Prior to scheduling a consultation, it is advisable to carefully review a potential surgeon's before & after photos, focusing on images featuring individuals with a similar body type to yourself.
How is a Brazilian butt lift done?
The duration of a Brazilian butt lift (BBL) surgery typically takes 2 to 4 hours. While specific techniques may vary among surgeons, here is a general outline of the procedure:
Markings and Photos:
- The surgeon will review your goals and discuss realistic expectations for the surgery.
- While standing your skin will be drawn on with a pen to outline the areas where fat will be extracted and injected.
- Before photos will be taken for documentation.
- Once you are in the pre-operative area, an intravenous (IV) line will be placed in your arm.
- General anesthesia is usually administered via the IV, ensuring that you are fully asleep, immobile, and comfortable during the procedure. Many surgeons prefer this approach as it provides optimal conditions. Local anesthesia alone, with sedation, has been reported as being very painful. Moreover, using local anesthesia for comprehensive surgeries like BBL increases the risk of lidocaine toxicity, which can be life-threatening.
Liposuction for Fat Harvesting:
- In the operating theatre, your skin will be cleaned using an antiseptic surgical preparation.
- A tumescent fluid, a mixture of saline, epinephrine, and lidocaine, will be injected into the area with surplus fat. This fluid helps reduce pain, bleeding, and bruising.
- To perform liposuction, the surgeon will make one or more small incisions and insert a thin tube attached to a vacuum to remove the fat.
- The extracted fat will then undergo purification to isolate the viable cells for subsequent transfer.
Fat Transfer to the Buttocks:
- Using a syringe connected to a cannula, the surgeon will inject the purified fat just below the skin surface in the buttock area. This process adds size to the butt, fills in hip dips, and shapes the body.
- To prevent the potentially life-threatening complication of a fat embolism, the fat must be injected above the muscle and fascia, rather than in or below. Some plastic surgeons now utilise ultrasound guidance during BBLs to ensure accurate fat placement in the proper plane.
- Layer by layer, the surgeon will continue injecting the fat below the skin, within the confines of safety, until the desired effect is achieved.
How much fat can be transferred with a BBL?
To achieve a substantial change, it is suggested to have a minimum of 250 to 300 cc of fat transfer per side.
Some individuals desire a large volume boost, opting for up to 1000cc (1.0L) of fat transfer. However, the actual amount of fat that can be successfully transferred depends on the buttock's soft tissue capacity and the limitations imposed by the skin envelope.
It is vital to avoid overfilling the buttocks, as it can lead to constriction. Overfilled fat cells may face challenges in establishing a new, robust blood supply, potentially resulting in a greater incidence of fat cell death (fat necrosis) or abscess formation. Doctors emphasize the need to exercise caution regarding this potential risk.
If your cosmetic goals require a larger volume of fat than can be accommodated in the subcutaneous layer during a single surgery, subsequent procedures, such as a second or even third BBL, may be possible.
In cases where there is an inadequate amount of surplus fat to achieve your desired look, your surgeon may propose a hybrid approach. This could involve a mixture of fat transfer and buttock implants to attain the desired projection.
How long does Brazilian Butt Lift recovery take?
The recovery period following a Brazilian butt lift (BBL) can range from 2 to 6 weeks, contingent upon the extent of liposuction performed and individual healing. It is advisable to plan for a minimum of 2 weeks away from work, although 4 weeks are preferred if feasible.
While recovery experiences differ, here is a rough timeline:
- Patients typically require prescription pain medication for a week post-operation before switching to over-the-counter options. Adhering to your doctor's pain management instructions is crucial.
- Patients who have travelled for their BBL can generally fly home within 10-14 days after surgery, provided they are in good health and lack preexisting blood clot risks. The likelihood of developing a clot from flying is highly improbable, as patients are carefully screened for clotting disorders before surgery. Opting for an aisle or extra-legroom seat can facilitate movement during the flight. To minimise pressure on the fat-grafted areas, utilising a buttock pillow that fits the plane seat is recommended. Your surgeon can provide a note for airport security assistance, facilitating a smoother boarding process.
- Intense exercise should be avoided during the first month of recovery. Once your surgeon grants approval, incorporating exercises like lunges and squats that target the gluteus muscles can enhance the final results. Maintaining a consistent body-fat percentage is also essential to preserve the achieved volume.
- Wearing a compression garment for up to 6 weeks can help reduce bruising, inflammation, and promote the tightening of loose skin. While compression gear offers many benefits, excessive compression can potentially harm the skin that underwent liposuction, leading to "girdle trauma" or "garment burns." It is recommended to remove the compression garment for about an hour each day during recovery.
