When it comes to plastic surgery, few procedures are surrounded by more questions, concerns, and curiosities than the Brazilian butt lift (otherwise known as the BBL). Although butt augmentation procedures have been commonplace for decades, the BBL, as it is done today, was relatively uncommon until recently — in fact, BBL statistics from the American Society of Plastic Surgeons weren’t even available until after the year 2000.
These days, the BBL, also known as buttock augmentation with fat grafting, is becoming more and more popular, with 21,823 cases completed in 2020 alone — a surge fueled partly by lockdown. “People have had more time to themselves, more time to reflect — many felt like this was the perfect moment to seek out procedures they have always wanted,” says Dr. William Rahal, a Beverly Hills plastic surgeon and BBL expert. “We’ve seen increased visibility on the BBL procedure due to social media and the use of morphing apps, as people are able to edit their own image, and end up loving the result so much that they’re looking for ways to make those enhancements permanent.”
Bustle reached out to three board-certified plastic surgeons and BBL authorities to shed light on the procedure, from what to expect during surgery to recovery, costs, and potential risks.
What Is A Brazilian Butt Lift?
The first thing to note is the name itself. “The Brazilian butt lift wasn’t invented in Brazil, which is a very common misconception,” says Rahal. “The real name comes from a 1996 surgery done by Leonard Grossman in New York, and they coined the procedure as a Brazilian butt lift because his patient was Brazilian.” Secondly, he notes that the procedure is not a “lift,” as there is no lifting or cutting of the skin. Lastly, a Brazilian butt lift doesn’t only entail a butt procedure — the surgeon will also perform liposuction of the waist, back, and abdomen.
Liposuction is a key component of the process, which people might not be aware of. “Once the fat is removed, it is processed and re-injected back into the buttocks to obtain an improved shape and contour,” says Dr. Smita Ramanadham, a New Jersey-based double board-certified plastic surgeon. “Typically, areas that may be chosen for liposuction are the stomach, back, and waist but can include the arms and legs, depending on the patient’s anatomy and goals.” She notes that the “harvesting” of the fat must be done strategically in order to sculpt the smooth, hourglass curves that people who undergo a BBL typically want to achieve.
In this way, BBL procedures can also help define areas of the body other than the butt. Ramanadham is quick to point out, however, that it should never be used as an alternative for weight loss or a healthy diet and lifestyle.
“This procedure does not have any medical benefits and is purely cosmetic,” Rahal says. “That said, there is really no such thing as purely cosmetic ... plastic surgery [can be] ‘surgery for the soul,’ because the cosmetic result is only a means to an end. The end result is more confidence and increased quality of life coming from that newfound confidence.”
What Are The Benefits Of A Brazilian Butt Lift?
A BBL’s benefits are cosmetic in nature, not medical, and include increasing the volume of the butt as well as refining its shape. A BBL can also re-contour the areas of the body, like the torso and thighs, that have undergone liposuction.
What Happens During Brazilian Butt Lift Surgery?
According to Ramanadham, the actual BBL procedure can vary slightly based on the practice and the surgical facility in which it is performed. It’s most commonly done under general anesthesia, although some doctors do perform the surgery under local anesthesia. “The surgery involves performing liposuction on different parts of the body such as the abdomen, flanks, and back to improve the contour of these areas in relation to the buttocks and to have enough fat for transfer,” Ramanadham says. “Other areas such as the thighs or arms may be used as well. This can result in a longer procedure with multiple position changes and fluid shifts within the body.” She notes that many surgeons will recommend general anesthesia in these instances to help with patient comfort and monitoring of their hemodynamics during surgery. However, she says that local anesthesia may be used if the BBL is being performed to improve a small contour deficit, depression, or irregularity, for example. “In these instances, isolated liposuction can be performed and fat transfer safely and comfortably for the patient,” she explains.
First, a fluid containing epinephrine and lidocaine will be injected via small, half-centimeter incisions. “This is infiltrated into the areas of liposuction to help decrease bleeding,” Ramanadham says. After that, the doctor will perform liposuction using those same incisions, and the technique will vary based on the surgeon. Rahal prefers to use a special variation of traditional liposuction called 360 Lipo, because he believes it gives a more “complete and beautiful result.” “In this procedure, I perform liposuction on eight areas of the body, bringing in the waist as much as possible and creating smooth curves from the armpit area down to the thighs,” he says.
