A Brazilian butt lift (BBL) uses your own fat to reshape the buttocks and waist, and many people are pleased with the natural feel of the result. It is also a procedure with specific serious risks, most importantly fat embolism, which is strongly linked to injecting fat into or beneath the buttock muscle. Understanding both sides, and how UK safety guidance aims to reduce risk, is essential before deciding.
What is a BBL?
A BBL, more accurately called buttock fat grafting, has two parts. Liposuction removes fat from areas such as the abdomen, flanks, lower back and thighs. The fat is then processed and injected into the buttocks to add volume and improve shape. Because fat is taken from around the waist, the combination can change the waist-to-hip proportion as well as the buttocks themselves.
The pros
- Uses your own tissue: there is no implant, so there is no foreign body to rupture or be replaced.
- Natural feel: transferred fat that survives feels like the rest of your body.
- Two areas treated: liposuction contours the waist and back at the same time.
- Small scars: the incisions are a few millimetres long and are usually placed discreetly.
- Long-lasting: fat that survives the first few months tends to remain, changing with your weight.
The cons
- Unpredictable fat survival: a proportion of the fat is reabsorbed, and how much varies. A second procedure is sometimes needed.
- You need enough fat: very slim people may not have enough to harvest; a ‘skinny BBL’ with smaller volumes may be an option.
- Recovery restrictions: you are usually advised to avoid sitting directly on your buttocks for a period and to wear compression garments for several weeks.
- Weight sensitivity: results can change if you gain or lose significant weight.
- Serious risks: including fat embolism, explained below.
Fat embolism: the most serious risk
The buttock contains large veins that lie deep, within and beneath the gluteal muscles. If fat is injected into or under the muscle, it can enter these veins and travel to the heart and lungs. This is called fat embolism. It can cause sudden breathing difficulty and collapse and can be fatal. It is uncommon, but because of its seriousness, the BBL has been the subject of international safety reviews. The key finding from this work is that the risk is closely linked to where the fat is placed. Other risks of the procedure include bleeding, infection, blood clots in the legs or lungs, fat necrosis (firm lumps), seromas (fluid collections), contour irregularities, asymmetry and changes in skin sensation.
UK safety guidance (BAAPS)
The British Association of Aesthetic Plastic Surgeons (BAAPS) has issued safety guidance for its members on buttock fat grafting. Its central recommendation is that fat should be injected only into the subcutaneous layer, the fat above the gluteal muscle, and never into or beneath the muscle. Surgeons also take care with cannula angle and direction, and ultrasound can be used to confirm the depth of injection. Mr Nassab, a BAAPS Council member, will explain the technique used and the safety measures in place at consultation. It is reasonable to ask any surgeon directly where they place the fat and how they check it.
The risks of having a BBL abroad
Lower prices abroad can be tempting, but there are important drawbacks.
- Regulation and training: standards, surgeon qualifications and hospital inspections vary between countries and can be difficult to verify.
- Flying after surgery: long flights soon after surgery increase the risk of blood clots.
- Aftercare: if a complication develops once you are home, your surgeon is not there to assess or treat you.
- Rushed decisions: package deals may include limited consultation time and little opportunity to reflect.
In the UK, you can check that a surgeon is on the GMC Specialist Register for plastic surgery.
Recovery and cost
Expect bruising, swelling and discomfort for the first two weeks. Many people return to desk-based work after about two to three weeks if they can avoid sitting directly on the buttocks, and to full exercise after about six to eight weeks. The final shape is usually assessed at around six to twelve months. Buttock fat grafting (BBL) with Mr Nassab is £12,500, plus a £150 consultation fee. BBL is cosmetic surgery for adults aged 18 and over.
Frequently Asked Questions
Is a BBL safe?
No surgery is risk-free. The BBL carries a specific risk of fat embolism, which is reduced by placing fat only in the layer under the skin, above the muscle, in line with BAAPS guidance.
How much fat survives after a BBL?
This varies between individuals and cannot be predicted precisely. Some fat is always reabsorbed during the first few months.
When can I sit down after a BBL?
You will usually be advised to avoid sitting directly on your buttocks for several weeks, with a gradual return to normal sitting from around six to eight weeks, and to use a specially designed cushion only if your surgeon approves.
Why do surgeons warn against BBL surgery abroad?
Because of variable regulation, the risk of flying soon after surgery and the lack of aftercare from your surgeon once you are home.
Can a BBL be reversed?
Transferred fat can be reduced with liposuction if needed, but it is not a simple reversal, so careful planning matters.
