A Brazilian butt lift, or BBL, reshapes the buttocks using your own fat instead of an implant. In the video above, Dr. Clayton Frenzel explains how the procedure works and how he plans it with patients, and one of his patients describes her experience.
Because a BBL carries serious risks when it isn’t done safely, this article also covers what plastic surgery societies say about safety and the questions to ask before you decide.
What a BBL is
Dr. Frenzel describes the BBL as several procedures in one. Fat is removed by liposuction, often from several areas of the body, and then injected into the buttocks to give them a rounder, fuller appearance. The American Society of Plastic Surgeons (ASPS) describes buttock augmentation with fat grafting the same way: fat is taken from an area where it isn’t wanted, such as the abdomen or thighs, and placed into the buttocks.
Because the shape comes from your own fat rather than an implant, the patient in the video says the result feels natural, not like an implant.
Who it may suit
According to Dr. Frenzel, a candidate is someone who wants a fuller, more rounded appearance to the buttocks, for example someone who feels their buttocks are flat and lack shape.
The procedure depends on having enough fat to move. Dr. Frenzel notes that the amount of fat a patient has affects the procedure, and that in very slender people it can be hard to collect enough.
The patient in the video wanted two things: a flatter stomach and fuller buttocks. She explains that when she exercised to lose weight, she lost weight from her legs and buttocks first and her stomach last. She had fat removed from her upper back, lower back and stomach.
Planning and consultation
Dr. Frenzel describes a personal consultation in which he discusses the results he thinks he can achieve for that particular patient, based on how much fat he expects to be able to harvest from different areas of the body. He then usually shows before-and-after photos of a past patient whose body shape is close to the new patient’s.
For the patient in the video, he says about 450 cc of fat was injected into each buttock. The amount is different for every patient.
What to expect on the day
Dr. Frenzel says the procedure is done in one session and usually takes about two to three hours, depending on how much fat the patient has.
For recovery, ASPS says your surgeon will give you very specific instructions about your activity level, the position to sleep in and compression garments. Follow those instructions closely and ask about anything that isn’t clear before your surgery.
The safety warnings you should know about
This video was recorded in 2013. Since then, plastic surgery societies have issued urgent warnings about the risks of the BBL. In 2018, a task force of plastic surgery societies, including ASPS, issued safety advisories about fat grafting to the buttocks, and ASPS urged surgeons and patients to talk in depth about the significant risks before considering a BBL.
The most serious risk is a fat embolism. ASPS explains that inadvertently injecting fat into the muscle can lead to a fat embolism, which can be fatal. ASPS also notes that knowledge of buttock anatomy and the use of ultrasound guidance can improve safety.
Other risks listed by ASPS include:
- blood clots in the legs, which can travel to the heart or lungs and cause serious complications
- infection
- numbness, which is usually temporary but can be permanent
- poor wound healing and scarring
- contour irregularities, such as unevenness or indentations
- fat necrosis, when some of the injected fat dies
ASPS advises choosing a board-certified plastic surgeon who is experienced with the procedure, and warns against discount clinics where several procedures run at once in different rooms, performed by people who aren’t board-certified plastic surgeons.
Questions to ask your surgeon
- Are you board certified, and by which board? How many BBLs do you perform a year?
- Where exactly will the fat be placed? Do you inject only under the skin, above the muscle?
- Do you use ultrasound guidance during the injections?
- Where will the surgery take place, is the facility accredited, and who gives the anesthesia?
- How many procedures do you do in one day?
- Do I have enough fat for the result I want? Which areas would you take it from?
- What will recovery involve: sitting, sleeping position, compression garments and time off work?
- Which complications should I watch for after surgery, and who do I call if I have them?
- Can I see before-and-after photos of patients with a body shape similar to mine?
Dr. Frenzel is a cosmetic and bariatric surgeon in the Dallas-Fort Worth area. See Dr. Frenzel’s Best Docs Network profile for more about the practice.
This article is for general information only and is not medical advice. Talk with a qualified health professional about your own situation. If you think you may have a medical emergency, call 911.
