As a plastic surgeon with years of experience, I have encountered numerous trends and procedures in the field of cosmetic surgery. One procedure that gained immense popularity over the past decade is the Brazilian Butt Lift (BBL). However, despite its popularity, it has also gained notoriety as one of the riskiest operations in the realm of cosmetic surgery. In this article, I delve into the reasons why I, as a plastic surgeon, choose not to perform BBLs and highlight the potential dangers associated with this procedure.
The Emergence of BBL
Approximately a decade ago, I was taken aback when women started requesting to have fat injected into their buttocks after spending the first two decades of my career performing liposuctions to remove fat from this area. This shift marked the rise of the Brazilian Butt Lift, a procedure popularized by celebrities that promises to enhance the shape and size of the buttocks. However, what initially seemed like a promising technique has since been marred by serious safety concerns.
A Troubling Trend: Complications and Controversies
The history of cosmetic surgery is replete with examples of procedures that initially gained popularity but eventually led to complications. As a member of New Jersey’s Board of Medical Examiners for ten years, I often questioned whether these complications were merely the result of poor execution or if the procedures themselves were inherently flawed. In the 1990s, liposuction, another popular procedure at the time, posed significant risks due to excessive fat removal and the administration of toxic amounts of lidocaine anesthesia, resulting in numerous fatalities. It was through careful study and analysis that we were able to make liposuction safer by establishing appropriate guidelines and standards.
The Misleading Name and Alarming Statistics
The Brazilian Butt Lift, despite its name, does not actually lift the buttocks but rather involves injecting fat or other materials into the buttocks to create a fuller appearance. However, this procedure has been associated with numerous complications and even deaths. The death toll from BBLs has risen significantly, with early cases of fatalities occurring in Mexico. From 2011 to 2016, 25 deaths related to BBLs were reported among members of the American Society for Aesthetic Plastic Surgery. Shockingly, a plastic surgery task force reported that approximately 3% of plastic surgeons performing BBLs had patients who died as a result of the procedure. Moreover, a single Florida clinic witnessed at least eight patient deaths from 2013 to 2018.
The Disturbing Death Rate and Complications
The death rate associated with BBLs is alarmingly high, approaching 1 in 3,000, making it one of the deadliest aesthetic procedures. To put this into perspective, the death rate from BBLs is comparable to that of gall bladder surgery, a significantly more invasive procedure. The risks associated with BBLs primarily stem from the accidental injection of fat into large muscle veins, which can cause fat embolism leading to fatal complications. Despite recommendations to inject fat only under the skin and avoid the muscle, it is technically challenging to adhere to these guidelines. Complications from BBLs can also result in uneven survival of transplanted fat, leading to unsightly and asymmetrical buttocks.
The Need for Self-Regulation in Plastic Surgery
Unlike other medical specialties, plastic surgery often witnesses the introduction of new procedures through television shows, lacking the rigorous academic scrutiny and research that fields like cardiac surgery demand. Even among board-certified plastic surgeons, the death rate associated with BBLs remains alarmingly high. This raises concerns about the practices of rogue doctors who perform the procedure without proper training or reporting of outcomes. Additionally, untrained individuals injecting dangerous substances like silicone caulk from hardware stores pose a significant threat to unsuspecting patients.
A Call for Change: Safety and Ethical Considerations
In light of the growing evidence regarding the risks and complications of BBLs, it is imperative for plastic surgeons to prioritize patient safety and well-being. As a plastic surgeon committed to upholding the principles of the Hippocratic Oath, I firmly believe that it is our ethical duty to “do no harm.” BBL procedures are inadequately studied and associated with significant risks. While many patients may request the procedure, it is essential to evaluate the risk-to-benefit ratio of cosmetic surgeries. In the case of BBLs, the risks outweigh the potential benefits.
The Brazilian Butt Lift, once hailed as the next big thing in cosmetic surgery, has emerged as a highly controversial and risky procedure. With alarming death rates and a myriad of complications, it is crucial for plastic surgeons to exercise caution and prioritize patient safety. The field of plastic surgery must engage in self-regulation to ensure that only procedures backed by rigorous research and proven safety profiles are performed. As the dangers of BBLs become more evident, it is incumbent upon the medical community to critically evaluate and make informed decisions regarding the future of this procedure.