I'm not sure I know of a cosmetics procedure that gets more airtime than the BBL. In fact, in all of my years as a beauty editor, I'd say the Brazilian Butt Lift is one of my most discussed topics with plastic surgeons. Not because it's groundbreaking as a procedure—but because it's just so incredibly popular and so incredibly dangerous. In fact, it is renowned for being one of the most dangerous cosmetic procedures anyone can undergo.
At the start of the year, I discovered some research carried out by Face Med Store that revealed, despite the dangers associated with the procedure, the BBL is the most popular cosmetic procedure on social media in the US. That means content around the Brazilian Butt Lift has been consumed and searched for more than Botox (masseter Botox included), lip filler, liposuction and even last year's viral buccal fat removal 'trend'.
I wrote about this back in January, and I highlighted that this might not have been indicative of trends here in the UK. But throughout my career I have learned one crucial thing about aesthetic trends—what's big news in the US tends to, eventually, make waves across the pond. And sadly, today I read the news that two arrests have been made on suspicion of manslaughter off the back of a 33-year-old woman having died after falling unwell after undergoing a non-surgical, 'liquid' BBL procedure.
So what exactly is a Brazilian Butt Lift, what are the difference between surgical and non-surgical options, and why do they remain so popular despite its dangers? To get some answers, I spoke with Dr Ashwin Soni, a GMC-registered plastic and reconstructive surgeon. Here's what he wants everyone to know about the BBL.
What is a Brazilian Butt Lift?
First things first, it's important to know the difference between a BBL and a non-surgical BBL. A standard BBL is an invasive surgery. "A Brazilian Butt Lift is a cosmetic surgery, which is performed under general anaesthesia in order to enhance volume in the buttocks, define curves and lift the gluteal region. The way in which this is performed is that liposuction is [carried out on] another area of the body, for example the tummy or lower back. Fat is harvested from those areas, and your own fat (autologous fat) is them re-injected into the buttocks and hips in order to sculpt and enhance that area," explains Dr Soni.
However, it is worth noting that in recent times we have seen the rise of 'non-surgical' or 'liquid' BBLs. These procedures tend to rely on the injection of dermal fillers into the area without lipsuction. However, just like the majority of injectable filler aesthetic treatments in the UK, there are huge issues with lack of regulation.
What are the risks of getting a BBL?
As previously mentioned, surgical Brazilian Butt Lifts are notoriously dangerous. Surgical BBLs were previously banned in the UK between 2018-2022 due to safety concerns and high mortality rates. But in 2022, British Association of Aesthetic Plastic Surgeons (BAAPS) lifted the ban due to the implementation of new safety guidelines. But many do not feel as though they go far enough and that a blanket ban is the way to go. For this reason, Dr Soni doesn't perform them. "The risks of the surgery would not be worth it to me as a plastic surgeon. The mortality rate is very high for a cosmetic surgery. If I wouldn’t have it done myself or recommend it to my family or friends, then I certainly wouldn’t be performing it on my patients. If you are a patient that is considering it, then please make sure you go to a plastic surgeon who is highly skilled, highly trained and is performing a large volume of these day in and day out," he urges.
It is very important to understand the risks associated with the Brazilian Butt Lift. "BBL surgeries have been associated with higher risks than other cosmetic surgeries, and have a higher mortality rate. There have been some worldwide deaths associated with this surgery. According to recent data, the mortality rate has dropped, but it is still higher than other cosmetic surgeries," reveals Dr Soni.
So what is it that makes BBLs a higher risk surgery? "Deaths are specifically linked to the risk of fat embolism, which is where droplets of fat are injected (mistakenly) into blood vessels, which can then cause serious clots in the body and can travel to the heart or lungs—potentially leading to disastrous complications, including death," he says.
According to Dr Soni, a contributing factor to increased risk is down to the trend in desire for significant volume enhancement. "Having very large volumes of fat re-injected into the buttocks and hips adds to the risk. You also don't want to put too much pressure on that area by over volumising, as that is when other issues can happen, such as death of fat cells, a worsened blood supply to the area and poor lymphatic drainage," he explains.
And while any invasive surgery that involves general anaesthesia is considered risky for obvious reasons, there are other risks involved with BBLs, including "seromas (collections of fluid), lumps, cysts, infection, post-operative pain and contour irregularities".
When it comes to non-surgical BBLs there are also similar risks—tissue death, blood clots and infections. Layer these risks with the fact that administering non-surgical BBLs is lacking seriously important regulation – particularly when it comes to the level of qualification needed to carry out the injections – and suddenly the concept of a 'harmless injection' becomes something much more dangerous.
Why is the BBL so popular?
Despite the above risks, it's clear that Brazilian Butt Lifts aren't going anywhere. It seems that society's desire for bigger bums overbears some of the fatal risks associated with the procedure. With a number of celebrities having been suspected of having this surgery (and other forms of augmentation, such as filler and implants), the BBL is in high demand. "BBL procedures have been trending on social media for many years now, and so have risen in popularity in the cosmetic surgery world. I personally think that it has become another social media trend, which is causing some of the public to have an unrealistic expectation," says Dr Soni.
As a beauty editor who has a lot of insight into such trends, I also think there is a lot of confusion around Brazilian Butt Lifts and what they are. Augmentation around the bum and hips can come in many forms, there a stark differences between surgical BBLs, liquid BBLs and butt implants that each come with their unique set of risks.
The conversations that take place around butt augmentation in the celebrity world and in the media only fuels people's interest, and subsequently, adds to their confusion. The fascination around whether or not any given celebrity has undergone augmentation is undeniable. It is, in my opinion, the lack of open discussion and admission around it that fuels the desire for larger derrières even more. While I don't believe any celebrity should have to discuss any personal cosmetic surgeries in the media, I do feel strongly that by denying it or refusing to discuss it honestly when asked only intensifies people's interest and desire to mimic their look.
"People can underestimate the risks and not fully appreciate that it is a serious surgery with recovery and downtime. People need to express a lot of thought, consideration and care prior to embarking upon such a surgery, in my opinion," shares Dr Soni.
How long does a BBL last?
A Brazilian Butt Lift isn't easily detectable (not even via x-ray or scans) and doesn't have an 'undo' button.
"It is important to know that this is a surgery where the results do last, and once the fat integrates it will shrink as you lose weight and increase in size as you gain weight, just like normal fat cells would behave. There is no real reversal of the surgery, besides performing liposuction to the area," explains Dr Soni.