In all BBL procedures, once the fat is removed, it is processed and separated from the fluid that was previously injected. It is then re-injected, via syringes or other specialized equipment, into the subcutaneous space of the buttocks. Again, where exactly the fat is re-injected depends on your surgeon’s own technique. Rahal prefers to add fat back not only to the buttock region, but also to the thighs to create more of an hourglass look. The entire procedure takes about two and a half hours.
How Long Does It Take To Recover From Brazilian Butt Lift Surgery?
While it might seem like a BBL would put a patient in an immobile state, at least temporarily, Rahal says that’s not necessarily the case. In fact, he says the initial recovery period typically lasts only two weeks. Then, patients are able to return to the office or the gym. It takes about a month before patients can safely travel, and three to see the final results. “Recovery is a little unpredictable, but on average patients are 100% ambulatory, meaning they can move around as much as they want, the following day,” he says. In fact, being ambulatory is critical to post-op care. “Post-surgical ambulation is important as it prevents the formation of blood clots that could potentially lead to a pulmonary embolism,” Rahal says. “When you walk around, you contract the muscle, and that muscle squeezes on the blood vessels, acting as a pump to allow venous drainage to move. If you don’t ambulate and remain lying down, the blood doesn’t circulate and can clot.”
Aside from being ambulatory and listening to your doctor’s instructions, Rahal says you can also do additional therapy such as hyperbarics and contactless massage therapy, like lymphatic drainage, to improve recovery.
Depending on the individual, Ramanadham says the patient may be advised to avoid exercising strenuously, lifting more than 10-15 pounds, and swimming for up to six weeks. Most doctors will also advise that patients refrain from sitting, lying, or otherwise putting direct pressure on their backside for a minimum of two to four weeks post-BBL surgery, and laying on your stomach or resting on your side with your weight on your hip instead. There are also compression garments specifically made for post-op BBL patients. “This will have an open area at the buttocks as to not apply pressure to this area,” she says. “You will be asked to either sit on your sides or on a cushion and avoid direct pressure on the areas where the fat was injected. Most often, the majority of the pain and discomfort is from the liposuction sites, which may feel sore.” Surgeons should also be able to give patients a pain regimen after surgery so that they feel as comfortable as possible during the postoperative period.
How Long Do Brazilian Butt Lift Results Last?
BBLs are permanent, as long as the patient maintains their weight. “Weight loss or gain may change the contour and overall appearance of your results,” Ramanadham says. “The remaining fat may hypertrophy, for example, with weight gain.” She notes that additionally, as people age or have pregnancies, they may develop loose skin that can change their results. According to Ramanadham, 40% to 50% of the injected fat may dissolve in the first six months to one year after surgery, which may require additional fat grafting sessions. Most surgeons should be seeing patients regularly in the first year following the surgery, and then annually after that.
“Typically, a surgeon (or their team: PA, NP, RN) should see their BBL patient at one to two weeks after surgery, four to six weeks, three months, six months, and at one year or some version of this,” Ramanadham says. “This ensures that the patient is seen for regular follow-up during key time periods of healing and any issues that may arise can be addressed in a timely manner. Of course, there can be different variations of this. If a patient has traveled and is outside of the immediate postoperative period, they may choose to see the patient virtually. Conversely, if the patient does have complications from their surgery, they should be seen more often.”
Luckily, you typically only need to undergo a BBL once, as “90% of patients are going to be happy with one round,” Rahal says. “However, patients with higher BMIs or patients looking for more dramatic results may want a second round. It depends on your desired look.”
Who’s A Good Brazilian Butt Lift Candidate?
Since post-op weight gain can affect the look of a BBL, Ramanadham says the best candidate is somebody who’s at their ideal body weight and in good health at the time of surgery. “They should be interested in an improved contour of their buttocks, which could include improving ‘hip dips,’ irregularity improvements, improved projection, or an overall augmentation,” Ramanadham says. “They should also have excess fat deposits in which the fat can be removed.”
