Brazilian Butt Lift: The Ultimate BBL Surgery Guide

Medically reviewed by Matthew Schulman, MDBoard Certified Plastic Surgeon
Written byKaryn RepinskiUpdated on May 23, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.
Medically reviewed by Matthew Schulman, MDBoard Certified Plastic Surgeon
Written byKaryn RepinskiUpdated on May 23, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.

Fast facts


A Brazilian butt lift, commonly called BBL surgery, is a popular cosmetic procedure that uses a patient’s own fat to create a higher, rounder, and fuller butt. 

In this outpatient procedure, a plastic surgeon first performs liposuction to harvest unwanted fat from other areas of the body like the thighs, back, stomach, and flanks. They purify the fat, and then use a technique known as gluteal fat augmentation to inject a portion of it into the butt cheeks (and often the hips), enhancing the size and shape of the buttocks. 

Dr. Matthew Schulman, a board-certified plastic surgeon in New York City, says that the Brazilian buttock lift has become so popular because “it is essentially two procedures in one. You are able to get rid of your unwanted fat and at the same time reshape your buttocks and hips—all without artificial injections or implants.” This combination can dramatically contour the body and create an hourglass shape.

Interested in a Brazilian butt lift?

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Pros

  • A Brazilian butt lift can create very natural-looking results when it’s performed by a skilled plastic surgeon. 
  • The lipo involved in a BBL can also contour your abdomen, waist, love handles, thighs, lower back, and other areas where you have excess fat.  
  • The fat that survives the transfer is there forever, so results are long-lasting (if you maintain a stable weight). 
  • When the fat is injected above the muscle and fascia, a BBL procedure is considered safe (more on that below). 
  • There’s no potential for an allergic reaction, since your own fat is used. This procedure also has a lower risk of infection than butt implants.
  • BBL scars from the tiny, hidden incisions for the liposuction cannula entry points are minimal.
  • Patients are usually pleased with their results. RealSelf reviewers give BBL surgery an 85% Worth It Rating, higher than the rating given by reviewers of silicone butt implants.

Cons

  • Due to some cosmetic surgeons’ risky techniques, Brazilian butt lifts have a reputation for being among the most dangerous cosmetic surgery procedures. 
  • The initial recovery period takes at least two weeks, and it can be very uncomfortable (even with pain medication). You’ll need to avoid sitting or applying direct pressure to your buttocks for several weeks post-op, to avoid disrupting the grafted fat. 
  • About 40% of the transferred fat naturally gets reabsorbed by the body during the first four months post-procedure, so results vary from patient to patient.
  • RealSelf members who rated this buttock augmentation procedure “Not Worth It” wanted more dramatic results or had dents, lumps, or slumping that had to be corrected by BBL revision surgery, at additional expense.

Hear from real patients whether their BBL was worth it, and learn more about the procedure from Dr. John Paul Tutela, a board-certified plastic surgeon in Livingston, New Jersey.

  • Average Cost:
  • $6,700
  • Range:
  • $3,700 - $15,900

Your Brazilian butt lift price will depend on your surgeon’s credentials, their location, the number of areas where your surgeon performs liposuction, the type of anesthesia you get, and a few other key factors.

Most surgeons offer payment plans or accept third-party financing options, such as CareCredit.

See our complete guide to Brazilian butt lift costs

Interested in a Brazilian butt lift?

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As you're choosing your surgeon, look for Brazilian butt lift pictures that show patients who had similar body types to your own, with the kind of fullness you’re looking for.

Pay attention not just to the butt, but also to the 360 lipo results, with an eye for proportional, natural-looking contours across the abdomen and back, with no visible lumps, incisions, or scars.

The swooping curve from the back to the lower butt should look especially smooth, with maximum projection at the center of the buttocks. Learn more. 

The BBL pictures in our photo gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Good candidates for BBL surgery:

  • Are in good health. If your provider has any doubts about whether you’re healthy enough for this operation, they may request medical tests or labs prior to your procedure.
  • Have good skin tone in the buttocks and hips. If you have lax or saggy skin, your provider may also recommend a nonsurgical skin tightening treatment or traditional buttock lift surgery (sometimes called a butt tuck), to firm or remove the excess.
  • Are at a stable weight, with enough fat in other areas to harvest for transfer.

A growing number of providers are offering a "skinny BBL" procedure for patients with a BMI below 21. Some use the BeautiFill system for fat harvesting and processing, which has an average fat cell viability rate of over 95%. 

Slimmer patients just need to keep their augmentation expectations in check: a skinny procedure involves a smaller amount of fat transfer than a traditional Brazilian butt lift, to ensure a natural result and optimal fat viability. 

An in-person or virtual consultation with a prospective surgeon should include a physical exam to make sure you’re a good candidate, discuss your complete medical history, and ensure you have realistic expectations about the outcome.

