The Real Risks Behind Brazilian Butt Lifts Manifest Years Later

Brazilian butt lifts have skyrocketed in popularity over the last half-decade, as a strictly defined voluptuous “hourglass” physique has become ubiquitous in popular culture. But the “BBL” was once regarded by experts in the medical community as one of the deadliest aesthetic surgeries out there. In fact, members of the American Society of Plastic Surgeons (ASPS) warned Americans back in 2018 that the mortality rate associated with BBLs was around one in 3,000. After industry efforts, it currently sits at one in 15,000.

The reasons BBLs were so risky included the fact that the procedure isn’t so simple; it requires a combination of liposuction and fat grafting, or migrating the fat from elsewhere on your body into your backside and surrounding areas. Still, many women feel the risk and recovery are worth it. The BBL is a surgical option for people — who are exercising regularly and enjoying a healthy lifestyle, but remain unhappy with their silhouette — to get the body they want.

Below, a pair of leading plastic surgeons has helped us lay out everything you need to know about BBLs, and we tackle FAQs about the surgery’s cost and what patients can expect in the years to come.

Editors’ Note: This article contains discussion of weight loss, and mentions calories, pounds, and/or other terms and external measures that people trying to recover from disordered eating or eating disorders may be seeking to avoid.

What is a Brazilian butt lift, and what kind of surgery is involved in this procedure?

The main goal of the Brazilian butt lift, also known as gluteal fat grafting to professionals, is to enhance your buttocks and its shape, as well as its size. In a single, 2 to 3-hour surgery, a plastic surgeon will work to remove fat deposits from other areas of your body, relocating them into your butt and the areas immediately around it. This provides a larger, more robust backside, as well as a more even shape. The areas from which the fat was removed (perhaps your midsection or lower back) may also look more contoured afterward, forming the signature shape that the BBL has become known for.

Alexis Parcells, M.D., a board-certified plastic and reconstructive surgeon and founder of Parcells Plastic Surgery in New York, New Jersey, California and Florida, explains there are multiple facets to a BBL:

1. Liposuction: The abdomen, lower back, and flanks are the most common areas where surgeons will collect fat — or “in areas that you’d like to have liposuction regardless,” Dr. Parcells explains.
2. Filtration processing: Any tissue gathered by the liposuction cannula is processed on the surgeon’s table during the procedure, with an enhanced filtration system. “It’s done in a way to discard the cells that aren’t viable, not going to be useful, and to separate cells from the fat cells that contain stem cells, which are then going to be reinjected,” to aid healing, she adds.
3. Reinsertion: “The patient is repositioned, and those fat cells are then grafted — using small cannulas — into the hips and the buttocks through very small incisions, in order to improve the shape and the projection of the buttocks,” Dr. Parcells tells Good Housekeeping.

Some of the reinserted fat cells may not survive, which is why the surgeon often injects extra fat into targeted areas. It is only after the swelling goes down and you begin to recover that the new fat cells integrate and you’ll have a better idea about the new shape of your derrière.

Why is this procedure called “Brazilian” at all?

“It actually has nothing to do with Brazil,” says Dr. Parcells. “The procedure many people think was invented in Brazil, but it wasn’t — in 1996, Dr. Leonard Grossman performed the fat transfer surgery on television,” she explains. “And the patient happened to be from Brazil; so they titled the show, Building the Brazilian Butt, and that’s where the nickname stuck.”

If you hear that this procedure is known as the “Brazilian” butt lift because doctors believe the result resembles the cultural ideal that South American women have been striving for even before American women, that’s not quite right.

Who can receive a Brazilian butt lift safely?

Because of the extensive surgery involved, not everyone is a candidate for a Brazilian butt lift. There are multiple prerequisites that the best surgeons (read: safest!) will consider before booking a procedure for a patient.

“It’s very important that you’re in good health, or healthy enough to have the surgery,” says Michael Horn, M.D., a board-certified plastic surgeon specializing in liposuction who heads up a renowned private practice in Chicago. “An experienced surgeon will also analyze your anatomy, look at it realistically from where you start — there are some people that have a shape that’s simply not going to be possible to get the shape usually provided by the procedure. Otherwise, they may consider other options, including butt implants.”

“You want to be in good health, a non-smoker and a non-diabetic,” adds Dr. Parcells. “You don’t want to have any medical conditions that are going to impair healing, or increase the risk from an anesthesia standpoint.” Candidates for a BBL should also be fully developed, i.e., adolescents should not consider this procedure, Dr. Horn adds.

And you want to be at a healthy, stable weight. In addition to having adequate fat on the body, the best candidates for this procedure are those who lead a lifestyle that’ll allow them to maintain their current weight. Rapid weight loss or weight gain after a BBL could ruin the result. This is not a weight loss procedure, Dr. Parcells emphasizes. “This is not a weight loss surgery, but a body contouring procedure. You shouldn’t expect to lose 15 or 20 pounds from this,” Dr. Parcells adds. “This is going to basically help shape your current form.”

The best plastic surgeons will spend plenty of time discussing a patient’s expectations for their procedure — there is evidence that suggests that body dysmorphic disorder is higher among those seriously considering plastic surgery. So if a provider suspects the person isn’t psychologically ready to have the procedure, they may refer to a psychotherapist. (They are not required to do so, however.)

Is the Brazilian butt lift permanent?

Successful BBLs will hold true for up to a full decade without requiring follow-up work. But everyone’s body changes as they age, meaning that your shape may be naturally affected over time. And your initial results are likely to change as you heal.

