Is BBL worth it?

Brazilian butt lift: dangerous risk or amazing body transformation?

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• All our articles on butt lifting

• “Last orders” for BBL surgery? Not yet…

• Intramuscular BBL: It's a guessing game, you can't see where you are going into, It's a matter of life and death when you are doing it.

• Is it worth dying for beauty?

• Are Instagram and shallow celebrities to blame for all this vanity and insecurity?

• Biggest is beautiful

• The Kim Kardashian BBL look breeds insecurity in young women

• The all-natural BBL: not as impressive as surgery but definitely natural and healthy

• Check our professional consultancy for a masterclass in radiofrequency, ultrasound cavitation, cellulite and skin tightening

• What about those who still insist on brazilian butt lift surgery?

• More reading

All our articles on butt lifting

• Brazilian butt lift (BBL) surgery: is it worth it? (this one)

• Non-surgical bum lift: everything you need to know

• Natural butt lift with gluteus maximus exercises and deep-acting, high-power radiofrequency treatments

• BBL / brazilian bum lift and cellulite: all you need to know

“Last orders” for BBL surgery? Not yet…

In August 2018 another a young woman died due to complications arising from the so-called “Brazilian butt lift” (BBL) cosmetic procedure.

Leah Cambridge suffered three heart attacks caused by fat embolism, i.e. fat from the fat implant crossing into the blood vessels and blocking her heart arteries.

This was the third British woman to die from the procedure, which involves the transfer of fat from the thighs or stomach deep into the buttocks, in two years.

In response to these deaths the British Association of Aesthetic Plastic Surgeons (BAAPS) have met to discuss whether to completely ban BBL surgery.

Perhaps disappointingly for some, they have announced that no specific decision would be made other than to kick the can down the road. That is, launch a review of the evidence and principles of best practice blah blah blah…

Of course, one would argue that since all three women died of the procedure abroad, there is no need to ban BBL in the UK, thereby forcing more women to have BBL surgery abroad. Yet, the association could at least have decided to educate the public about:

• The dangers of BBL (as the American Society of Plastic Surgeons have done; more also here)

• The additional dangers of cut-price BBL surgery performed abroad

And, as mentioned above, they could restrict or - why not? - ban completely intramuscular BBL.

But then again, if you ban intramuscular BBL and only stick to superficial / subcutaneous BBL, you end up with results such as those seen here (1) and here (2).

Oh well…

Intramuscular BBL: It's a guessing game, you can't see where you are going into, It's a matter of life and death when you are doing it.

Here is an update on Ms Leah Cambridge’s case on 20/11/2019:

“Ms Cambridge's partner Scott Franks told Wakefield Coroner's Court the surgeon who carried out the procedure told him he had 'injected the fat too far into the muscle and it entered her veins'.

Mr Franks said when he flew out to Turkey after his partner died Dr Ali Uckan had told him:

'It's a guessing game, you can't see where you are going into.' He said Dr Uckan's 'exact words' were: 'It's a matter of life and death when you are doing it.'“

We rest our case.

(At around the time of updating this article (January 2024), another sad case of a British young women dying of BBL became known, that of mum-of-three Demi Agoglia who has suffered multiple heart attacks caused by a fat embolism after her BBL surgery. Apparently, in 2023, the British Foreign Office issued a warning to Brits travelling to Turkey for medical treatments in July, after learning of 25 people who have died there since January 2019.)

Is it worth dying for beauty?

We don’t think there will be an outright ban anytime soon, but we would expect the association to perhaps restrict the most dangerous technique, that of deep muscle fat grafting, which is 16 times more dangerous than the superficial option.

The undeniable fact is that brazilian butt lift surgery is the most dangerous surgical cosmetic procedure - with abdominoplasty, a.k.a. “tummy tuck”, a close second.

According to a 2017 study by the American Aesthetic Surgery Education and Research Foundation, anything between 1 in 2351 to 1 in 6214 people died from this procedure, usually due to fat embolism.

This means that BBL is 3-5 times more dangerous than abdominoplasty (the second most fatal cosmetic procedure with a fatality rate of 1 in 13,147 people) and 10-20 times more dangerous than the average of all surgical cosmetic procedures (fatality rate 1 in 55,000 people).

This is in addition to complications other than death, such as local tissue deformity, scar tissue and infections.

Are Instagram and shallow celebrities to blame for all this vanity and insecurity?

But where did it all start? Just a decade or two ago most women wanted to reduce the size of their bum, not increase it.

We believe the “big bum” look is a natural reaction to the previous trend, that of the horrible “heroin chic” look, which dominated fashion in the 1990s, with ultra-skinny supermodels like Kate Moss promoting it.

That was an artificial trend: no one, man or woman, really liked that unhealthy look, so naturally it faded away and by the early 2000s it was replaced by a more wholesome look, based on more curves and larger buttocks.

Jennifer Lopez and Beyonce popularised this look, making millions of curvy women happy. Later Kim Kardashian took it to the extreme, and that we believe is the cause of a new mass female insecurity about their bodies: apparently their bum is too small now.

(* Of course now that everyone in show business is on Ozempic, we will see this trend reversing in the next few years. Already Kim Kardashian is advertising a slimmer look, away from the “bigger is better” mantra. Kim et al denied they are on Ozempic, but in the past they denied they had surgery and claimed that their weird body shape - huge butt, slim waist, slim legs - is natural.)

Biggest is beautiful

Another reason is our infatuation with excess: everything must be bigger and more impressive and there is a constant social competition and constant FOMO pressure on Instagram, which leads men and women to feel insecure and try to become something they are not.

