How Dangerous Is a Brazilian Butt Lift? [Updated 2023]

Among cosmetic procedures, the Brazilian butt lift, or BBL, has received the most attention-both positive and negative. The booty continues to have a major moment, whether it's due to social media or a general cultural shift. Between 2020 and 2021, buttock augmentation increased by 37%, according to The Aesthetic Society.

Although all butt augmentation procedures have risks (and illegal-market butt injections, in particular, can be problematic), the BBL is especially controversial because of its associated dangers. Are these bad reputations warranted or are they just overblown? What are the potential dangers of BBLs? Here, top plastic surgeons explain the risks and benefits of Brazilian butt lift surgery.

What is a BBL, exactly?

Using fat from other parts of the body, a Brazilian butt lift changes the size and shape of a person's butt. Board-certified plastic surgeon George Bitar, MD, tells SELF that fat cells are removed via liposuction from the abdomen, hips, thighs, or lower back. Purified fat is then strategically injected into specific areas of the derriere to help patients reach their desired size and shape."

SELF's board-certified plastic surgeon Alex Earle, MD, a Miami-area plastic surgeon and president of the World Association of Gluteal Surgeons, tells SELF that a BBL can transform someone's shape in ways that are simply not possible with butt exercises alone.

Why is a BBL potentially dangerous?

The risk associated with any cosmetic procedure is real, even a minimally invasive one like injectable eye fillers. Brazilian-butt-lift-related complications and deaths seem to be a never-ending stream of news reports.

Is there a reason for such an alarming number? According to the 2017 research, pulmonary fat embolism was the most common cause of death. In a BBL, fat is injected under the skin with a cannula (a thin, straw-like tube). Fat can injure the superior and inferior gluteal arteries if the surgeon is inexperienced or does not have a good understanding of anatomy. Fat can go directly into the heart and lungs if these vessels are injured and fat gets into them. The patient can die immediately if this happens."

There are many risks associated with Gluteal Fat Grafting, and many plastic surgery societies have formed Task Forces for Safety in Gluteal Fat Grafting. Creating safer Brazilian buttlift guidelines was their goal. According to Dr. Bitar, these recommendations included injecting fat only in the subcutaneous space above the muscle (directly under the skin) and using larger cannulas that don't bend so that the tip is easier to see.

It appears that implementing this protocol has had the desired effect so far. The death rate associated with Brazilian butt lifts in 2020 had dropped to approximately 1 in 15,000, according to a study published in the Aesthetic Surgery Journal2. BBL deaths are 1 in 20,000, as opposed to 1 in 13,000 for tummy tucks, according to another 2020 study in Plastic and Reconstructive Surgery.3

BBL guidelines continue to be updated by experts. As of June, the Aesthetic Society recommended that all surgeons use ultrasound technology during BBL surgery fat injection. Dr. Earle explained that this method transforms the procedure from one in which you are essentially doing it blindly to one in which you can see where the cannula is, preventing fat embolisms by staying within the safe space between the muscle and the skin. A potential cause of complications and problems, according to these most recent guidelines, is surgeon fatigue.

BBLs can also have other side effects. What are they?

A Brazilian butt lift procedure is typically associated with mild and manageable complications, according to Dr. Williams. As a precaution, it's important to perform the procedure in a hospital or accredited facility where the providers are well-trained and follow appropriate steps to maintain sterility, because infection is possible. 

There are also cosmetic issues; Dr. Williams adds; you may have seen an example of a botched BBL in which too much fat was removed or added, or there were contour irregularities, like different-sized butt cheeks or lumps and divots along the buttocks. According to him, inexperienced or unqualified surgeons are more likely to make these mistakes.

When compared to other forms of butt enhancement, how dangerous is a BBL?

Butt augmentations done by unlicensed providers can lead to serious infections and deformities even though fat can be safely injected into the buttocks via a BBL. Often, "illegal substances are placed into the buttocks, which can lead to infection or death," he says. FDA-approved silicone implants are not approved for use in buttocks, and silicone injections have caused inflammation and infection, among other complications. Silicone can even migrate into the lymphatic system and vascular systems.

According to Dr. Bitar, butt implants also carry their own set of risks, such as the possibility of bacterial infections and the possibility of the implant dislodging.

BBL risks and how to minimize them

All of the surgeons we spoke with emphasized the importance of patient education. Specifically, choose a surgeon who is well-trained, experienced, and certified by the American Board of Plastic Surgery. Dr. Earle cautions that you shouldn't just go to anyone offering a BBL, just as you wouldn't have a cardiac bypass performed by someone who hasn't done one. The term "board certified" can mean various things depending on the context; a dermatologist who is "board certified" by the American Board of Dermatology may not necessarily be qualified to perform cosmetic surgery, so make sure you do your research thoroughly.

During your consultation, ask your doctor if ultrasound guidance is used, and find out how many BBLs they usually perform daily (ideally three or fewer) and have performed throughout their career (Dr. Earle recommends someone who has performed at least 50 BBLs). Ask them about complications they've encountered and whether they have ever lost a patient, says Dr. Williams. Furthermore, you should check the Federation of State Medical Boards' website to learn more about your doctor, including where they're licensed and whether they've had any complaints or actions taken against them.

Make sure you do even more research if you're considering having the procedure outside the US. Despite the ASPS's work with international partners to improve patient safety abroad, Dr. Earle says the training guidelines above aren't necessarily applicable elsewhere. You might be tempted to get a cheaper BBL in another country, but if the surgeon isn't qualified, you could end up paying the price.

Based on Dr. Earle, the procedure costs anywhere from $3,000 to $20,000 in the US, depending on the doctor and location. He warns that he “would be very wary of any place charging less than $5,000, as these tend to be high-volume centers not focused on patients.”

A BBL is a serious and serious procedure with some potentially deadly risks associated with it, even with the new safety guidelines, which makes it even more imperative than ever to research your options and find a doctor who is well-trained and reputable.