August 22, 2018
Bottoms up! Maybe it’s the influence of the Kardashians, but, according to the Americans Society of Plastic Surgeons (ASPS), requests for Brazilian butt lift (BBL) surgery are on the rise—and have been for several years. In 2017, ASPS reports, about 20,300 buttock augmentation procedures using fat grafting were performed, and the number of procedures has more than doubled during the past five years.
Unfortunately, that’s not necessarily a good thing. In fact, the ASPS warns, that the BBL is one of the most dangerous cosmetic procedures that doctors perform.
There are always risks involved in surgery—however, among BBL patients to date, there has been a daunting mortality rate: As many as 1 in 3,000 people who undergo the procedure die, or 0.033 percent, compared with 0.002 percent for all office-based cosmetic procedures, according to a 2016 study published in Aesthetic Surgery Journal.
And the cause of these deaths is troubling: Fat that’s injected too deep can enter a patient’s circulatory system, possibly leading to a pulmonary embolism. Indeed, because there are a lot of blood vessels in the buttock area that can be torn or punctured if the fat is injected too deeply, the fat can travel through the circulatory system into the lungs—causing immediate and life-threatening complications.
According to Dr. Douglas Senderoff, a board-certified plastic surgeon based in New York City, the BBL is associated with the highest complication rate of any plastic surgery procedure or elective surgery for healthy people. It’s “unacceptably high,” he told the Huffington Post recently.
Senderoff told HuffPost, “[A pulmonary embolism] is basically a blood clot in the lungs, and you can’t get oxygen to your body because there’s obstruction, and that’s fatal,” he said. “You really don’t have much time to do intervention. It’s something a patient can’t [always] recover from, and it can be immediate.”
To find out more about the procedure and why it’s so dangerous, HuffPost also spoke to Dr. Alan Matarasso, then, the president-elect of the American Society of Plastic Surgeons.
The first thing you should know about the BBL, Matarasso told the news outlet, is that it’s not really a lift. “It’s a little bit of a misnomer,” the doctor said, explaining that the cosmetic procedure enlarges the buttock area through the injection of fat. That fat is usually taken from other parts of the body―usually the abdomen and thighs—for additional contouring effects.
“People like the concept of using their own body fat,” he told HuffPost, noting that there’s more of an “overall change” to the body shape. “For example, you may reduce the thighs and enlarge the butt, and they sort of go hand in hand.”
Other elements that can affect the outcome of the procedure, according to Matarasso, include the amount of fat that’s injected, the angle at which it’s injected and the type and size of instrument (a cannula) used.
In addition, the BBL can have a number of non-life-threatening complications—including bleeding, infection,n and issues with skin healing, Matarasso said.
According to Senderoff, patients can also experience fat necrosis, in which the injected fat cells die, resulting in firm lumps that can lead to infection.
The risk increases greatly, if the surgery is performed by an uncertified doctor (or back-alley profiteeer). Indeed, Matarasso said, people who aren’t doctors even are injecting “inappropriate substances,” such as silicone into patients’ butts—which is very dangerous.
“It’s unfortunately not as uncommon as you’d hope it would be,” he told HuffPost—adding, “On any given day, there is somebody going into the emergency room with siliconomas,” or hard lumps of tissue that form around silicone gel that has migrated from an implant or injection site.
Is there any alternative? It’s also possible to combine fat injections with implants, Senderoff told the news outlet. That way, the doctor doesn’t have to rely on the fat to build the core volume of the buttock. He called this method a sensible approach because it allows for more precision.
Exercising, of course, is the most natural alternative. Matarasso noted that while it’s possible to build muscle and enlarge your buttock area, it’s harder to reduce the size of other areas.
Research contact: varun.gupta@vanderbilt.edu