We specialise in cellulite, skin tightening and non-surgical butt lifting, but although you would expect us to be happy about this massive and persistent new trend, we actually have to say that the butt lifting trend is more trouble than good.

Most women who call us, believe the miracle claims they read on tabloids and Instagram about non-surgical butt enlargement (impossible with energy-based machines and totally unsustainable with fillers) or about immediate and impressive butt lifting with one session (also impossible, with any method of any kind except surgery) and they expect us to to provide it.

When you explain:

• that butt enlargement without dangerous surgery is impossible

• that you cannot keep injecting large quantities of fillers on your buttocks every few months and expect not to have horrible complications

• and that the one-session miracle butt lifting treatments that they see on the internet (with all the fake “before and after” pictures that go with it) are a fraud

…they get upset and simply go to the smooth operators who promise them anything and everything, where they are predictably get taken advantage of.

Oh well, human nature…

The Kim Kardashian BBL look breeds insecurity in young women

Unfortunately Instagram and the Kim Kardashian trend has bred enormous insecurity when it comes to body confidence and body standards.

As a result, we have seen in the last 2-3 years a sharp rise in enquiries from highly insecure, naive or sometimes simply vein women, usually young girls in their 20s, who want to - and think they can - become Kim Kardashian, Blac Chyna or Nicki Minaj almost overnight.

We turn away 8 out of 10 women who enquire about bum lifting, simply because they either have unrealistic expectations or they are clearly insecure and vulnerable.

In the latter case we simply advise them that they should never get depressed to the point of crying about their bodies and they would be better off spending their money on a life coach or a counsellor. The last thing you want in your treatment room is a highly insecure, vulnerable person.

Unfortunately we find women yet again becoming insecure about their bodies, but this time from the opposite side of things: it’s not about wanting to be slim any more it’s about wanting to be fat on one specific area.

It seems that nobody cares about balance in our world.

It is perfectly normal to want to improve some aspects of our appearance, with fashion, makeup, treatments or surgery, but the intense insecurity - and sometimes profound vanity - is something we cannot understand.

The all-natural BBL: not as impressive as surgery but definitely natural and healthy

So if Brazilian butt lift surgery is not a great idea and provided that one is not driven to having a treatment due to deep insecurity, but out of a healthy and balanced self-improvement drive, what is the best way to improve the appearance of the butt area, safely and healthily?

We suggest a two-prong solution:

• Tighten, lift and enlarge your gluteus maximus muscle (the one that keeps your butt naturally round and lifted) with squats, deadlifts, donkey kicks and pelvic thrusts

• And combine this with high-power, deep-acting radiofrequency to tighten and lift the skin and the superficial fascia

The former works from the inside and the latter works from the outside, thereby improving the shape and size of the butt area from all directions, naturally.

Working on the gluteus maximus internally, for non-surgical bum lifting

Tightening up the skin externally, for non non-surgical bum lifting

More toned gluteus maximus and tighter skin together lift the butt upwards, in a natural way

Indeed there is a fitness revolution taking place at the moment, sparked to a large extent by the “toned and round butt” trend and one sees more and more young - as well as many older - women performing squats, attending HIIT and all sorts of “bootcamp” classes.

At the same time, sales of sports leggings and yoga pants that emphasise the buttocks have skyrocketed. In January 2024, when this article was updated, for example, Lululemon was worth $58 billion!

What about those who still insist on brazilian butt lift surgery?

It is true that not all cases are good candidates for non-surgical methods.

For example, some people may not be able to do squats, others may have extreme skin laxity on the buttocks while some others do not want to spend months at the gym and in the treatment room. So what are the options for those people?

Here are my guidelines:

• First off, opt for superficial fat grafting. That involves the transfer of fat on the subcutaneous tissue, just under the skin. The vast majority of complications from BBL happen with deep, intramuscular fat graft that injures nerves and blood vessels and allows fat to enter the blood circulation, causing embolism. This complication is absent with superficial fat transfer. Sure, the deep method offers a better shape and does not run the risk of this, but then again, according to a board-certified Brazilian Plastic Surgeon study “the risk of death was 16 times greater when fat was injected intramuscularly”. Perhaps, to minimise the risk of sagging opt for a more modest enhancement, as opposed to enormous that some women choose.

• Secondly, do not overdo it. The same association above recommends no more than 800 ml of fat injected into each buttock, although some doctors think otherwise to the detriment of their clients: “Dr Ali Uckan, of the Elite Aftercare clinic in Ismir, Turkey, boasted that he makes patient's bums as big as possible ‘every time’”.

• Thirdly, use only fat transfer, not silicone implants or other man-made material

• Fourthly: whatever you do, don’t go for a dirt cheap option abroad, do it here in Britain. You do not know what you will experience abroad and if something goes wrong, no one will be there to help you. And it is unfair to ask from the taxpayer and the NHS (which should be caring for cancer cases, not plastic surgery disasters caused in Istanbul) to bear the brunt of the corrective procedures, which usually cost tens of thousands of pounds.

• Lastly, please consider that excessive fat transfer, deep or superficial, will eventually lead to a drooping bottom, as the skin will be too weak to support the excessive fat injected. So a Brazilian bum lift typically looks good for 2-3 years and then it starts heading south - always. You can’t beat gravity. Of course, one can always have a second BBL, with all its dangers of a botched job or even health consequences…

More reading

• Plastic Surgery Societies Issue Urgent Warning About the Risks Associated with Brazilian Butt Lifts 

• A plastic surgeon explains the dangers of the Brazilian butt lift

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