Brazilian Butt Lifts (BBL): Increased Mortality Rate

Nurse Beth, MSN

You Get A Butt Lift. Everyone Gets A Butt Lift!

Back in 2021, during Covid, when we were regularly onboarding huge groups of traveling nurses, a few nurses perched on pillows while they sat at their computers completing Orientation computer modules. When they left to go to the hospital to meet their new managers and get a working schedule or go to lunch, they would grab their oddly shaped pillows to take with them.

What was up? It was puzzling.

Suddenly, the light came on- they'd had Brazilian butt lifts!

It made sense when we considered how many were making 10K a month. They had disposable income and could take time off whenever they wanted to have any aesthetic procedure they desired.

Several openly shared that they'd had a Brazilian butt lift and proudly modeled their curvy shapes.

Big Butt Trend

We all remember the apple-bottom jeans song by Flo Rida that popularized big round buttocks. Big butts were the stuff of rap songs, and buttock augmentations to get the coveted look were not far behind.

Kim Kardashian and Jennifer Lopez's body types became the new standard, replacing leaner looks of the past. Women compared their backsides to the new rounded version and came up flat.

According to the American Society for Aesthetic Plastic Surgery, the Brazilian butt lift quickly became one of the fastest-growing aesthetic procedures. In 2011 there were 7,382 buttock augmentation procedures which increased to 61,387 in 2021.

Unfortunately, the mortality rate also increased, with South Florida as the deadly epicenter for low-cost cosmetic procedures.

The Procedure

Brazilian butt lift, or gluteal fat grafting, is a procedure where fat is harvested from different parts of the body-stomach, flanks, back, and arms via liposuction. The fat is then injected into the buttocks. The operation takes 3 to 4 hours.

While hugely popular, BBL has gained notoriety as the most dangerous aesthetic surgery. Deaths have occurred from pulmonary fat embolisms caused by unintended fat injections into blood vessels, leading to respiratory failure and death.¹

Other causes of death include sepsis, anemia, bowel perforation, and ischemic strokes.¹

South Florida Epicenter for Deadly Procedure

Twenty-five pulmonary fat embolism BBL deaths were reported in South Florida alone between 2010 and 2022.¹

High-volume, budget clinics

92% (23) of the above 25 deaths occurred at high-volume, budget clinics.¹These clinics offer low rates and operate on a volume-based business model. Surgeons are incentivized to perform as many cases as possible, sometimes up to 10 cases per day, at record speeds of 90 minutes per case.²Surgeries are scheduled into the evenings.¹

The average cost of a buttocks augmentation is $4,004 (surgeon's fee only) with some South Florida clinics advertising bargains for under $3,000.²Advertisements for BBLs in Miami offer low monthly payment plans starting at $99.00.

For the low cost, patients often do not meet their doctor until the day of surgery. Aftercare may consist of being told to go to an emergency department if they have a problem.

Florida's rules

Florida's Board of Medicine took notice of the high number of deaths.

In response to the high mortality rate, in 2019, the Florida Board of Medicine (FBOM) passed a temporary emergency "subcutaneous-only" rule prohibiting doctors from injecting fat lower than the subcutaneous level.¹ This was intended to reduce the chance of unknowingly injecting fat into a blood vessel.

However, it soon became apparent that surgeons performing blind passes with the cannula did not realize they were in the gluteal muscle and believed they were safely in the subcutaneous space.²

As a result, deaths still occurred, and in 2022 the FBOM issued another temporary emergency rule restricting surgeons to performing no more than 3 BBL procedures per day (the most recent proposal is 5 cases per day) and requiring real-time ultrasound to ensure they stayed in the subcutaneous space. ^{1, 2}

Trends

Fads come and go. Thin eyebrows, thick eyebrows, thin eyebrows again (mark my words!)

Just like fashion, if we wait long enough, even skinny jeans will make a comeback. Sure, there will be a new twist on them, but it will happen. Our grandchildren will even believe they invented them.

Each time we think a new beauty ideal is permanent...we need to realize it's not. One can hardly picture elegant beauty symbols such as Jackie Kennedy or Audrey Hepburn with protruding, exaggerated buttocks.

Trends will always be with us, but no fleeting look of the moment is worth risking health and life to achieve.

Some say the trend for oversized buttocks is already beginning to pass, with speculation that some celebrities are reversing the procedure. BBL revisions are far more costly than BBLs, and the results may be disappointing.

Still want more shapely buttocks? Squats and lunges are the safest way to go.

References/Resources

¹Brazilian Butt Lift-Associated Mortality: The South Florida Experience: National Center for Biotechnology Information: National Library of Medicine

²What Makes Brazilian Butt Lifts So Deadly?: Medpage Today

Cosmetic Surgery National Data Bank Statistics (2011): American Society for Aesthetic Plastic Surgery (ASAPS)

Aesthetic Plastic Surgery National Data Bank Statistics (2021): The Aesthetic Society