Brazilian butt lift: the controversy won't go away

“Last orders” for Brazilian butt lift surgery? Not yet…

Just a couple of months ago another young woman died due to complications arising from the so-called “Brazilian butt lift” (BBL) cosmetic procedure. Leah Cambridge suffered three heart attacks caused by fat embolism, i.e. fat from the fat implant crossing into the blood vessels and blocking her heart arteries.

This was the the third British woman to die from the procedure, involving the transfer of fat from the thighs or stomach deep into the buttocks, in the last two years. In response to these deaths the British Association of Aesthetic Plastic Surgeons (BAAPS) have met today to discuss whether to completely ban BBL surgery.

Perhaps disappointingly for some, they have announced today that no specific decision would be made other than to kick the can down the road (that is, launch a review of the evidence and principles of best practice blah blah blah)….

Of course, one would argue that since all three women died of the procedure abroad, there is no need to ban it in the UK, forcing more women to have BBL surgery abroad. Yet, the association could at least have decided to educate the public about the dangers of BBL, as the American Society of Plastic Surgeons have done, about the added dangers of BBL surgery performed abroad and, as mentioned above, restrict (if not ban completely) intramuscular BBL.

But then again, if you ban intramuscular BBL and only stick to superficial / subcutaneous BBL, you end up with results such as those on picture #5 here. Oh well…

Brazilian butt lift surgery and the alternatives

Is it worth dying for beauty?

I didn’t think there would be an outright ban, but I would expect them perhaps to restrict the most dangerous technique, that of deep muscle fat grafting, which is 16 times more dangerous than the superficial option.

The undeniable fact is that Brazilian butt lift surgery is the most dangerous surgical cosmetic procedure (with abdominoplasty, a.k.a. “tummy tuck” being second).

According to a 2017 study by the American Aesthetic Surgery Education and Research Foundation, anything between 1 in 2351 to 1 in 6214 people died from this procedure, usually due to fat embolism. This means that BBL is 3-5 times more dangerous than abdominoplasty (the second most fatal cosmetic procedure with a fatality rate of 1 in 13,147 people) and 10-20 times more dangerous than the average of all surgical cosmetic procedures (fatality rate 1 in 55,000 people).

This is in addition to complications, such as local tissue deformity and infections.

Are Instagram and shallow celebrities to blame for all this vanity and insecurity?

But where did it all start? Just a decade or two ago most women wanted to reduce the size of their bum, not increase it.

I believe the “big bum” look is a natural reaction to the previous trend, that of the horrible “heroin chic” look, which dominated fashion in the 1990s. That was an artificial trend: no one, man or woman, really liked that unhealthy look, so naturally it faded away and by the early 2000s it was replaced by a more wholesome look, based on more curves and larger buttocks.

Jennifer Lopez and Beyonce popularised this look, making millions of curvy women happy. Later Kim Kardashian took it to the extremes, and that I believe is the cause of a new mass female insecurity about their bodies: apparently their bum is too small now.

Another reason is our infatuation with excess: everything must be bigger and more impressive and there is a constant social competition and constant FOMO pressure on Instagram, which leads men and women to feel insecure and try to become something they are not.

I specialise in cellulite, skin tightening and non-surgical bum lifting, but although you would expect me to be happy about this massive and persistent new trend, I actually have to say that the bum lifting trend is more trouble than good.

Most women who call us, believe the miracle claims they read on tabloids and Instagram about non-surgical butt enlargement (impossible) or about immediate and impressive butt lifting (also impossible) and they expect you to to provide it.

When you explain that butt enlargement without dangerous surgery is impossible and that the one-session miracle butt lifting treatments that they see on the internet (complete with photoshopped “before and after” pictures) are fake, they get upset and simply go to the smooth operators that promise anything and everything, where they are taken advantage of.

Unfortunately Instagram and the Kim Kardashian trend has bred so much insecurity when it comes to body confidence and body standards, that I have seen in the last 2-3 years a sharp rise in enquiries from highly insecure, naive or sometimes simply vein women, usually young girls in their 20s, who want to - and think they can - become Kim Kardashian or Nicki Minaj almost overnight.