RealSelf Tip: Before you schedule a consultation with a potential surgeon, look carefully at their before and after photo gallery and zero in on before pics that are similar to your body type. Here's what to look for in BBL before and after photos.

BBL surgery takes two to four hours. Every surgeon has their own technique, but here’s a general run-down of what happens.

1. Markings and photos

  • First, your surgeon will recap your goals and the results you can realistically expect.  
  • Your skin will be marked with a pen while you’re standing up, to delineate the areas where fat will be removed and added.  
  • Someone will take your “before” photos. 

2. Anesthesia

  • Once you’re moved to a pre-op area, an IV will be placed in your arm. 
  • General anesthesia should be administered through the IV. Most surgeons perform this surgery with general anesthesia because it allows patients to be fully asleep, still, and comfortable. Some RealSelf members who’ve had it with just local anesthesia say it was very painful, even with sedation. Using local anesthesia for long surgeries like this one also raises the potentially fatal risk of lidocaine toxicity.

3. Liposuction to harvest the fat

  • In the operating room, your skin will be cleansed with an antiseptic surgical prep. 
  • Your surgeon will inject a tumescent fluid—a mix of saltwater, epinephrine, and lidocaine, to reduce pain, bleeding, and bruising—in the area where you have excess fat.
  • To perform the lipo, they’ll make one or more tiny incisions to insert the cannula (a thin tube attached to a vacuum) and suck out the fat.  
  • The extracted fat will be purified, to isolate the healthiest cells for transfer. 

4. Fat transfer to the butt

  • Using a syringe attached to a cannula, your surgeon will inject fat into the tissue just below the surface of your skin, to give the butt more projection, fill in hip dips, and create your desired contours. 
  • To avoid a life-threatening fat embolism during or after the fat transfer procedure, fat must be injected above—not within or below—the muscle and fascia. Some plastic surgeons now perform BBLs under ultrasound guidance to ensure they’re placing fat in the proper plane.
  • They will continue to inject layers of fat just below the skin until they’ve achieved pleasing contours, within the bounds of what’s safe.

To see a significant difference, you’ll need to have at least 250–300 cc of fat transfer per side.

It’s possible to have up to 1000cc (1.0L) of fat transferred, and patients looking for a dramatic volume bump often want that maximum amount of fat. However, the volume of fat transfer you’ll be able to get will depend on the capacity of your butt’s soft tissues and what the skin envelope can contain. Experts say overfilling can create constriction that leads to a greater rate of fat cell death (fat necrosis) or abscess, as the transferred fat cells struggle to establish a new, healthy blood supply. 

If your aesthetic goal requires more fat than can be placed in the subcutaneous layer in one surgery, you could have a second procedure, or even third, down the line. 

“Probably one-third of my patients come back for a second round,” says Dr. Alexander Aslani, a plastic surgeon in Marbella, Spain. “They don’t necessarily need more, but they want more. Many patients just fall madly in love with the very swollen, exaggerated look directly after surgery.”

If you don’t have enough excess fat to create that look, your surgeon may recommend a combination of fat transfer and buttock implants to get the projection you want.

Recovery time varies between two and six weeks, depending on the extent of your lipo and how well your body heals. Plan on taking at least two weeks off work, though it’s better to take four if you can get it.

Everyone heals differently, but here’s a general recovery timeline.

  • Most patients take prescription pain medication for up to a week post-op before transitioning to over-the-counter medications. Follow your doctor’s instructions for managing post-surgery pain. 
  • If you traveled for your BBL, surgeons will generally give the all-clear to fly home within 10–14 days of surgery. “Assuming patients are healthy and have no preexisting risk for blood clots, the risk of a clot from flying is highly unlikely,” says Dr. Schulman. “All of our patients are prescreened for clotting disorders, and we encourage frequent walking after surgery, to keep the blood flowing properly.” (Booking an aisle or extra-legroom seat may allow you to move about more easily during your flight.) To minimize pressure on the fat-grafted areas, get a buttock pillow that fits in an airplane seat. Dr. Schulman supplies patients with a note to present at the airport, requesting assistance through security for faster boarding. Ask your surgeon to do the same.
  • Skip vigorous exercise for the first month of your recovery. Once your surgeon gives you the OK, “lunges, squats and other exercises that cause hypertrophy of the gluteus muscles will enhance the result,” says Los Angeles–based plastic surgeon Dr. Kenneth Hughes. Just make sure your body-fat percentage is held in check, or you’ll lose some of your new volume.
  • You’ll need to wear a compression garment, known as a faja, for up to six weeks to decrease bruising and inflammation and help any loose skin retract. “Compression garments come with both benefits and risks,” cautions Dr. Aslani. “Too much compression can damage the recently liposuctioned skin and lead to so-called ‘girdle trauma’ or ‘garment burns.’” He recommends leaving the skin without compression for about an hour a day during your recovery.
  • It can take six to eight weeks or more for the majority of post-op swelling to subside and for the buttocks to soften up and feel less tight and tender.
  • By six months, any fat that’s going to reabsorb will have done so. What you see at this point is your real result, which should stick if your weight stays consistent.