- It may take 6 to 8 weeks, or possibly longer, for most of the postoperative swelling to subside, resulting in a softer, less tight sensation in the buttocks.
- By the 6-month mark, any fat that may be reabsorbed would have done so. The outcome observed at this stage represents the final result, which should remain stable with consistent weight management.
Additional Recovery Tips:
- If you are planning to stay at a recovery house, ensure to inquire about essential aspects before making a booking decision.
- Smoking and vaping can elevate the risk of severe complications and impede the healing process. Complete abstinence from all nicotine products during the recovery period is imperative.
- Should your doctor recommend lymphatic massages to manage BBL side effects, select a masseur experienced in BBL aftercare. Incorrect massage techniques may adversely affect your results.
Melon Hint: While some patients use the term "fluffing" to describe tissue settling after a BBL, plastic surgeons stress that there is no formal concept of "fluffing" in relation to BBL surgery. The term is more commonly associated with breast augmentation. However, certain aspects of a BBL can be compared to this phenomenon. Initially, the buttocks appear inflated and tight due to the injected fat. Over time, some fat dissolves, swelling subsides, and the buttocks settle, becoming rounder and more natural. As swelling from liposuction diminishes, the waist appears smaller, creating a curvier appearance in contrast.
When can you sit after a BBL?
Following a Brazilian butt lift (BBL) surgery, it is crucial to avoid sitting or lying directly on your buttocks for a minimum of 2 weeks. This precautionary measure allows the newly transferred fat to establish a healthy blood supply, ensuring their survival. Fat cells can only thrive when new blood vessels grow into them. The pressure exerted from sitting can jeopardize your results by causing fat cell death.
After the initial 2-week period, your surgeon may grant permission to sit using a specialized ring-shaped pillow. This unique pillow helps redistribute pressure to your thighs, reducing direct pressure on the buttocks.
When can you have sex after a Brazilian Butt Lift?
Typically, doctors advise waiting for up to 4 weeks before engaging in sexual activity following a Brazilian butt lift.
As long as patients feel comfortable and avoid applying pressure to the buttocks, they can resume sexual activity as soon as they feel physically capable.
How long before you see your BBL results?
Immediate results following a Brazilian butt lift (BBL) showcase a significant increase in volume. However, it is crucial to understand that the final outcome can take up to a year to fully set in.
During the initial 4 months after the procedure, it is common for up to 40% of the transferred fat cells to be naturally absorbed by the body. While the most noticeable swelling should have subsided by this point, any remaining will gradually dissipate over the following months.
After the one-year mark, if any concerns arise such as asymmetry, dimples, or results that fall short of your expectations, additional fat transfer can be considered to enhance the appearance of your buttocks.
How long does a BBL last?
Approximately 4 months after a Brazilian butt lift (BBL), the fat cells that have successfully integrated into the buttocks area are considered permanent.
However, it is essential to recognize that changes in weight can influence the overall outcome. Substantial weight loss may lead to a reduction in buttock volume, while significant weight gain can potentially affect the proportionality of your body as the existing fat cells expand.
The dynamic nature of BBL results, adapting with your body's changes, contributes to its allure. The procedure employs your body's own living fat cells and as your body naturally evolves, your BBL results will evolve with it.
Can you have a tummy tuck and a BBL at the same time?
Yes, it is possible to combine a tummy tuck with a Brazilian butt lift (BBL), offering the advantage of avoiding duplicate expenses like facility and anesthesia fees.
Combining these procedures extends the operating time and introduces additional risks. Moreover, the recovery process becomes notably challenging, as patients are unable to sit or lie on their bellies for several weeks.
Due to these factors, doctors caution against pairing these procedures. It is crucial to thoroughly discuss the potential risks, benefits, and recovery implications with your surgeon before making a decision.
What to look for in a Brazilian Butt Lift surgeon
you should prioritise the following:
- Your surgeon should hold a board certification in plastic surgery from a respected institution such as the Royal Australasian College of Surgeons Plastic Reconstructive Surgery.
- Membership in reputable societies (e.g. Australian Society of Plastic Surgeons, International Society of Aesthetic Plastic Surgery) is another vital credential, further confirming their professionalism and commitment to their craft.
- Your chosen surgeon should ideally have extensive experience in performing BBL procedures - ideally hundreds, if not thousands, of successful operations.
- Request to see a portfolio of before & after photos, especially of patients with similar physical characteristics to yours. This will give you a glimpse of their aesthetic judgement and skills, as well as a realistic expectation of possible results.
- Make sure they are knowledgeable in the latest techniques and safety standards related to BBL surgery, and importantly, are open to discussing these with you.
- Lastly, your surgeon should be ready and willing to thoroughly explain all potential risks and complications associated with a Brazilian Butt Lift.
