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The before and after of the Brazilian butt lift. While it is one of the most popular plastic surgery procedures in the world, it is also the deadliest.

Explainer | Why the Brazilian butt lift is the deadliest cosmetic surgery procedure, what the risks are and the requirements for recovery

  • The Brazilian butt lift is a procedure – with a mortality rate as high as one in 3,000 – involving liposuction and fat grafting to add volume to your buttocks
  • Doctors explain everything about it, from what the surgery entails, to why it is more risky than other procedures, to what to expect during recovery

Beauty standards have changed dramatically in the past few years and we have seen many plastic surgery trends rise and fall.

The Brazilian butt lift, while not new, is at its peak right now. It is a procedure involving liposuction and fat grafting to add volume to, define and lift your buttocks.

The Brazilian butt lift, also known as BBL, is one of the most requested forms of cosmetic surgery. According to the American Society for Aesthetic Plastic Surgery, there were 61,387 glute augmentations performed in the US in 2021 – and that number will have grown since.

There are side effects and dangers attached to having a BBL, which is considered one of the deadliest cosmetic procedures – something that not enough people talk about. If you are considering getting one, you should make sure you understand everything the surgery entails, from risks to post-op care.

A reference chart for getting a Brazilian butt lift.

What is a BBL?

A Brazilian butt lift is an outpatient procedure where the surgeon extracts fat from different parts of your body – such as your thighs, arms, hips, abdomen and lower back – and injects it into your glutes. This has two benefits – it slims down those areas, and adds size to your rear.

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Besides the slimming benefits of the liposuction, many choose BBLs over silicone implants because the results look more natural.

While techniques may differ from surgeon to surgeon, the essentials are the same. Before surgery, the doctor draws on the body to define where they will extract fat and where they will inject it.

Then the patient is put under general anaesthesia, and the surgeon injects intravenous fluids such as adrenaline and lidocaine into the areas marked for liposuction to ensure easier fat detachment, less bleeding and less pain during recovery.

Many choose BBLs over silicone implants because the results look more natural.

Once the fat is extracted, it goes through a filtering process that extracts the live fat cells from the liposuction fluid. The fat is then injected into the desired areas through tiny incisions.

“The body transformation provided by the BBL may be a reason for the surgery’s popularity,” says Samuel Lin, a plastic surgeon and associate professor of surgery at Harvard Medical School, adding that people seem to be more open to talk about it now than ever before.

“The procedure’s visibility on social media and in popular culture may also contribute to its growing popularity.”

A woman wearing a recovery suit after having a Brazilian butt lift.

What is recovery like?

The procedure itself is pretty straightforward but, as many patients have said, the recovery is the hardest part.

While some may feel it more than others and medication is provided, you should expect to experience pain, soreness and swelling for about two to six weeks after the procedure.

The before and after of getting a Brazilian butt lift.

During the first two weeks, you are not allowed to sit down, lie on your back or in any way rest your glutes on hard surfaces. That means you will have to sleep either on your stomach or your side and remain standing for all daily activities – except for going to the bathroom.

“It is imperative that the patient undergoes the recommended number of massages, wears the appropriate garments and follows all necessary directions,” says Constantino Mendieta, a plastic surgeon in the US state of Florida.

Once your surgeon gives you the go-ahead, you can start to sit using a special doughnut-shaped seat, or to place pillows strategically around your thighs, to lessen the pressure on your BBL. Only after eight to 10 weeks will you be allowed to sit down normally.

A recovery suit. During the first two weeks, you are not allowed to sit down, lie on your back or in any way rest your glutes on hard surfaces.

What to expect

The results of a BBL are semi-permanent, so there is a chance you would need to undergo surgery to go back to your original shape. Only 70 to 80 per cent of grafted fat remains in the intended area – the rest is absorbed back into the body, which can lead to a decrease in size or a change of shape.

The fat cells injected into your buttocks will perform just like the rest of your body’s fat cells – they become a part of your glutes. This means that, if you gain weight, the cells will collect more fat and get bigger. If you lose weight, the cells will dwindle and become smaller.
Brazilian butt lift measurements.

The risks

“The mortality rate from BBL is estimated to be as high as one in 3,000. This is greater than [for] any other [form of] cosmetic surgery,” Lin says. “Any patient considering a BBL should be informed of the risk of death from this procedure.”

The leading cause of death from a BBL is a fat embolism. This is when fat gets into the bloodstream, travels through the blood vessels and gets stuck, which creates a blockage. This causes a disruption to the blood supply that can be lethal.

It is estimated that about three per cent of BBLs performed around the world have complications that lead to death. Photo:

During a BBL procedure, fat is supposed to be injected into the subcutaneous space – the space between your muscles and your skin. When not done correctly or done without proper knowledge, it can be accidentally injected into the muscles.

When this happens, the fat may travel to your lungs or heart, causing a cardiopulmonary collapse which can have medical consequences or cause your death.

It is estimated that about 3 per cent of BBLs performed around the world have complications that lead to death, which is a significantly higher mortality rate than that for any other form of cosmetic surgery.

“This is a level of risk that is extremely alarming and totally unacceptable for an elective cosmetic procedure,” plastic surgeon Lara Devgan says. She stresses the importance of carrying out research to find a highly qualified surgeon.