POSTED: 25 Jul 2023

Is the Brazilian Butt Lift Really the World’s Most Deadly Cosmetic Surgery and What Are the Alternatives?

The Brazilian Butt Lift (BBL) has become a byword for body sculpting in recent years. BBL surgery is extremely popular because it can dramatically enhance the size, position and shape of the buttocks. It also carries a reputation as one of the world’s most dangerous cosmetic surgeries. In this post we take a deep dive into what is a BBL, risks and side effects and how effective it is. We also compare it with a wide range of both surgical and non-surgical alternatives.

Origins of the Brazilian Butt Lift

The Brazilian Butt Lift is thought to have been pioneered by the Brazilian surgeon Ivo Pitanguy. Dr Pitanguy was a leader in plastic and reconstructive surgery. He gained fame in the mid 20th century for his innovative surgical techniques and is thought to have established Brazil as a cosmetic surgery tourism destination. For his part, Dr Pitanguy believed in enhancing one’s body for self-esteem and well-being. This formed the philosophy behind his work including the BBL which helps individuals achieve a curvier silhouette by redistributing body fat.

What is BBL Surgery

BBL surgery is a body contouring cosmetic procedure that done to enhance the size and shape of the buttocks. It involves taking excess fat from specific parts of the body such as the belly, thighs or hips using liposuction. Liposuction is done using a small, thin tube called a cannula. This is is inserts through small cuts in the skin. The surgeon then moves the cannula back and forth to break up the fat cells. These are then suctioned out of the body. The fat is then spun in a centrifuge, purified and injected back into the buttocks to enhance their size and shape. This all happens in one surgical procedure.

Does it Work?

The Brazilian Butt Lift can be a highly effective way to augment the size and contour of the buttocks. It’s a good option for those who are looking for a significant change in their silhouette. The procedure works by taking fat from areas where it’s not wanted and injecting it into the buttocks. Hence it can slim those areas and create a more curvaceous and smoother look. This custom approach allows for a very bespoke result. Patients with good results often report a boost in self-confidence following the surgery. However, this is a major surgical procedure. The recovery period typically lasts between 2-3 weeks but can be longer. During this period your mobility maybe limited and you may have drains or compression garments.

The final outcome can take several months to fully materialise and results vary based on individual body types, health status and the technical expertise of the surgeon. Also, BBL is not permanent because it does not prevent the effects of future weight changes or aging on the shape of the body. As such, you will need to maintain a stable weight and a healthy lifestyle to maintain the effects of the surgery for as long as possible.

Risks of BBL Surgery

Brazilian Butt Lift does come with significant risks. According to a 2019 report by the American Society of Plastic Surgeons, BBL surgery has a mortality rate of up to 1 in 3,000, making it the most fatal of all cosmetic procedures. The primary cause of this alarming statistic is the risk of fat embolism, where fat enters the bloodstream and can travel to the lungs or brain. If this happens, it can lead to severe complications or even death.

Furthermore, other risks include infection, bleeding, numbness, scars, and uneven results. There can also be changes in skin sensation that may persist. If the procedure is not done correctly, the injected fat can cause lumps or asymmetry. Another important factor to consider is fat absorption. After the surgery, the body naturally absorbs some of the transferred fat cells, which can lead to disappointing results. Studies show that approximately 40% of the transferred fat may be reabsorbed within the first few months.

If you’re considering BBL surgery, then you need to consider the risks very seriously. Whilst there’s no way to completely prevent them, you can reduce them. The best way to do this is to choose a highly experienced and qualified plastic surgeon who can also ensure you achieve the best results possible.

What are the Alternatives to BBL?

Before having any procedure and especially one that carries major risk, its important to consider all your options. Below we’ve put together some of the most popular and effective alternatives to BBL surgery.

Surgical Alternatives

Surgical alternatives like Buttock implants and lower body lift offer long term results and like BBL can achieve dramatic results. They also may carry fewer serious risks compared with BBL. They do however have longer recovery periods and greater costs.

Buttock Implants

This procedure involves inserting silicone implants into the buttocks. Although implants pose a lower mortality rate than the liposuction and transfer of BBL, they are not risk free. Buttock implants have higher risks of infection because this is a foreign body implant. They also carry risk of extrusion, nerve damage, scars and displacement. The recovery period lasts 2-4 weeks on average and you may have drains and compression garments during that time. Whilst the results are immediate, you won’t see the final result until the swelling and bruising settles. Although they are long lasting, they are not permanent. You also usually need to implants every 10 years. Nonetheless, buttock plants maybe a more suitable option if you want to avoid the risks of BBL. They’re particularly good if you do not have a lot of excess body fat but want a more pronounced buttock enhancement.