“You may initially be surprised at how full you look after surgery — that’s a combination of overfilling plus swelling, with the understanding that the swelling is going to go down and you’re going to lose about 40% of those cells,” Dr. Parcells explains. “It isn’t until 3 or 6 months later that you’ll get a good indication of what things look like for final shape, and final curvature may take about a year. Permanence depends on how your body progresses, from a genetic standpoint as well as diet and general exercise.”

In other words, how you take care of yourself and how you age naturally will influence the long-term results.

How active you are during the recovery process also affects the new shape of your butt. During recovery, you’ll try to minimize the amount of time you’re sitting or putting pressure on the area.

You may have to:

• Wear a compression garment in the areas where you received liposuction.
• Maintain a temporary drain in the incision area to remove excess blood or fluid build-up
• Stand frequently and sleep on your stomach and sides.
• Use a special pillow that distributes weight and pressure when sitting
• Reduce exercise and strenuous activity for up to one month, depending on your provider’s instructions

“Some practitioners recommend a lymphatic massage from a licensed massage therapist,” Dr. Parcells adds. “We do want to have walking around to reduce the risk of blood clots immediately after surgery, but most women are back to exercise usually six to eight weeks after.” You should expect bruising and potential bleeding, and within 14 days, pain at the surgery site will decrease.

Can a Brazilian butt lift be reversed?

It’s not recommended by most providers, but yes, the procedure can technically be reversed. Dr. Horn says that for those who choose to have their procedure reversed, you may need additional cosmetic procedures to tighten skin back to a normal appearance — and Dr. Parcells says there isn’t a guarantee that you’ll look the same after a reversal.

“The reversal procedure is liposuction of the fat that was initially transferred, now removed. But those results can vary, depending on whether you’re taking everything out or just a small amount,” she explains, adding that additional skin tightening may lead to permanent scarring. “It’s possible, but the results can be unpredictable and you may need additional procedures.”

How much does a BBL cost?

There’s something of an industry standard when it comes to costs associated with procedures — a good starting point often comes from price listings published by the ASPS. The board polls thousands of surgeons every year to ask what their charge is for a BBL, and while there is variation based on geography and the type of provider, the list gives a good starting point for patients to consider.

According to recent 2020 statistics published by the ASPS, a Brazilian butt lift surgery can range upwards of $5,300, with the average cost for fat grafting specifically landing at $4,800.

“That’s not going to include hospital facility costs, nor anesthesia, or prescriptions, and it doesn’t include garments required after procedures,” Dr. Parcells adds. “Plus, it doesn’t include any special pillows or postoperative tools and pre-operative labs, those are all additional.”

There are indeed markets for cheaper BBLs, especially abroad, provided by clinics that may lack proper accreditation; as many as 3 million Americans travel to destinations ranging from Mexico to Turkey in search of cheaper plastic surgery, as illustrated in this recent USA Today report. But a reputable, licensed surgeon is much more likely to perform a surgery that won’t cause severe risks or damage to your health, which is well worth the cost.

Are Brazilian butt lifts actually safe? What risks should I be aware of?

The death rate associated with BBLs has greatly improved over the last few years, as organizations like the ASPS have since educated surgeons on inherent risks and procedure improvements. Currently, mortality rates are closer to one in 15,000, often due to pulmonary embolism.

There are other risks to consider, including:

• Infections at the surgery site
• Changes in nerve sensations around the site of surgery
• Scarring and other healing issues
• Fat embolisms
• Skin discoloration or skin sensation loss

Alternatives to the BBL that you may consider:

If your surgeon indicates that a BBL isn’t a possibility, or if you’re looking for added shape in your butt without invasive surgery, there is a buzzy non-invasive procedure that can be done in clinics without anesthesia.

It’s known as an injectable butt lift, in which Sculptra, a dermal injectable filler that stimulates collagen growth in the skin, is used to enhance the patient’s natural curves without liposuction or fat grafting. “It often requires three treatment sessions over a few months in order to achieve the result, but it’s going to promote collagen production [in your butt] and allows the skin to thicken and improve volume over time,” Dr. Parcells adds.

Filler treatments, however, are semi-permanent, which is why some patients may turn to silicone implant augmentation. This procedure isn’t considered as favorable or safe as BBLs, according to Dr. Parcells, as it comes with the additional risk of infection and pain while sitting.

“Basically, surgeons will take a product implant and place those deep within the tissue of the buttocks,” she adds. “They have fallen out of favor because they can migrate easily… that’s what was done before BBLs became popular, but it’s still an option and some patients do elect for that.”

The bottom line:

The Brazilian butt lift, despite its increasing popularity, isn’t for everyone — and is far from a weight loss procedure. In fact, those who successfully undergo a butt lift will need to maintain their current weight for best results. And while surgeons have made strides in reducing the high mortality risk associated with this controversial procedure, materials distributed by the ASPS indicate that a BBL still “carries more risk than most other plastic surgery procedures.”

Risks are heightened especially when someone seeks out a cheaper procedure, as BBLs can cost up to $5,300. But turning to medical tourism — or flying to another country for a cheaper surgery bill fronted by a provider without verifiable accreditation — isn’t a smart move when it comes to mitigating risks associated with cosmetic surgery.

“The surgeon should be a board-certified plastic surgeon, and not just a cosmetic surgeon — there’s a huge difference between the two that people don’t realize,” Dr. Parcells explains. “Board-certified plastic surgeons are required to attend medical school for four years, with anywhere from six to 10 years of surgery training focused in plastic surgery, including fat grafting. And we have several board exams. Cosmetic surgeons are usually doctors trained in other fields who do limited training in this area, maybe a year at most. For best results, we always say to make sure you’re using a board-certified plastic surgeon.”