We turn away 8 out of 10 women who enquire about bum lifting, simply because they either have unrealistic expectations or they are clearly insecure and vulnerable. In the latter case I simply advise them that they should never get depressed to the point of crying about their bodies and they would be better off spending their money on a life coach or a counsellor. The last thing you want in the treatment room is a highly insecure, vulnerable person.

Unfortunately we find women yet again becoming insecure about their bodies, but this time from the opposite side of things. It seems that nobody cares about balance in our world. It is perfectly normal to want to improve some aspects of our appearance, with fashion, makeup, treatments or surgery, but the intense insecurity - and sometimes profound vanity - is something I cannot understand.

The all-natural Brazilian bum lift: not as impressive as surgery but definitely natural and healthy

So if Brazilian butt lift surgery is not a great idea and provided that one is not driven to having a treatment due to deep insecurity, what is the best way to improve the appearance of the butt area, safely and healthily?

I suggest a two-prong solution: tighten, lift and enlarge your gluteus maximus muscle (the one that keeps your butt naturally round and lifted) with squats, deadlifts, donkey kicks and pelvic thrusts and combine this with high-power, deep-acting radiofrequency to tighten and lift the skin and the superficial fascia.

The former works from the inside and the latter works from the outside, thereby improving the shape and size of the butt area from all directions, naturally.

Working on the gluteus maximus internally, for non-surgical bum lifting

Working on the gluteus maximus internally, for non-surgical bum lifting

Tightening up the skin externally, for non non-surgical bum lifting

Tightening up the skin externally, for non non-surgical bum lifting

More toned gluteus maximus lifts and tighter skin lift the butt upwards, naturally

More toned gluteus maximus lifts and tighter skin lift the butt upwards, naturally

Indeed there is a fitness revolution going on at the moment, sparked to a large extent by the “toned and round butt” trend and one sees more and more young, as well as older, women performing squats, attending HIIT - and all sorts of bootcamp - classes, while sales of sports leggings and yoga pants emphasising the buttocks have skyrocketed. Lululemon, for example, is currently worth $25 billion!

What about those who still insist on brazilian butt lift surgery?

It is true that not all cases are good candidates for non-surgical methods. For example, some women may not be able to do squats, others may have severe skin laxity and some others would not want to spend months at the gym and in the treatment room. What are their options?

Here are my guidelines:

  • First off, opt for superficial fat grafting. That involves the transfer of fat on the subcutaneous tissue, just under the skin. The vast majority of complications from BBL happen with deep, intramuscular fat graft that injures nerves blood vessels and allows fat to enter the blood circulation, causing embolism. This complication is absent with superficial fat transfer. Sure enough the deep method offers a better shape and does not run the risk of this, but then again, according to a board-certified Brazilian Plastic Surgeon study “the risk of death was 16 times greater when fat was injected intramuscularly”.

  • Secondly, do not overdo it. The same association above recommends no more than 800 ml of fat injected into each buttock, although some doctors think otherwise to the detriment of the clients: “Dr Ali Uckan, of the Elite Aftercare clinic in Ismir, Turkey, boasted that he makes patient's bums as big as possible ‘every time’”.

  • Thirdly, use only fat transfer, not silicone implants or other man-made material

  • Fourthly: whatever you do, don’t go for a dirt cheap option abroad, do it here in Britain. You do not know what you will experience abroad and if something goes wrong, no one will be there to help you. And it is unfair to ask from the NHS and the taxpayer to bear the brunt of the corrective procedures, which may cost tens of thousands of pounds.

  • Lastly, please consider that excessive fat transfer will eventually lead to a drooping bottom, as the skin will be too weak to support the excessive fat injected. So a Brazilian bum lift typically looks good for 2-3 years and then it starts heading south.

More reading

How to lift your bum naturally, tighten up your skin and get rid of cellulite

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