Lower Body Lift

This procedure includes removing excess skin and subcutaneous tissue from the buttocks, abdomen, waist, hips and thighs. While this surgery can reshape the entire lower body, it’s very invasive. The main risks include infection, haematoma, scarring and slow or impaired wound healing. Recovery takes about 2-4 weeks and will require drains and compression garments. As this is quite an extensive procedure and because it doesn’t add volume to the buttocks, its usually best for people with a lot of excess or sagging skin. For example, patients who have had massive body weight loss and who require skin removal to contour the body. The results can be quite dramatic.

Body Contouring with Liposuction

Liposuction is a good alternative to Brazilian Butt Lift if you are looking to improve the contours of your thighs and buttocks but do not need to add volume. Liposuction involves removal of fat from specific areas to reshape the buttocks. It can give the illusion of a more prominent, shapely buttocks without the need for fat transfer which is the second step of a BBL. However, unlike BBL surgery, liposuction doesn’t add volume to the buttocks, it merely highlights the existing contours by reducing fat in the surrounding areas. The downtime and recovery for liposuction is similar to BBL.

The risks associated with liposuction are similar to BBL and so there is a risk of fat embolism with this too. Other risks include infection, bleeding, contour irregularities and changes in skin sensation. It is also worth noting that liposuction does not tighten loose skin. So, if you have poor skin elasticity, then you might need to consider other procedures like RF microneedling to address this issue.

Non-Surgical Alternatives

There are a number of non-surgical alternatives to BBL surgery like Sculptra Butt Lift, Dermal Fillers, 3D-Lipo, EMSCULPT and CoolTone. These are less invasive, carry fewer risks and have shorter recovery times. However, they produce less dramatic results, are temporary and require regular maintenance.

Sculptra Butt Lift

The Sculptra Butt Lift is a non-surgical alternative to Brazilian Butt Lift. It involves injecting Sculptra Aesthetic, a poly-L-lactic acid filler, to enhance the shape and volume of the buttocks. It’s a a quick and minimally invasive procedure, that requires little to no downtime. The results can last up to two years. It however does come with its own set of risks.

One of the most common side effects of Sculptra Butt Lift is the development of small bumps under the skin. These are known as nodules. These are usually painless and may not be visible, but can be felt. They can form a few weeks to a few months after the procedure. Other possible side effects include redness, swelling, pain or tenderness, bruising, itching, or discolouration in the area of injection. These are usually temporary and resolve within a few days. In rare cases, more serious complications can occur, such as allergic reactions to the injected material, infection, or formation of a granuloma (a type of inflammatory lump). There is also a possible risk of vascular occlusion when injecting any filler into the body which can compromise the blood supply and cause skin necrosis or even worse form an embolus that travels up into the body. This can be life-threatening.

Sculptra Butt Lift does not produce as dramatic or long lasting results as surgical alternatives. As it works by stimulating collagen production to provide subtle lift and contouring, the results can take several months to become noticeable. It is also not dissolvable and so if you don’t like the results you will need to wait till it wears off. This is a major problem if there is a severe side effect as you may need surgery to remove the Sculptra.

Dermal Fillers

Like Sculptra injections, dermal fillers add volume and can lift the buttocks. Dermal fillers have little to no down time and can give immediate results. However, they usually require multiple sessions and the results are temporary. They usually lasts 6-12 months but this depends on the type of filler used. Hyaluronic acid dermal fillers and Radiesse are most commonly used for dermal filler butt lifts.

Types of Dermal Fillers for Buttock Enhancement

Hyaluronic Acid (HA) dermal fillers are made of a dissolvable colourless gel. The HA filler is injected into targeted areas of the buttocks to enhance volume and shape. Benefits of this treatment include immediate results and minimal downtime. HA fillers are also reversible and so if you are not satisfied with the results or if there is a problem, they can be dissolved.

Radiesse is another dermal filler that is commonly used to enhance the size and shape of the buttocks. The procedure involves injections into the target areas. However, unlike HA fillers, Radiesse is not dissolvable. Radiesse works like Sculptra, in that it stimulates the body to produce collagen. Whilst there is an immediate result, it can take 6-8 weeks to see the full effect of Radiesse.

