Brazilian Butt Lift (BBL) is one of the most researched and popular procedures on RealSelf. It also has the highest mortality rate of any cosmetic surgery. It’s estimated to be as high as 1 in every 3,000 procedures.

There is some good news on the horizon though. A new task force is set to tackle this complex issue and just made a major announcement.


What is a Brazilian Butt Lift

A BBL is a surgical procedure where fat is liposuctioned from one area of your body and then transferred to your butt for a rounder shape, also knowns as fat grafting.

There are two main techniques to a BBL. The safest involves injecting fat into the subcutaneous tissue, the area closest to the surface of your skin.

The riskier technique is to inject fat into the deeper muscular plane. This technique is said to produce more dramatic results than the subcutaneous technique, but at a much greater risk, especially in unskilled hands.


Related: This new device claims to help sculpt your abs and boost your butt — without surgery


Where’s the risk

Autopsies from Brazilian Butt Lift patients show that the number one cause of death is from a fat embolism.

A fat embolism happens when a vein is injured during the fat transfer, causing fat to enter the blood vessel. The vein in question is located in the deeper muscular plane. That’s why injecting into the muscle is the riskier technique even though results might be more favorable.


What’s being done

This week, all plastic surgeons received an urgent announcement. It warns them that from now on, fat should no longer be placed in the muscle, only in the subcutaneous tissue. This is an unprecedented announcement.

“Never before has a plastic surgery society come out with such a strong warning about a procedure,” says LA-based plastic surgeon, Dr. Steven Teitelbaum. “But never before has there been a procedure associated with such a high death rate.” 

The newly formed, multi-organization task force that issued this statement will continue to conduct studies to help develop specific technical safety guidelines for BBLs.

The following organizations make up the task force: The American Society for Aesthetic Plastic Surgery (ASAPS), American Society of Plastic Surgeons (ASPS), The International Society of Aesthetic Plastic Surgery (ISAPS), International Federation for Adipose Therapeutics and Science (IFATS) and International Society of Plastic Regenerative Surgery (ISPRES).


How to be safe

While the death rate is alarming, many board-certified plastic surgeons have a lot of success with Brazilian Butt Lifts. So why all the complications? “The majority of this year’s deaths to date have been from ‘unaffiliated,’ renegade doctors, practicing outside of their training,” says Dr. Teitelbaum.

He recommends finding a “board-certified plastic surgeon who expresses familiarity with this risk, brings it up in a forthright way with the patient, and demonstrates that they understand what they need to do — most notably to never inject into the muscle.”

Setting the right expectations is also key. Your aesthetic goal may not happen in one surgery. It’s best to listen to your surgeon and not push for more volume or results than they recommend.

“We are very confident that these complications only occur if very large veins deep in the buttock are injured,” says Dr. Teitelbaum. “If surgeons avoid them the risk of death should approach zero.”