“I typically evaluate candidates based on BMI and their desired shape, but regardless of what their height, weight, and the desired shape is, just about anyone can get it done,” adds Rahal. “I have patients anywhere from 16 to 68 years old and with BMIs ranging from 18 to 40.”
“This is a cosmetic and purely elective procedure and patients should be in good preoperative health,” Dr. Ramanadham says. “In rare circumstances, a patient may be underweight with a BMI less than 18.5 or their bloodwork may reveal malnutrition. In these cases, the patient should be encouraged with their primary care doctor to maintain a normal body weight and adequate nutrition prior to any procedure. More often than not, however, patients may present with a BMI of 30-35 or higher and we often may ask that they lose weight, as a higher BMI can be associated with more risks and complications from surgery.”
What Are The Risks Of A Brazilian Butt Lift?
BBLs are infamous for the potential risks they pose. “BBLs are typically noted to have the highest risks and complications in the field of plastic surgery,” Ramanadham says. “Potential risks can include fat embolism, which can be the most devastating. This can occur when fat is injected within the muscle and travels in a blood vessel back up to the lungs. Other complications can include blood clots, infections, fat necrosis, [when] fat becomes hard and can be painful, contour irregularities, and asymmetries. This can also occur in areas of liposuction.”
Rahal seconds this, noting that a Brazilian butt lift, like any major surgery, can be fatal if performed incorrectly. He says the risk comes from where the fat is injected during this procedure. “For [BBLs], I only inject fat beneath the skin, above the muscle, into what is known as the subcutaneous compartment,” he says. “This placement of the fat transfer is a best practice and ensures a safer procedure. Unfortunately, surgeons are often injecting fat right into the muscle to create a more dramatic result. Injecting fat into the muscle builds up pressure, causes veins to tear, and potentially allows fat to enter the vein and fatally travel to the lungs.”
Although these potential risks are cause for concern, Ramanadham says there’s an easy way to avoid them: Go to a board-certified surgeon. “The most effective and important way to minimize risks is to find a surgeon that is board-certified by the American Board of Plastic Surgery,” she says. “This is the only board specific to our field and should not be mistaken for other boards like the American Board of Cosmetic Surgery, which typically do not include true plastic surgeons.”
Every procedure can be dangerous if it’s not done properly, which is why surgeons continually educate themselves on best practices. “When done properly, cosmetic procedures are very safe,” says Rahal. “Patients should be armed with the knowledge of how the surgery is performed, how results will measure up against their goals, and if a secondary procedure is necessary to achieve their desired results.”
How Do I Find A Reputable Doctor?
Finding a reputable doctor is critical for two reasons. The first is to minimize risks and maximize safety, which is why going to a doctor who is board-certified by the American Board of Plastic Surgery should be considered the bare minimum. Once you’ve found someone who meets this criterion, ask them how often they perform the procedure. “If they are board-certified, you should select a doctor who is comfortable and familiar with the procedure and who performs it regularly, which means at least once or twice a week,” says Rahal. “The procedure can be dangerous if you lack the expertise and experience, and you simply can’t get there if you are just performing this surgery once or twice a month.”
Seeing a reputable doctor will also help ensure that you’ll be happy with the results. “Some doctors are creating a signature, very unnatural look that social media [personalities] show up with on Instagram,” says Dr. Kelly Killeen, a double board-certified plastic and reconstructive surgeon based in Los Angeles. “Most surgeons doing BBLs are creating natural results that help women feel better about themselves — some, however, I'm not so sure.”
If you need help finding an experienced, board-certified surgeon, Ramanadham suggests heading to the official websites of the plastic surgery societies or board. “Any surgeon who is qualified to do these cases will be listed on these sites,” she says. “These include plasticsurgery.org, the official site of the American Society of Plastic Surgeons; surgery.org, the official site of The Aesthetic Society; and abplasticsurgery.org, the official site of the American Board of Plastic Surgery.”
How Much Is A Brazilian Butt Lift?
