Brazilian butt lift: Compare practices from our network

A BBL combines liposuction and fat transfer. Fat is harvested from areas such as the abdomen, flanks, back, or thighs, processed, and then injected into the buttocks to add volume and improve shape.

Because it uses your own tissue rather than an implant, the result feels natural. It is a contouring treatment, and it depends on you having enough donor fat to work with.

BBL has historically carried the highest mortality rate of any cosmetic treatment. The mechanism is well understood: fat injected into or beneath the gluteal muscle can enter large veins and travel to the lungs.

Contemporary practice has changed accordingly. Safer technique means:

– Fat placed only in the subcutaneous layer, above the muscle

– Cannula angled away from deep structures throughout

– Increasingly, real-time ultrasound guidance to confirm depth

– Conservative volumes rather than maximal transfer

These are reasonable things to ask your surgeon about directly, and a specialist will welcome the question.

A BBL suits people in good health with enough donor fat and reasonable skin elasticity. Your surgeon may advise against it if you:

– Do not have sufficient fat to harvest for a meaningful result

– Are at an unstable weight, as fluctuation changes the result

– Smoke, which impairs both healing and fat survival

– Cannot avoid sitting directly on the buttocks during early recovery

– Have a condition affecting healing or blood clotting

01 Consultation and planning. Your surgeon assesses your donor areas, skin quality, and buttock shape, and discusses what volume is realistically achievable from the fat available.

02 Preparations. Medical evaluation, medication adjustments, stopping smoking, and arranging recovery at home including how you will sit and sleep.

03 Anesthesia. Usually general anesthesia, with monitoring throughout by an anesthetist.

04 Harvesting. Fat is removed by liposuction from the agreed donor areas, which also contours those areas as a deliberate part of the result.

05 Processing. The harvested fat is purified to separate viable fat cells from fluid and debris, improving the proportion that survives transfer.

06 Transfer. Fat is injected in small amounts across multiple passes in the subcutaneous layer above the muscle, building shape gradually rather than in one deposit.

Recovery has one distinctive feature: you must protect the transferred fat from pressure while it establishes a blood supply. This shapes the first weeks considerably.

– Avoid sitting directly on your buttocks, typically for two to three weeks, using a cushion when you must sit

– Sleep on your front or side rather than your back

– Wear the compression garment on donor areas as directed

– Avoid strenuous exercise for around six weeks

– Maintain a stable weight, as fluctuation alters the result

Swelling in both donor and recipient areas settles over months. Because a proportion of transferred fat is reabsorbed, final results are judged at around three to six months.

BBL carries the risks of both liposuction and fat transfer, and one risk specific to gluteal injection:

– Fat embolism, the serious risk associated with deep injection, and the reason technique and depth matter so much.

– Partial fat reabsorption, expected rather than a complication, but it affects final volume.

– Contour irregularity or asymmetry, in either donor or recipient areas.

– Fat necrosis, where transferred fat does not survive and forms firm lumps.

– Infection or seroma, uncommon but possible at donor or transfer sites.

– Blood clots, a consideration in any longer operation.

When to seek medical attention:

– Shortness of breath, chest pain, or coughing, which require emergency care immediately

– Fever, or increasing redness, warmth, or discharge at any incision

– Severe or worsening pain not controlled by prescribed medication

– Swelling or pain in one leg

Contact your surgeon's practice directly, or seek emergency care, if you experience any of the above.