Brazilian Butt Lift (BBL)


Aesthetic and beauty perceptions of the societies alter in time. Today, the shape and beauty of the buttocks are as important as the rest of the body. Women (and a smaller percent men) are seeking for better-looking, steep, round and bigger buttocks. This trend got even more popular with celebrities like Kim Kardashian, who was one of the first people having a buttock augmentation surgery. Some women desire to get rid of their manly square-shaped appearance, some want to have a little more projectile butt, and some are looking for a really big and round butt that will take attention. Today the buttock enlargement surgery is more popular that it has ever been and can be described with different names like “buttock augmentation”, “gluteal augmentation”, “gluteal enlargement”, “gluteal fat transfer or injection” and most commonly “BBL” for “Brazillian Butt Lift”.  There are mainly two ways to enlarge buttocks: 1- silicon implant placement and 2- the more commonly used technique; Fat transfer. In women who do not have enough fat tissue in their bodies are candidates for buttock enhancement with silicone implants. The implant is inserted to the pocket from the cut that is made on the groove between the buttocks. The risks for gluteal implant are wound healing problems, infection of the implant, bleeding, seroma (fluid accumulation), rotation of the implant in its pocket and damage of the nerves and vessels in this area. In long term, the implant can move and the buttocks may sag and the implant can be obvious from outside. Under this topic, we will mainly stay on the second technique that is the buttock enhancement with fat injection.



It is very lucky for us surgeons to have this technical capability to successfully enlarge the buttocks. But what are the risks for BBL? We know that this surgery has some risks that can be even “life-threatening”. So we guess that your questions are:


Why is BBL risky?

What is “fat embolism?”

What does my doctor do to avoid complications?

Is there a way to be done more safely?

Will it worth it to have this surgery?

Is it going to be like I wanted?



Ok, we will quickly pass on to the answers of these important questions. Let’s take a fast glance at the surgical technique. We collect fat tissue from the different parts of the body where available without giving an aesthetical (or medical) harm. Then we filter the aspirate to purify fat and we prepare the fat tissue for injection to the buttocks.  Up to this part, the risk is minimal. The risk starts in the fat injection part. There are two spaces in our buttocks, first is the fat tissue under the skin and the second is the muscles under the fat. If the fat injection is done on the muscular or submuscular space, the risk is high because of the deep veins passing through this plane. And because there is negative pressure within these veins, the injected fat can get into the veins, get into the circulation and ultimately go to the lungs and cause “fat embolism” which is almost always fatal. So, the first thing to be cared of is not to go deep into the muscular layer but stay in the safe subcutaneous fat layer. The recent studies showed that the subcutaneous injection of fat gives the same aesthetic results as the muscular injections. So what else your doctor does, or should do to stay safe when performing a BBL on you? The position of the patient is also very important to avoid the fat embolism. Giving too much fat and pressure increases the risk. In certain cases anticoagulants must be used to prevent micro-embolism. The technique of the fat injection is also important; it is better to give the fat while withdrawing the cannula. Pressure stockings must be used during the surgery to minimalize leg thrombosis. When we obey these rules, the risks of BBL are minimalized.


Ok, but, is it worth to have this surgery while there are such risks? Many women are extremely happy with their operation and having the round butt and curves they always dreamed of. Good informal and patient-doctor communication is critical. The final shape and size must be discussed. The limitations must be considered. When everything is discussed before the surgery, and the patient-doctor trust is formed, patients feel safe going to the operation theatre.


Is it going to be like I wanted? BBL is one of the operations that surgeons and the patients are satisfied the most. With a good consultation, you and your doctor can decide on a reasonable size and shape, of course with in the limitations of the available fat tissue in your body. Smoking is forbidden starting from 1 week before and 1 month after the operation. Smoking will impede the fat cell survival and will impair the result of the operation. You will wear a corset for 1 month to heal in a good shape.