Brazilian Butt Lift

The Brazilian Butt lift is one of many aesthetic procedures available. It can be performed safely, as long as strict medical procedures are followed. Here, we look at some of the issues and why, if you are considering this - or any - procedure you should only visit a fully qualified and regulated medical professional.

A Brazilian butt lift (BBL), also known as gluteal fat augmentation, has been performed by Brazilian plastic surgeons for more than 30 years. It is a procedure where fat is harvested by a closed-system liposuction technique, separated by gravity, and injected into the gluteal region using a peristaltic pump and reticulating basket cannulas (a cannula with a flared tip so it can separate tissue) The increasing popularity of this procedure, with its associated complications, has made experts associate it with the highest risk of mortality of any aesthetic procedure. The most common post-procedural complications are fat or pulmonary embolism (PE) and deep vein thrombosis (DVT), along with instances of skin and soft tissue infections.

By 2017, the risk of death from pulmonary fat (PFE) was identified, earning the BBL the highest mortality rate of any aesthetic surgical procedure. South Florida carries the highest BBL mortality by far in the USA. (1)

The risk of complications from this procedure is minimal when performed by appropriately trained surgeons but can have disastrous outcomes if performed in settings with poor infection control practices. These surgeries can lead to complicated postoperative infections that require extensive surgical interventions and lengthy antibiotic course regimens if poor sterilisation techniques are used.

Mycobacterium Abscessus complex (MABC - a mycobacterium found in water, soil and dust) is a group of rapidly growing, multidrug-resistant, nontuberculous mycobacterium (NTM) responsible for pulmonary, ocular, and skin and soft tissue infections. It is often regarded as one of the most antibiotic-resistant mycobacteria due to various virulence factors, host interactions, and resistance mechanisms, leaving few therapeutic options. M. Abscessus is the most common NTM to cause complicated skin and soft tissue infections through direct inoculation via skin barrier breaks and causes a complicated and lengthy treatment course.

The lack of proper surgical equipment sterilisation in combination with poor surgeon sterile technique/training most likely led to a seriously problematic outcome in many cases. It is important to consider NTM after cosmetic surgeries as it has been associated with an increasing cause of numerous cosmetic procedure-related infections worldwide.

That said, there are recent concerns regarding butt-lift injections that have been raised due to death from fat embolism. Despite numerous theories on the mechanism of entry, the fact that venous injury occurs with the introduction of boluses of fat in enough quantities to cause mechanical disruption of the cardiopulmonary circuit is not in dispute. This cannot occur in the awake patient without the surgeon being acutely aware of a misguided cannula.

Buttock fat grafting under local anaesthesia can be a safe and effective procedure with an excellent safety profile and durable results as long as the procedure is undertaken by properly qualified surgeons under precise and controlled circumstances. It is said that fat should only be placed in the subcutaneous space, which is the area between the skin and the muscle and with the use of rigid large-diameter cannulas (over 3mm), injecting the fat slowly and at a specific, slanted angle. The use of ultrasound is strongly encouraged by medical organisations along with medical governing bodies, all of which recognise its value in providing surgeons with real-time imaging of their cannula placement.

The trend has been to visit places overseas for this type of operation where standards of both the treatment as well as post-operative care are simply not high enough, resulting in prolonged and lengthy - not to mention, expensive - remedial treatment.

This article is not my own work and is taken from (please read the full article if you are considering ANY aesthetic procedure!)

Bies JJ, Allen JC, Barsi ZE, Hassan M, Prakash S, Aguilar MP, Meza A, Peralta DP. Brazilian Butt Lift Gone Wrong: A Case Series of Non-Tuberculous Mycobacterial Gluteal Infection After Brazilian Butt Lifts. Cureus. 2023 Dec 3;15(12):e49881. doi: 10.7759/cureus.49881. PMID: 38174196; PMCID: PMC10762286.

(1) Brazilian butt lift-associated mortality: The South Florida experience. Pazmiño P, Garcia O. Aesthet Surg J. 2023;43:162–178. doi: 10.1093/asj/sjac224. [DOI] [PMC free article] [PubMed] [Google Scholar]