Brazilian Butt Lift (BBL)
The BBL — A Brief History
The BBL is a clever procedure because it is a “twofer.” It is a Plastic Surgery fat recycling procedure. Sites in the body that have an excess of fat such as the abdomen, waist, back, inner thighs, inside of the knees, sacral triangle undergo liposuction and are made thinner. The suctioned fat is collected, prepped, and then injected back into the body as a filler. Breast reconstruction surgeons have been using this technique for years to safely add shape and volume to the breasts during cancer reconstructions. I am sure you know that buttock augmentation with your fat [aka, autologous fat buttock augmentation] is an extremely popular procedure.
What Are the Risks?
Did you also know that it is the second most lethal procedure in cosmetic surgery? It is true but let us remember that all surgery carries some risk and every reasonable and ethical Plastic Surgeon should tell you this fact all of the time even if she/he is afraid that you might walk away from surgery. No exceptions. That being said, we should look at the actual data, so that you can make an informed decision. A BBL has a reported mortality ratio of 1 in 15,000-20,000. For comparison, the chance of getting killed by a lightning strike is 1 in 180,000; the chance of dying in an accidental firearms discharge is 1 in 9077; the chance of dying in a car accident is 1 in 608. So, you are about 16 times more likely to die in a car accident and about 14 times more likely to die from a firearm’s discharge than from a BBL surgery. You are about 12 times less likely to be killed by a lightning strike. So, the BBL is a fairly safe procedure.
FAQs
BBL stands for Brazilian Butt-Lift.
The procedure involves harvesting your excess fat and transferring it to the buttocks to augment the projection of the buttocks. Dr. Heffel and Dr. Kordestani collect the fat by performing liposuction of multiple areas around your body. Typically, patients store excess fat around the abdomen, at their waist, the flanks, the inner thighs, and the back. Please remember everyone is different. Typically, between two and three areas are used as harvest sites for liposuction and contouring. More sites are used if more fat is needed. The liposuctioned/harvested fat is collected under sterile conditions, prepared, and then systematically injected into the buttocks area to accentuate the contour.
The way to a successful BBL can be somewhat complicated. There are PRE-OP and POST-OP protocols that help with a successful surgery. If you are really looking and considering a BBL, we ask and encourage you to find us and to seek our advice. Our team along with Drs. Heffel and Kordestani would be more than happy to share their experience with you.
No.
The BBL procedure is considered a cosmetic/elective procedure and is not covered by most health insurance programs/products.
The procedure is done either in a surgery center or in a hospital operating room. Both Dr. Heffel and Dr. Kordestani use the hospital and the hospital-affiliated surgery center. They feel that the hospital or the surgical center setting gives them more ability to get a better result.
Yes.
In most cases, to complete the most appropriate operation with the most amount of fat grafting, the patient needs to be asleep. This alleviates any angst the patient may have. Also, should there be a need to access more fat areas to get more fat graft, a general anesthesia setting gives the surgeons the most amount of flexibility to give the patient the best result.
It depends on you.
Everyone is different but more than likely you will be up and walking the day of surgery. You will feel fairly sore the day of surgery and the day after the procedure–It will feel as if you did a strenuous workout or as if you went on a 10-mile hike over and down steep hills.
Right after the procedure you will be in some sort of wrap. Within the first two weeks, depending on the extent of your swelling, you will be placed into a compression garment which is a surgical girdle that will act as compression at the areas where you had liposuction. It is critical to wear this garment as it helps prevent the development of isolated fluid pockets in the suctioned areas.
It depends on you and your body.
The cost is proportionate to the number of areas that undergo liposuction. What does that mean? If you undergo liposuction of the abdomen and waist only, then the cost will be less than if you undergo liposuction of the abdomen, waist, outer thighs, and back. The more time the procedure takes, the more costly the procedure will be. Once the doctors see you and have an idea of what you wish to get done, they can give you a fairly accurate estimate. Please speak to our team members so that you know the exact cost of the procedure before scheduling the case.
Yes
Every major surgical procedure has recognized complications. BBL is no different. However, with any well known team, the task is not to focus on the complications but to focus on how to minimize the complications. Drs. Heffel and Kordestani have extensive experience with this procedure and can help to plan out your surgical procedure weeks before and can help to minimize any chance of any post-operative complications. A good surgical plan can do much to minimize any possible complications.
