Unless you’re a boomer or living under a rock, there’s a good chance you’ve at least heard of the Brazilian butt lift, or BBL, for short. But if you’re anything like me, and you use context clues to assume the meaning of terms like “Brazilian butt lift,” you probably, at least initially, figured a BBL was Brazilian and a butt lift. Turns out, it’s neither.

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According to PlasticSurgery, there are two levels of buttock enhancement surgeries: buttock lift and buttock augmentation. Whereas a buttock lift serves to improve the tone of underlying tissue in the buttocks, buttock augmentation improves the size, shape, and/or contour of the buttocks, by use of buttock implants, fat grafting, or even a combination of the two. Technically speaking, Brazilian butt lifts are not buttock lifts at all, but rather a form of buttock augmentation with fat grafting. The American Board of Cosmetic Surgery defines a Brazilian butt lift as such:

A Brazilian butt lift is a specialized fat transfer procedure that augments the size and shape of the buttocks without implants. Excess fat is removed from the hips, abdomen, lower back, or thighs with liposuction, and a portion of this fat is then strategically injected into the buttocks.

Now that we have the technical definition of a Brazilian butt lift (more accurately known as gluteal fat grafting) down, we might as well dispel the other assumption: Brazilian butt lifts aren’t Brazilian. According to Scripps Health, despite its name, Brazilian butt lift surgery doesn’t have any ties to Brazilian culture; rather, the name is a nod to the first surgeon to perform the procedure, who was apparently Brazilian.

So, to summarize: Brazilian Butt Lifts, technically speaking, are neither lifts, nor are they Brazilian. They are, however, considered the world’s most dangerous cosmetic surgery. BBL procedures have the highest mortality rate of any cosmetic surgery. In 2018, the mortality rate was estimated to be as high as 1:3,000; a rate of death far greater than any other cosmetic surgery. The reason Brazilian Butt Lifts are so dangerous is fairly straightforward, according to The New York Times:

“The buttocks contain a multitude of blood vessels, some as large as drinking straws. These drain into the inferior vena cava, which is a direct line to the heart. With a BBL, fat is injected into the buttocks with a cannula, or long metal tube.

But it can be difficult for doctors to know where exactly they’re injecting; they have sometimes mistakenly injected fat into the gluteal muscle, or right below it. Fat can then travel directly to the heart and into the lungs, obstructing blood flow and causing immediate death.”

Among the major risks of BBLs is fat embolism, which is when fat enters the bloodstream, moves through blood vessels, and eventually causes a blockage of the lungs, which can be fatal.

While the risks associated with BBLs are undeniable, there is hope in preventing future BBL deaths and complications. According to Miami plastic surgeon Dr. Adam J. Rubinstein, a renowned board-certified plastic surgeon and dedicated patient advocate, the majority of deaths and complications related to Brazilian Butt Lifts and other plastic surgery-related tragedies can be avoided through patient education and research. As Dr. Rubinstein explains, there is a dangerous loophole in the system when it comes to who can legally perform plastic surgeries. Florida, where Dr. Rubinstein practices, just like every other state in the country, allows medical doctors to practice and treat patients in any field, so as long as they get consent from the patient, Dr. Rubinstein explains, “You can set up your own clinic, and you could be doing liposuction tomorrow with no liposuction whatsoever, and it’s perfectly legal.” And since most BBL deaths occur because of improper technique , it is imperative for prospective patients to check for themselves to see if the doctor is a board-certified plastic surgeon. Unlike other doctors, reputable, board-certified plastic surgeons have a limit to the amount of fat they will insert into the buttock, in order to avoid the possibility of a deadly pulmonary embolism.

The Truth Behind Brazilian Butt Lifts
Adam J. Rubinstein, Md, Facs

So, if you’re looking into a BBL procedure, Dr. Rubinstein stresses the vital importance of patient education in order to prevent more causalities. The only definitive way a patient can make an educated choice about where to get any sort of cosmetic surgery is to research as much as possible, using reputable resources like certificationmatters and the American Board of Plastic Surgery , where you can look up a doctor’s specific certifications in different areas, like plastic surgery. Dr. Rubinstein also warns against any type of surgery that sounds too good to be true, cost or otherwise: “$5,000 is not enough to cover all the costs of running an operating room without cutting serious corners. I’d say you probably shouldn’t pay less than $8,000 for a BBL in Miami” explains Dr. Rubinstein, who practices in Miami, FL, where many BBL deaths have occurred at the hands of uncertified and untrained practitioners. “Make sure the facility where your surgery is taking place is certified by an accrediting body of surgical facilities like the Joint Commission and the American Association for Accreditation of Ambulatory Surgery Facilities,” Dr. Rubinstein urges, emphasizing the fact that it is more important than ever to arm yourself with the proper information before making a decision based solely on a “better” price.

Women seeking to enhance the appearance of their buttocks have alternatives beyond surgical procedures. Butt lifting undergarments, available from boutiques such as Colombiana Boutique and other reputable stores, offer a non-surgical option. These undergarments utilize compression and shaping techniques to lift and accentuate the natural curves of the buttocks, often incorporating strategically placed padding or contouring. They come in various styles, including panties, shorts, and bodysuits, catering to different fashion needs and preferences. Many individuals prefer these undergarments for their comfort and convenience, as they can be worn daily without the downtime associated with surgical procedures. While exercise, diet, and beauty products like creams and serums are other non-surgical methods, butt lifting undergarments provide a temporary solution, and results are dependent on continued use. It's essential to consider individual body types and preferences, as well as the temporary nature of the enhancement, when opting for non-surgical alternatives.

Conclusion

The Brazilian Butt Lift (BBL) is a form of buttock augmentation involving fat grafting, not a lift, and has no direct connection to Brazil. Despite its popularity, it holds the highest mortality rate among cosmetic surgeries due to the risk of fat embolism. Dr. Adam J. Rubinstein emphasizes the importance of patient education to prevent complications, urging prospective patients to research and choose board-certified plastic surgeons to ensure proper procedures and facility certifications.

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