Alternatives to a Brazilian Butt Lift (BBL)
Here are a few alternatives to a Brazilian Butt Lift (BBL) worth exploring if you are unsure about undergoing this surgical procedure.
- Some dermal fillers can enhance collagen production in your body and are occasionally used off-label by plastic surgeons for a filler butt lift. However, this option comes with its own limitations - the results last only about two years and, for dramatic changes, it can cost nearly as much as a BBL.
- Emsculpt: This TGA-cleared procedure uses high-intensity electromagnetic energy to stimulate muscle contractions up to 20,000 times per minute in your buttocks and other muscles. While it is excellent for toning and firming the butt, Emsculpt cannot replicate the effects of a BBL.
- Butt Implants: For those with insufficient fat for transfer, butt implants can provide the desired volume. Some surgeons recommend both silicone implants and fat grafting for more precise shaping.
- Butt Lift: For individuals who have experienced significant weight loss resulting in loose, sagging skin, a butt lift or lower buttock tuck might be a better option. This surgery removes excess skin to achieve a smoother, tighter look.
Medical professionals caution against the use of liquid silicone, acrylic, and hydrogel injections. Untrustworthy practitioners often use industrial-grade silicone for unapproved procedures, colloquially known as "butt shots". These procedures can lead to severe, permanent side effects, including chronic pain, tissue necrosis, or even death.
Melon Hint: Some fitness chains use the term "Brazilian butt lift" in their marketing. While exercises targeting your glute muscles can indeed shape and lift your buttocks, this toned look is quite distinct from the curvy appearance achieved by a BBL, which involves adding more fat.
Sources & Studies
Cansancao, AL, Condé-Green, A, David, JA & Vidigal, RA 2019a, ‘Subcutaneous-Only Gluteal Fat Grafting’, Plastic and Reconstructive Surgery, vol. 143, no. 2, pp. 447–451, viewed 12 June 2023, <https://journals.lww.com/plasreconsurg/Abstract/2019/02000/Subcutaneous_Only_Gluteal_Fat_Grafting__A.18.aspx>.
Cansancao, AL, Condé-Green, A, Gouvea Rosique, R, Junqueira Rosique, M & Cervantes, A 2019b, ‘“Brazilian Butt Lift” Performed by Board-Certified Brazilian Plastic Surgeons: Reports of an Expert Opinion Survey’, Plastic and Reconstructive Surgery, vol. 144, no. 3, pp. 601–609, viewed 12 June 2023, <https://journals.lww.com/plasreconsurg/Abstract/2019/09000/_Brazilian_Butt_Lift__Performed_by_Board_Certified.17.aspx>.
Cárdenas-Camarena, L, Bayter, JE, Aguirre-Serrano, H & Cuenca-Pardo, J 2015, ‘Deaths Caused by Gluteal Lipoinjection’, Plastic and Reconstructive Surgery, vol. 136, no. 1, pp. 58–66, viewed 12 June 2023, <https://journals.lww.com/plasreconsurg/Abstract/2015/07000/Deaths_Caused_by_Gluteal_Lipoinjection__What_Are.11.aspx>.
Mofid, MM, Teitelbaum, S, Suissa, D, Ramirez-Montañana, A, Astarita, DC, Mendieta, C & Singer, R 2017, ‘Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force’, Aesthetic Surgery Journal, vol. 37, no. 7, pp. 796–806, viewed 12 June 2023, <https://academic.oup.com/asj/article/37/7/796/3075249?>.
Pazmiño, P & Garcia, O 2022, ‘Brazilian Butt Lift–Associated Mortality: The South Florida Experience’, Aesthetic Surgery Journal, vol. 43, no. 2, viewed 12 June 2023, <https://academic.oup.com/asj/article/43/2/162/6661367?>.
Tillo, O, Nassab, R & Pacifico, MD 2022, ‘The British Association of Aesthetic Plastic Surgeons (BAAPS) Gluteal Fat Grafting Safety Review and Recommendations’, Aesthetic Surgery Journal, vol. 43, no. 6, viewed 12 June 2023, <https://academic.oup.com/asj/article-abstract/43/6/675/6887101?>.
Wall, S, Delvecchio, D, Teitelbaum, S, Villanueva, NL, Dayan, E, Durand, P, Sanniec, K & Rohrich, RJ 2019, ‘Subcutaneous Migration’, Plastic and Reconstructive Surgery, vol. 143, no. 5, pp. 1343–1351, viewed 12 June 2023, <https://journals.lww.com/plasreconsurg/Abstract/2019/05000/Subcutaneous_Migration__A_Dynamic_Anatomical_Study.13.aspx>.