Common side effects of HA and Radiesse dermal filler buttock enhancement include swelling, bruises, redness and pain at the injection site. These typically resolve within a few days. There’s also a risk of forming nodules or lumps under the skin. If this happens with HA fillers, you can dissolve them with hyaluronidase. More serious risks include infection, allergic reactions and like Sculptra, there is a risk of filler compressing a blood vessel or embollising which can cause tissue necrosis or can even be fatal.


Often referred to as non-surgical liposuction, 3D-Lipo is an innovative technology that offers an alternative method for butt enhancement. This approach combines various processes like fat freezing (cryolipolysis), ultrasound cavitation, and radiofrequency skin tightening. Whilst it is normally used to tackle areas of excess fat, it can work for butt lifting and contouring. This is because 3D-Lipo selectively removes fat from specific areas around the buttocks. This can give a more sculpted and lifted appearance.

The process begins with cryolipolysis, a procedure that targets and cools fat cells to temperatures that trigger their natural death, without affecting the surrounding tissues. The next step is ultrasound cavitation, which uses low-frequency ultrasound waves to rupture fat cell membranes. This releases their content for natural removal by the body. The final step is radiofrequency skin tightening, which uses radiofrequency energy to heat deep skin layers. This boosts collagen and elastin production and leads to skin tightening.

3D Lipo is a great alternative to surgery because it has reduced downtime, lower risks and does not need anaesthesia. The treatment plan is easily customised to address your individual needs. However it is probably best for people with reasonable amounts of fat around the buttocks to have enough material for contouring. 3D Lipo is not without risks. Some individuals may experience discomfort during or post procedure, or mild pain may persist. Skin redness and swelling are common side effects but normally settle within a few hours or days. There’s also a risk of uneven fat cell removal, which could lead to irregular contours. Temporary numbness in the treated area might occur due to the cooling effect of fat freezing. While it’s rare, there’s a small risk of burns from the radiofrequency and ultrasound components of the procedure.


EMSCULPT and CoolTone are two innovative non-surgical treatments for butt enhancement. They work by stimulating the muscles, providing definition and lift without requiring any fat transfer or removal.


EMSCULPT uses High-Intensity Focused Electromagnetic technology to induce strong muscle contractions, which are not easy to achieve through voluntary contractions in regular work outs. The muscle tissue responds to these contractions by remodeling its inner structure. This results in muscle building and sculpts the body. When used for buttock lifting, EMSCULPT stimulates the gluteal muscles, causing them to lift and firm. It’s often sold as “like doing thousands of squats in one session”.

The benefits of EMSCULPT include that it’s non-invasive, has no downtime and simultaneously burns fat while building muscle. However, it does come with some risks, such as muscle pain and discomfort, similar to what you might feel after an intense workout. It will also require multiple sessions to see noticeable results and there is a limit to what it can achieve.


Like EMSCULPT, CoolTone is a non-surgical butt lift procedure that uses Magnetic Muscle Stimulation technology to go through the skin and fat layers to target only the muscle layer. This induces strong muscle contractions that the body could not otherwise achieve on its own. With time, these contractions improve the tone and strength of the muscles. For butt lifting, CoolTone strengthens, tones, and firms the gluteal muscles, thus lifting and tightening the butt. The benefits of CoolTone are similar to those of EMSCULPT. However, CoolTone can also cause more muscle pain and discomfort. It also requires multiple treatment sessions to achieve optimal results. Again, these are very limited if you compare them to surgical and 3D lipo options.

It is important to note that while both EMSCULPT and CoolTone can enhance the buttocks by increasing muscle mass, they do not add volume in the same way a traditional Brazilian butt lift or dermal fillers can. Nor can they achieve the contour that surgery and 3D-Lipo can. Therefore, the choice between these treatments will depend on your specific goals and body type.

As you can see there is a vast array of options to contour your lower body and enhance your buttocks. Whilst BBL surgery has extremely serious risks, alternatives also have potential risks and side effects. If you are thinking of a BBL or its alternatives, please take careful consideration of the risks, your individual body type, health and personal aesthetic goals. Always consult with a qualified and experienced surgeon to help you choose the best option for you. This will also reduce the risks and enhance the results you can get.


Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

Connect with us

  • Facebook Logo
  • Twitter Logo
  • Instagram Logo
  • Pinterest Logo
  • YouTube Logo
  • LinkedIn Logo

Start Your Online Consultation

The journey to great skin starts here. Start your online consultation for personalised prescription-strength skincare.

Start Consultation