Although the cost of a BBL is substantial, it can be worth it for some people who are looking for a more shapely, defined posterior. “The average cost of buttock augmentation with fat grafting is $4,807, according to 2020 statistics from the American Society of Plastic Surgeons,” Ramanadham says. However, she says this does not include anesthesia, operating room facilities, or other related expenses. A surgeon’s fee for buttock enhancement will be based on his or her experience, the type of procedure used, the office location, and how much liposuction is performed.
Once related costs come into play, you can expect to pay at least five digits. “I would say to never proceed with a doctor who charges less than $10,000,” Rahal says. “For industry standard, you can expect to pay $10,000 to $20,000, and most experienced doctors with good results would be upward of $20,000.”
In general, both doctors agree the pricing should be shared with the patient before the operation is underway, to avoid any sort of surprises post-operation. When booking a consultation, don’t be afraid to ask about the costs upfront.
Brazilian Butt Lift Reviews
Bustle spoke with two women who received Brazilian butt lifts about their experiences.
Preparation Is Key
“I turned 40 this year and wanted to do something fantastic for myself, so I endeavored upon an entire body transformation that included the BBL as my grand finale. I exercise five times a week and am in good health, but with aging, I’d look into the mirror at the reflection staring back at me and realize it’s changed so much from my youth — after having my son, my stomach skin never quite retracted, my breasts looked sad, and my bum lost its shape.
I got my BBL in early October. I’m now 11 days post-op, and while my pictures and clothing show a rounder, more pronounced rump, I’m struggling with the post-op care more than I imagined I would. While everyone’s journey is unique to them, I think in reflection I could have done more to prepare for the surgery by being on my feet more and getting a stand-up desk to be more self-sufficient. Today, I have been tired and sad and dreading putting in a full 10 hours of work tomorrow. I find myself piling my pillows on my bed and moving hourly up and down the stairs, waiting for the recovery to accelerate. [I’m still] drinking lots of water, eating pineapple, taking Bromelain supplements, and using Arnica gel and tablets.
I had to gain 15 pounds for the surgery, and I was devastated at what my body looked like. You can share your wish pics, but know that your body is going to show results unique to your physique and your physician’s skills.
The combination of liposuction and fat grafting has resulted in a successful BBL for me of added volume, defined curves, and a butt that appears plump and lifted. However, as a working woman with a desk job, not being able to sit down at all for six weeks feels [extremely difficult].” — Anonymous
“I first started thinking about getting a BBL in May 2021. I knew I didn’t want any other plastic surgery and I was happy with everything else on my body. I was never overly insecure about my butt, but if I had to change one thing about myself, that would be it. The procedure went perfectly and I am beyond happy with my results. The doctor listened to what I wanted when I said I wanted natural but noticeable results.
“The recovery process has been a lot, but nothing I didn’t expect, given my extensive research. I am only one month post-op, and final results do not happen until at least three months — but sometimes takes six months. I’m confident that I will still love my final results. I am taking great care of my new butt and I had a wonderful surgeon, which, when it comes to BBLs, are the two most important factors in great results.” — @geniexoxo
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Kwiatt, M. E., & Seamon, M. J. (2013, January). Fat embolism syndrome. International journal of critical illness and injury science. Retrieved October 25, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665122/.
Matthews, M. R., Helmick, E. A., Caruso, D. M., & Foster, K. N. (2017, June 16). Necrotizing soft tissue infection as a result of a Brazilian butt lift procedure. Trauma & Acute Care. Retrieved October 25, 2021, from https://trauma-acute-care.imedpub.com/necrotizing-soft-tissue-infection-as-a-result-of-a-brazilian-butt-lift-procedure.php?aid=19457.
Mofid, M. M., Teitelbaum, S., Suissa, D., Ramirez-Montañana, A., Astarita, D. C., Mendieta, C., & Singer, R. (2017). Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force. Aesthetic surgery journal, 37(7), 796–806. https://doi.org/10.1093/asj/sjx004
Dr. William Rahal, board-certified plastic surgeon and BBL expert
Dr. Smita Ramanadham, double board-certified plastic surgeon
Dr. Kelly Killeen, double board-certified plastic and reconstructive surgeon