When most people think of buttock augmentation, they think of a procedure we call the Brazilian butt lift (BBL). Why do we call it that?
In 1996, The Learning Channel featured a board-certified plastic surgeon performing the first televised BBL. The patient had fat liposuctioned from other parts of her body and injected into the buttock area. Since the patient was from Brazil, the episode was titled “Building the Brazilian Butt.” The media, which nearly always prefers a catchy phrase or idea over the literal truth, ran with the name and now we all know it as the BBL. The fact that plastic surgery of all types is extremely popular in Brazil may have also been a factor. I was reminded of this when I recently read an editorial by Drs. Del Vecchio and Rohrich in the January 2020 edition of the Plastic and Reconstructive Surgery Journal about this type of buttock augmentation, and I wanted to highlight some of the key points of this article.
The BBL is neither particularly Brazilian (it was not invented by a Brazilian surgeon) nor is it even a lift. A lift, such as a facelift or a breast lift, requires moving the skin and usually the underlying structures. These structures are then repositioned in a more anatomical (upright) position and the excess skin is removed. That’s not what we’re talking about. The most notable feature of the BBL is that it is a type of buttock augmentation that uses the patient’s own fat in place of using silicone buttock implants.
As you might imagine, simply adding the fat is not enough to create an aesthetically pleasing shape. Of course, we have to properly shape the buttocks but it is also critical the surrounding areas be contoured for the best result. Almost all patients require liposuction of the love handles and surrounding areas to contour the back. Sometimes the outer thighs may need to be contoured as well. The goal is to remove excess fat from areas surrounding the buttocks in order to highlight the buttock region.
Recently there has been much concern about patient mortality from BBL procedures. There is now sufficient evidence to show that the fat should not be injected into the muscle, as the muscle contains large vessels. In most cases, accidental intravascular injection of fat into a blood vessel is what causes this dreaded complication. Plastic surgery is very safe overall, but it’s clearly wise to choose an experienced, board-certified plastic surgeon for this procedure – though¸ even then, not all plastic surgeons are the same.
In our practice, we frequently perform this procedure under local anesthesia, and this has some important advantages. First is the cost to the patient; there is the expense of the actual anesthesia and the fact that using more than local anesthesia requires the use of an operating room which involves a significant charge. Second is the avoidance of very rare, but potentially serious complications associated with general anesthesia that you have likely heard about. Third, and perhaps the most important, is that accidental intra-muscular entrance of the injection cannula will cause pain. This might not seem like an advantage, but it will alert the surgeon to the problem and further manipulation in that area will be avoided.
Under any name, the BBL has produced results that have consistently delighted my patients. If you’d like to find out more, call us at 714-242-5908 or reach out through our contact page.