Also keep these recovery tips in mind:

  • If you're traveling for your surgery, ask these questions before you book a recovery house.
  • Smoking and vaping can increase the risk of serious complications and compromise your ability to heal, so you’ll need to abstain from all nicotine products during recovery.
  • If your doctor recommends lymphatic massages to help manage Brazilian butt lift side effects, choose a masseur who has experience with BBL aftercare, advises Dr. Aslani. “Massage in the wrong place can be detrimental to your results.”

Related: 8 Products Plastic Surgeons Recommend For a Successful Brazilian Butt Lift Recovery

RealSelf Tip: Some patients use the term "fluffing" to refer to the natural tissue settling after BBL surgery. But according to numerous plastic surgeons on RealSelf, there’s really no such thing as “fluffing” after a BBL. The word “is usually used for breast augmentation and describes the phenomenon that occurs over several months in which the implant will drop into a more natural position and the tissues will relax allowing the implant to fall in a more soft and natural formation,” Philadelphia plastic surgeon Dr. Christian Subbio explains. 

“I suppose one could describe some aspects of a BBL in a similar way: Initially the buttocks is inflated and tight from all the fat injected, but with time, some of that fat will dissolve, swelling will dissipate, and the tight and inflated appearance will drop and settle some, becoming rounder and more natural,” says Dr. Subbio. As liposuction-related swelling diminishes, your waist will appear smaller, which can make the butt look curvier by comparison.

Avoid sitting or lying directly on your butt for at least two weeks post-op, to allow the new fat grafts to establish blood supply. Transferred fat only lives if new blood vessels grow into it, and the pressure from sitting can compromise your results by causing fat cell death.

After two weeks, your surgeon may allow you to sit on a special donut-shaped pillow that redistributes pressure to your thighs.

Related: The 5 Best Post-Operative Pillows for the Most Uncomfortable Surgeries

Doctors on RealSelf recommend waiting up to four weeks to have sex after a Brazilian butt lift, but this is really a personal choice. 

“I tell my patients that as long as they are comfortable, and avoid pressure on the butt, they can have sex as soon as they feel up to it,” says Dr. Schulman.

You’ll see much more volume immediately, but It can take up to a full year to see your final results.

During the first four months post-op, up to 40% of the transferred fat cells can be lost. The worst of the swelling should have resolved at this point, but it will continue to resolve over the coming months.

After a year, asymmetry, dents, or less-than-ideal results can be improved with additional fat transfer to your buttocks, if you’re up for the additional expense and have enough unwanted fat left to harvest.

The fat cells that remain about four months post-op will stay permanently. 

That said, weight fluctuations can impact your results: too much weight loss will slim down your butt, while gaining a lot of weight can alter your proportions as the remaining fat cells grow.

Related: Plastic Surgeons Say Doing These Two Things Can Ruin Your BBL Results

Dr. Schulman explains that the ability of your results to change with you is part of the appeal. “The beauty of the Brazilian butt lift is that since it’s your own living fat cells, it will change as your body changes.”

Yes, a tummy tuck and a Brazilian butt lift can be combined, allowing you to “avoid having to pay some fees twice, such as the facility and anesthesia fees,” says Dr. Scott Chapin, a plastic surgeon in Doylestown, Pennsylvania.  

However, there is a downside: combining the two increases OR time and risks, and it makes for a very difficult recovery, leaving you unable to sit or lay on your belly for several weeks. 

For these reasons, a number of doctors on RealSelf advise against pairing the procedures. Dr. Schulman has safely performed thousands of BBL and tummy tuck combo operations, but he notes that “a combination procedure is not for everyone.”

BBL surgery is not so dangerous, when done right. But it has a reputation for being risky, due in part to a spate of BBL deaths that occurred several years ago in the hands of uninformed surgeons, who were injecting fat into and below the gluteal muscle, causing fatal blood clots. 

Stigma surrounding the BBL was further heightened by a 2017 study—later deemed flawed by BBL thought leaders—which calculated the risk of death from a BBL to be between 1 in 6,214 to 1 in 2,351.

Further study revealed a more accurate Brazilian butt lift mortality rate of 1 in 14,952 patients, which is similar to that of an abdominoplasty (tummy tuck), when it’s performed by a board-certified plastic surgeon following the latest safety protocols.

