The Brazilian Butt Lift (BBL) has become a byword for body sculpting in recent years. BBL surgery is extremely common because it can dramatically enhance the size, position and shape of the buttocks. However, it also carries a reputation as one of the world’s most dangerous cosmetic treatments. In this post we take a deep dive into what a BBL is and how it works. We look at how effective it is and the very real risks involved. We also look at where it stands in the UK. Then we compare it with a wide range of surgical and non-surgical options.
What Are the 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 new techniques. He is also thought to have established Brazil as a cosmetic surgery tourism destination. For his part, Dr Pitanguy believed in enhancing the body for self-esteem and well-being. This formed the philosophy behind his work, including the BBL. The procedure helps people achieve a curvier shape by moving their own body fat.
What Is BBL Surgery?
BBL surgery is a body-contouring procedure performed 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 with a small, thin tube called a cannula. The surgeon inserts this through tiny cuts in the skin. They then move it back and forth to break up the fat cells, which are suctioned out of the body. The fat is 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 a BBL Work?
A Brazilian Butt Lift can be a highly effective way to augment the size and contour of the buttocks. It is a good option for people looking for a significant change in their silhouette. The procedure works by taking fat from areas where it is not wanted and injecting it into the buttocks. This can slim those areas and create a more curvaceous, smoother look. Because the fat is your own, the result is very bespoke. People who are happy with their results often report a boost in self-confidence afterwards.
However, this is a major operation. The recovery period typically lasts between 2 to 3 weeks, but it can be longer. During this time your mobility may be limited and you may have drains or compression garments. The final outcome can take several months to fully show. Results also vary with body type, health status and the surgeon’s technical expertise. A BBL is also not permanent. It does not prevent future weight changes or ageing from altering the shape of the body. As such, you will need a stable weight and a healthy lifestyle to keep the effects for as long as possible.
Why Is BBL Surgery So Dangerous?
A Brazilian Butt Lift comes 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. That makes it the most fatal of all cosmetic procedures. The NHS agrees that it has the highest death rate of any cosmetic procedure. The main cause is the risk of fat embolism. This is where fat enters the bloodstream and travels to the lungs or brain. A fat embolism in the lungs (a pulmonary embolism) can be fatal. The risk of death from a BBL is thought to be at least ten times higher than for many other procedures.
Beyond this, other risks include infection, bleeding, numbness, scars and uneven results. There can also be lasting changes in skin sensation. If the treatment is not done correctly, the injected fat can cause lumps or asymmetry. Another factor is fat absorption. The body naturally reabsorbs some of the transferred fat after surgery, which can lead to disappointing results. Studies suggest that around 40% of the transferred fat may be reabsorbed within the first few months.
If you are considering BBL surgery, you need to take these risks very seriously. Whilst there is no way to remove them completely, you can reduce them. The single best way to do that is to choose a highly experienced, qualified and properly regulated surgeon.
Is BBL Surgery Banned or Regulated in the UK?
BBL surgery is not banned in the UK, but it is treated with real caution. After a series of deaths, the British Association of Aesthetic Plastic Surgeons (BAAPS) advised its members not to perform BBLs. The advice stood for several years while the treatment was undergoing review. In 2022 it issued new safety guidelines recommending a safer technique called superficial gluteal lipofilling. Here the fat is injected only just under the skin, rather than deep into the muscle. The advise to surgeons is to use ultrasound guidance to keep the needle in the correct layer.
One unintended effect of this caution is that many people now travel abroad for cheaper surgery. Overseas, BBLs can cost far less than in the UK. The NHS has warned about these “bargain basement” procedures and is often left to treat the complications when people return home. It is also worth knowing about non-surgical “liquid BBLs”, which use dermal filler injected into the buttocks. These are currently unregulated in the UK and can be just as dangerous if performed badly. The safest path, if you are set on the treatment, is to find a qualified UK surgeon working in a regulated facility.
What Are the Alternatives to BBL?
Before having any procedure, and especially one that carries major risk, it is important to consider all your options. There is a broad range of options to BBL surgery, which fall into two groups. Surgical options can achieve dramatic, long-lasting results but involve longer recovery and greater cost. Non-surgical options are less invasive and carry fewer risks, but they give more modest, temporary results that need regular maintenance.
What Are the Surgical Alternatives to BBL?
Surgical options like buttock implants and a lower body lift offer long-term results and, like a BBL, can be dramatic. They may also carry fewer serious risks than a BBL, though they have longer recovery periods and higher costs.
Buttock Implants
This treatment involves inserting silicone implants into the buttocks. Although implants carry a lower mortality risk than the fat transfer of a BBL, they are not risk free. Because an implant is a foreign body, there is a higher risk of infection. There is also a risk of extrusion, nerve damage, scarring and displacement. Recovery lasts 2 to 4 weeks on average, and you may have drains and compression garments during that time. The results are immediate, but you will not see the final outcome until the swelling and bruising settle. Implants are long lasting rather than permanent, and you usually need to replace them every 10 years. Even so, they may suit you better if you want to avoid the risks of a BBL. This is particularly true if you do not have much excess body fat but want a more pronounced enhancement.
Lower Body Lift
This treatment removes excess skin and tissue from the buttocks, abdomen, waist, hips and thighs. It can reshape the entire lower body, but it is very invasive. The main risks include infection, haematoma, scarring and slow or impaired wound healing. Recovery takes around 2 to 4 weeks and will require drains and compression garments. Because it is so extensive, and because it does not add volume to the buttocks, it is usually best for people with a lot of excess or sagging skin. A good example is people who have had massive weight loss. The results can be quite dramatic.