Here is a list of potential complications of which you should be aware. During your consultation, we ask and encourage you to ask Dr. Heffel or Dr. Kordestani about these possible complications. In lieu of that, please feel free to contact the office and ask any of the team members.
- Anesthetic risks
- Bruising
- Change in skin sensation
- Damage to deeper structures
- Deep vein thrombosis
- Pulmonary Embolism
- Pulmonary complications such as fluid overload
- Infection
- Irregular contours or asymmetries
- Irregular skin pigmentation
- Persistent swelling or an isolated fluid collection [seroma]
- Poor wound healing
- Rippling or loose skin/ failure of skin contraction
Hopefully, none of these complications occur. However, should one occur, you should ask yourself, “Am I prepared to potentially deal with a complication?” That is a genuine and real question.
If a complication does occur, the team at The Associates will be available and with you throughout the recovery period. We have a wealth of experience and will do our best to recruit others to help in getting you appropriately recovered. Having over twenty years of experience each, Drs. Heffel and Kordestani will work with you to ensure your proper recovery from any of these complications.
Load More
“Houston, We Have a Problem.”
In the past, surgeons were placing the harvested fat into the gluteal muscles. A surgeon would take a metal infiltration cannula, attach it to a fat-filled syringe and push the fat into the muscle. The muscle was a good target for fat transfer because it has a wonderful blood supply and fat graft survival is based on blood supply. As a surgeon, if you have ever done a free flap from the buttocks for breast reconstruction, you would recognize why injecting the fat into the gluteal muscles, especially near the midline is a bad idea. There are very large veins deep to the muscle that have a diameter of about half your pinky finger and there are a few of them. It is a target-rich area for adverse outcomes. These veins are easy to penetrate or tear with a metal cannula and easy to fill with injected fat. Injecting fat into a vein is similar to putting lard into your kitchen drain. It is a bad idea and can causes major problems. The fat travels to the heart, then the lungs, and then …well you get the picture. Several years ago, the Plastic Surgery Societies recognized the increase in mortalities associated with this procedure and tried to determine what was causing this increase.
The problem was the level or the depth of the fat injection(s). Today’s well-trained Plastic and Reconstructive Surgeon is quite aware that submuscular or intramuscular injection of autologous fat is a big No-No! The depth of the fat injection should be into the subcutaneous tissues and should stop at the level of the (gluteal) muscles. The injection pressure should be low. If the surgeon stays in the right tissue plane, the procedure is most often very safe.
In the past, when injections into the gluteal muscle were all the rage, the injected fat could be dispersed over a larger area– into the muscular plane and also into the subcutaneous tissue planes. Now the fat should only be injected into the subcutaneous tissue plane. So, the volume of injected fat has unfortunately decreased from what we could previously do.
The amount of fat that can be injected must be tailored to each patient and to their bodies. A small person will tolerate less volume injection than a larger person because the available volume is appropriately less. Some patients will receive only 200 milliliters and some patients will get as much as 800 milliliters of transferred fat. This again depends on their body contour and the available fat. If a surgeon attempts to transfer too much fat into the buttocks, the excess fat will simply be too much and will eventually die because it simply does not have enough oxygen to survive.
The BBL procedure often works very well. We have found that our patients are generally happy with the results of this procedure. However, not all of the injected fat survives. The actual percentage of injected fat that survives grafting is variable. Survival of the transplanted fat depends on the harvest technique, the preparation, the method of injection, the body of the patient, and the compliance of the patient with the post-procedure/post-op regimen. Most surgeons will agree that 50%-80% of the injected fat survives long-term. This means that between 20%-50% of the fat does not survive.
Right after surgery, your augmented buttocks will be at its largest. Over a few weeks, some of the transplanted fat will die and the body will simply absorb it. This will continue for the next few weeks. At 3 months, you will begin to see your final result. This does depend again on your body shape and the amount of fat grafting. At around 3 months, you will also notice any and all asymmetries. Based on these, sometimes a second smaller procedure, a touch up, may be needed. That is something to be discussed between you and your surgeon. The take-home point here is that the procedure does work and is relatively low risk, and the final result is most often seen at 3-4 months.