Brazilian Butt Lift- Indications, Procedure, Risks, and Recovery

Introduction

BBL(Brazilian Butt Lift), or gluteal fat grafting, is a procedure to augment the buttock region using unwanted (excess) fat deposits from the body. These excess fat deposits are taken from areas such as the lower back, inner thigh, outer thigh, abdomen, etc., by liposuction procedure and then used for buttock augmentation. In recent years, the need for BBL has increased to a large extent. BBL has nothing to do with “lift,” and the procedure involves grafting. The most number of BBL surgeries are reported in Brazil.

Gluteal fat augmentation( buttock augmentation) involves:

• Fat grafting - BBL(Brazilian Butt Lift).

• Silicone implants. OR

• Combination of the above two techniques.

Who Are Fit to Undergo Brazilian Butt Lift?

Those who are fit to undergo BBL include:

• Those patients have a body fat percentage between 20 % to 30 %.

• BMI (Body Mass Index) is between 20 and 30 kg/m2.

• Those who have excess fat deposition in their body.

• Those who want larger and contoured buttocks but do not prefer implants.

• Those ready to avoid sitting on their buttocks for several weeks after surgery.

• Those ready to avoid sleeping on their back for several weeks after surgery.

• Non-smokers.

• Non-alcoholic.

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• Patients with realistic expectations.

• Individuals with good skin tone in the hips and buttocks.

How Is the Brazilian Butt Lift Procedure Done?

1. The procedure is performed under general anesthesia, and local anesthesia is used where only a tiny amount of fat needs to be transferred. An anti-emetic medication may be given before the procedure to avoid nausea and vomiting.

2. Excess fat is then removed from the body using a liposuction procedure. Small incisions are made into the body, and a cannula is inserted into the fatty area between skin and muscle. Fat is removed from sites like the thigh, abdomen, lower back, etc.

3. Fat removed from the body is purified before being injected into the buttocks.

4. The processed fat is then injected into specific buttocks areas to achieve a more contoured and fuller look. Around three to five incisions are made around the buttock for transferring fat. Next, the processed fat is injected into the subcutaneous tissue.

5. The incisions made during liposuction and those made around the buttocks are now sutured, and compression garments are placed to minimize bleeding.

Post-operative Care After BBL

• Most surgeons recommend using compression garments for a variable period of four to eight weeks after the surgery.

• Surgeons suggest avoiding sitting on the buttocks for a few weeks after the surgery.

• In some cases, postoperative massaging is recommended to reduce fat lumps, reducing the risk of fat necrosis.

• Postoperative care mostly depends on the surgeon’s preferences.

What Are the Benefits of Brazilian Butt Lift ?

The benefits of BBL include the following:

• BBL gives a more natural-looking appearance when compared to implants.

• The risk of infection is lower than with implants.

• Enhances lower body curves.

• Overcome aging problems (like sagging) to some extent

• Removes excess fat from the body.

• Better fit of clothes.

• Boost self-esteem.

• Exaggerated waist-to-hip ratio attained.

What Are the Associated Risks?

The fatal complication rate is higher when compared to other cosmetic procedures and includes:

Fat Embolism:

This is the most common and serious complication contributing to the high mortality associated with BBL. It can be of two types micro embolism or macro embolism. Microembolism occurs when a small number of fat cells enter the bloodstream; it can cause a pulmonary embolism. A macro embolism occurs when large fat particles enter the bloodstream. The risk of fat emboli is related to IM (Intramuscular injection). Most studies support the “direct hit” theory, in which the nearby blood vessel is traumatized by the cannula directly, and thus fat enters the bloodstream. Other studies point to passive embolism, where fat passively migrates to an injured vessel.

Other common major complications reported are:

• Anemia.

• Symptomatic hypovolemia.

• Septic shock.

Minor Complications Include:

• Erythema (skin redness).

• Pain.

• Contour irregularities.

• Fat necrosis (fat tissue death).

• Transient sacral numbness.

• Cellulitis (a serious bacterial skin infection).

• Sciatic nerve injury may occur in some cases, either a minor injury or if severe, can result in bilateral foot drop; in such cases, one may need wheelchair assistance.

• Rarely it can also result in mycobacterial infection and granulomatous reactions.

• Complications increase with the increase in the volume of the injected fat.

Safety Precautions to Reduce Risk:

• Proper selection of patients.

• An experienced board-certified plastic surgeon should only do BBL.

• Using a blunt cannula reduces the risk of trauma to the blood vessel.

• Injecting parallel to the buttocks in a retrograde fashion reduces risk.

• Avoid the danger zone (the danger zone should be avoided as it contains major gluteal neurovascular structures).

• Avoid injecting fat into deep muscle.

Result Evaluation

• Most surgeons evaluate results using pre and post-operative photographs or patient satisfaction surveys.

• As per individual satisfaction surveys, BBL has a satisfaction rate of 97.1%

• About 6 % to 10 % of patients request an additional fat grafting procedure to achieve the desired results.

• Other evaluation methods are physical measurements, ultrasound, and MRI (magnetic resonance imaging) for detecting gluteal changes.

Recovery After BBL

As with any cosmetic surgery, special care is needed after BBL. For example, one could not sit on one’s butt for a few weeks after the surgery. One must also sleep on one’s side or the stomach for a few weeks following surgery. Effects of surgery last for several months to years. In some cases, more than one procedure will be needed to achieve the desired effect.

Activity like being seated is possible after eight weeks or so. One should strictly follow the surgeon’s instructions and may return to work in a few weeks. Significant changes in body weight can affect surgery results, so a stable weight should be maintained.

Conclusion

Though BBL (Brazilian Butt Lift) is a popular cosmetic procedure, the procedure's success depends on individual factors, the surgeon’s expertise, and many others. A certified, experienced plastic surgeon should always carry out the procedure. One should speak of their expectation to the surgeon and proceed further only under the doctor's advice. Before making the final decision, one should also know the procedure, risks, expected results, selection criteria, and other factors. Once done appropriately on the right patient, BBL can yield good results and improve self-esteem.