Brazilian butt lift (BBL) surgery: how big are the risks?

The Kardashians have done a lot for us. But one of their most notable contributions just might be their aesthetic and the normalization of a big booty. 

Brazilian butt lift surgery is the fastest-growing cosmetic procedure in the world, which some experts say is a direct result of social media (Rohrich, 2020). The popularity of buttock surgeries has skyrocketed in recent years, jumping nearly 40% in 2019 alone (ISAPS, 2019). That’s a worrisome trend considering the increased risk of complications when it’s performed by inexperienced hands.

And while butt implants (using preformed things like silicone) used to be all the rage, Brazilian butt lift surgery (or BBL for short) is slated to surpass the older technique. The procedure, which involves using a person’s own fat to create a fuller backside without the use of artificial butt implants, is becoming more common.

Here’s what you can expect during a Brazilian buttock augmentation and what red flags to look out for when shopping for a surgeon.

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BBL is a fat grafting or fat transfer procedure. Surgeons use standard liposuction to remove fat from one area of your body (like the thighs or belly), and inject it into your butt cheeks to create a rounder, fuller booty.

You may be surprised to learn that BBLs are often an outpatient procedure, meaning you don’t have to stay overnight in the hospital. Usually, the operation is done with either light sedation or general anesthesia, and some surgeons even perform the operation when the patient is awake (Chia, 2018).

First, fat is taken from the thighs, belly, or other areas using liposuction. The technique involves using a long metal tube inserted through a small incision in your skin to break up the fat tissue and suck it out into a holding chamber. 

The fat removal process is an intense one and you’ll likely see significant bruising and discomfort in those areas for weeks after the procedure. The fat that was removed is then blended and purified before being injected into the butt cheeks through discreet incision sites to achieve the desired results.

The final results of a BBL vary based on the amount of fat transferred, the shape of your buttocks, and how they’re contoured. Aftercare is critical as well, which includes wearing a compression garment to help your new tush hold its shape (Sadideen, 2020).

The American Society of Plastic Surgeons says you can expect to have bruising and swelling at the injection and fat grafting sites, but most people are up walking around within a day or two following surgery. 

Many people report mild discharge from the injection site that is either clear or slightly bloody. That’s normal. White discharge, severe redness, or discharge that carries a strong odor might be a sign of an infection that requires medical attention (ASPS, 2016). 

Here’s the hard part: you should avoid sitting directly on your new cheeks for about eight weeks following surgery. This means sleeping on your stomach or side, too. 

If you can’t avoid sitting for a little while, putting a pillow under your legs helps take the pressure off your behind. Experienced surgeons know that fat cell loss after the transfer is common, so they typically inject more than the target volume. But increased pressure on your tush can reduce blood flow to the area and increase fat cell loss, leaving you with significantly less volume (ASPS, 2016). 

After a month or so, you should be able to resume light exercise such as fast-paced walking, but nothing high-impact. Expect to be able to get back to your normal workout after about eight weeks (ASPS, 2016). 

While the procedure seems pretty straightforward, it has quickly gotten a reputation for just how deadly it can be. 

Any medical procedure can carry risks, and those risks increase as you dive into more complex surgical procedures and those that require anesthesia. But with BBL, the risks seem precipitously higher. 

The reason for that is the technique. Fat transfers from one part of a person’s body to another are generally safe since they skip all the risks associated with putting foreign objects in your body (think: silicone breast implants). 

But while fat is typically innocuous when injected right under the skin, some surgeons swear that the final contour looks better with deeper injections and therefore prefer to inject the fat into the muscle. But many experienced surgeons warn would-be patients about the potentially fatal risks of this approach. 

Below the muscle are large blood vessels and if the fat is injected into one of those blood vessels by mistake, it can travel to other parts of the body—a condition known as a fat embolism. If it reaches areas like the lungs or heart it can block blood flow there causing difficulty breathing, a heart attack, stroke, or even death. 

Another risk of this procedure is infection. While many aesthetic procedures are rarely practiced by people other than experienced plastic surgeons, certain injection procedures (like botox, fillers, and even BBLs) have gained traction among other healthcare professionals seeking to expand their offerings. 

Procedures performed in a clinic rather than a sterile operating room are more likely to carry a risk of infection, especially if the practitioner performing them is less experienced. 

For those who go abroad to save a few bucks on their procedure, post-surgical care might be limited once they return home. Fewer follow-ups mean fewer chances to catch potentially dangerous complications like infections (Singh, 2016).

The cost of cosmetic surgery (including BBLs) varies significantly by country, state, city, and clinic, but according to the American Society of Plastic Surgeons, the average cost of a buttock lift in 2020 was $5,482. 

The average cost of buttock augmentation with fat grafting that same year was slightly less, at $4,807, so you can expect to spend at least that if you’re getting your procedure done in the U.S. (ASPAS, 2021). 

The most important thing to consider is reputation and safety. Opt for a surgeon who specializes in aesthetics and make sure you have access to follow-up appointments to check for and treat any complications that might arise. 

Going with an inexpensive cosmetic surgeon isn’t just dangerous, it could end up costing you a lot more in extra medical fees if complications arise (ASPS, 2018; Singh, 2016).

While BBL procedures have attracted many, lots of experts warn against them. A 2020 survey reported that two-thirds of UK plastic surgeons interviewed believed the country should continue recommending against BBLs (Sadideen, 2020). 

That being said, if done correctly––and by someone with the proper credentials–– BBL surgery can be as safe as, if not more so, than other popular cosmetic surgeries like a tummy tuck (Rohrich, 2020). 

Still, it’s important to be aware of what complications can arise so you can make an informed decision about your health.

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Current version

October 15, 2021

Written by

Kaitlin Sullivan

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.