Body Contouring with Liposuction
Liposuction is a good option if you want to improve the contours of your thighs and buttocks without adding volume. It removes fat from specific areas to reshape the buttocks. This can give the illusion of a more prominent shape, without the fat transfer that makes up the second step of a BBL. The downtime is similar to a BBL, and so are some of the risks. These include fat embolism, infection, bleeding, contour irregularities and changes in skin sensation. Liposuction does not tighten loose skin. So if you have poor skin elasticity, you might need other treatments like radiofrequency microneedling to address that.
What Are the Non-Surgical Alternatives to BBL?
There are several non-surgical options to BBL surgery, including the 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 more modest results, are temporary and need regular maintenance.
Sculptra Butt Lift
The Sculptra Butt Lift involves injecting Sculptra, a poly-L-lactic acid filler, to enhance the shape and volume of the buttocks. It is a quick, minimally invasive procedure that needs little to no downtime, and the results can last up to two years. It does come with its own risks. One of the most common side effects is the development of small bumps under the skin, known as nodules. These are usually painless and may not be visible, but you can often feel them. They can form a few weeks to a few months after the treatment. Other possible side effects include redness, swelling, pain, bruising, itching or discolouration at the injection site, which are usually temporary.
In rare cases more serious complications can occur, such as allergic reactions, infection or a granuloma (a type of inflammatory lump). There is also a possible risk of vascular occlusion whenever you inject any type of filler into the body. This can compromise the blood supply and cause skin necrosis, or form an embolus that travels up into the body. This can be life-threatening. Sculptra is not dissolvable. So if you do not like the result or have a severe side effect, you may have to wait for it to wear off, or even need surgery to remove it.
Dermal Fillers
Like Sculptra, dermal fillers add volume and can lift the buttocks. Dermal fillers have little to no downtime and can give immediate results. However, they usually need multiple sessions, and the results are temporary, typically lasting 6 to 12 months depending on the filler. Hyaluronic acid fillers and Radiesse are the two most common injectables for this purpose:
- Hyaluronic acid fillers are made of a dissolvable colourless gel that is injected into targeted areas to enhance volume and shape. The benefits include immediate results and minimal downtime. They are also reversible, so if you are not happy or there is a problem, it is possible yo dissolve them using hyaluronidase.
- Radiesse is a very popular injectable for enhancing the size and shape of the buttocks. However, unlike hyaluronic acid, it is not dissolvable. It works like Sculptra by stimulating the body to produce collagen. So although there is an immediate result, it can take 6 to 8 weeks to see the full effect.
Common side effects of both include swelling, bruising, redness and pain at the injection site, which usually resolve within a few days. There is also a risk of nodules or lumps under the skin. As with Sculptra, more serious risks include infection and allergic reactions. There is also the chance of a filler compressing a blood vessel or causing an embolus, which can lead to tissue necrosis or even be fatal.
3D-Lipo
Often called non-surgical liposuction, 3D-Lipo combines several processes including fat freezing (cryolipolysis), ultrasound cavitation and radiofrequency skin tightening. Although its main use is to reduce areas of excess fat, it can also work for butt lifting and contouring. It does this by selectively removing fat from around the buttocks to give a more sculpted, lifted appearance. The process begins with cryolipolysis, which cools fat cells to temperatures that trigger their natural death without affecting surrounding tissue. Next, ultrasound cavitation uses low-frequency waves to rupture the fat cell membranes so the body can remove their contents naturally. The final step is radiofrequency skin tightening, which heats the deeper skin layers to boost collagen and elastin and tighten the skin.
3D-Lipo is a good option to surgery because it has reduced downtime, lower risks and does not need anaesthesia. The plan is also easy to tailor to your needs. It is probably best for people with reasonable amounts of fat around the buttocks, so there is enough material for contouring. It is not without risks, though. Some people feel discomfort during or after the treatment. Skin redness and swelling are common too, but usually settle within hours or days. There is also a risk of uneven fat removal leading to irregular contours, and temporary numbness from the cooling effect. Although rare, there is a small risk of burns from the radiofrequency and ultrasound.
EMSCULPT and CoolTone
EMSCULPT and CoolTone work by stimulating the muscles to provide definition and lift, without any fat transfer or removal. The way EMSCULPT works is by using high-intensity focused electromagnetic technology to trigger strong muscle contractions that you could not achieve through ordinary exercise. The muscle responds by remodelling its inner structure, which builds and sculpts it. When used on the buttocks, it lifts and firms the gluteal muscles. It is often marketed as being like doing thousands of squats in one session. CoolTone is very similar but uses magnetic muscle stimulation to reach the muscle layer through the skin and fat. Both are non-invasive with no downtime. However, they can cause muscle pain similar to an intense workout, and both need multiple sessions to see results.
It is important to note that EMSCULPT and CoolTone enhance the buttocks by increasing muscle mass. They do not add volume the way a traditional BBL or dermal fillers do. Nor can they achieve the contour that surgery and 3D-Lipo can. The right choice between all these treatments will always 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, the options carry potential risks and side effects too. If you are thinking about a BBL or one of its options, weigh it up carefully. Consider the risks, your body type, your health and your aesthetic goals. Always consult a qualified, experienced surgeon who can help you choose the safest option and get the best result. In the UK that means a GMC-registered surgeon working in a regulated facility. It is also worth being very cautious about cheaper procedures abroad or unregulated liquid BBLs. The NHS and BAAPS have repeatedly warned about both.
City Skin Clinic is an online skin and hair clinic. This means we do not offer BBL surgery, liposuction, injectable butt lifts or any other body or surgical procedure. What our doctors do offer is custom topical prescription skincare for acne, hyperpigmentation, melasma and skin ageing. If one of those is on your mind, you can use our online skin consultation form or book a video consultation. The journey towards great skin starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical professional with any concerns about your skin or treatment options.