A review of gluteal fat grafting published in the Aesthetic Surgery Journal (ASJ) in May 2023 underscores “increasing evidence regarding the safety of subcutaneous gluteal lipofilling
 principally related to new technologies, surgical techniques, and training being developed to avoid intramuscular injection of fat.” The authors go on to note that “patients seeking surgery at unregulated facilities or via medical tourism are deemed to be at higher risk of being exposed to serious complications.”

Another new study looks specifically at the unusually high rate of BBL fatalities in South Florida, which, according to the authors, “carries the highest BBL mortality by far in the nation.” The plastic surgeons (both BBL experts) who conducted the research reviewed the anatomic findings from 11 post-BBL surgery autopsies and found that, in all cases, fat was injected into the gluteal muscles. They also discovered that “the great majority of patients (92%) [underwent] surgery at high-volume, budget clinics located in South Florida,” and that “short surgical times of approximately 90 minutes appeared to be the norm for these cases.” Some surgeons we’ve spoken to refer to these practices as “assembly lines.” 

Brazilian butt lifts are known to have the highest incidence of post-op complications of any plastic surgery procedure, but the most common ones are cosmetic and fixable: irregular contours, dents, or lumps.

The aforementioned ASJ study includes hypothermia, sepsis, skin necrosis, poor aesthetic results, and fat embolism among more serious risks and complications of the BBL.

A pulmonary fat embolism can generally be prevented if the surgeon stays above the gluteal muscle and away from veins. The danger comes in if a surgeon penetrates the fascia or injects into the muscle, a technique that can create more volume at the expense of patient safety.

“An embolism occurs when an injection cannula injures a vein, allowing injected fat to enter the vein,” says Dr. Ricardo L. Rodriguez, a plastic surgeon in Lutherville, Maryland. “The gluteal region is very vascular—there are a lot of blood vessels in and below the gluteal muscle.” 

Fat that enters a vein can be carried into the heart or lungs, blocking critical vessels. This can quickly lead to death—even on the operating table.

Again, while the procedure has a notoriously dangerous reputation, plastic surgeons have been studying BBL risk factors and refining techniques, to make the procedure safer.

To further reduce the risk of complications, Dr. Rodriguez advises having surgery in a facility that’s accredited by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), an accredited ambulatory facility, or a hospital.

See our complete guide to BBL safety

When choosing your plastic surgeon, ensure that they:

  • are board-certified in plastic surgery by the American Board of Plastic Surgery
  • are a member of a reputable society, like the American Society of Plastic Surgeons or The Aesthetic Society
  • have performed hundreds (if not thousands) of BBL procedures
  • can show you an impressive array of before and after photos, including patients who look like you
  • are trained in the most up-to-date techniques and safety protocols (and willing to tell you about them)
  • walk you through all Brazilian butt lift risks and complications

For a complete list of essential questions to ask, see our BBL surgery consultation checklist.

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Sculptra MobileSculptra

nonsurgical

Butt Lift (Page Image)Butt Lift

surgical

Worth It Rating85%76%74%79%88%
Average Cost$6700$1775$3000$9800$7875
Downtime2–6 weeks of downtimeMinimal downtimeNo downtime2 weeks of downtime2–3 weeks of downtime
AnesthesiaGeneral anesthesiaTopical anesthesiaNo anesthesiaGeneral anesthesiaLocal anesthesia with IV sedation or general anesthesia

If you’re on the fence about this procedure, there are a few other butt augmentation options worth considering.

Nonsurgical treatments

  • Sculptra is an FDA-approved facial filler designed to stimulate your body’s natural collagen production. Some plastic surgeons use it off-label for a buttock enhancement procedure called a Sculptra butt lift. The downsides: results fade after about two years, and the procedure can cost almost as much as BBL surgery if you want dramatic improvement. 
  • Emsculpt uses high-intensity electromagnetic energy to contract your butt muscles up to 20,000 times a minute. It’s FDA-cleared for toning and firming the buttocks (as well as stomach, arm, and leg muscles), but the results cannot mimic the results of a BBL.  

Surgical procedures

  • Butt implants add volume, even if you don’t have enough of your own fat to transfer. Some surgeons recommend a combination of silicone implants and fat transfer because fat can be shaped more precisely. 
  • A butt lift (from above) or lower buttock tuck (from below) is often a better choice for people who have lost a significant amount of weight and been left with sagging skin. The surgery removes extra skin for a smoother, tighter appearance. 

Doctors actively warn against liquid silicone, acrylic, and hydrogel injections. Unscrupulous injectors often use industrial-grade silicone (sometimes in their home, a hotel room, or at a nail salon) for a procedure some call “butt shots.” None of these injections is FDA-approved for body contouring, and all can cause serious, permanent side effects, including debilitating pain, tissue death, or patient mortality. See the FDA’s safety warning. 

RealSelf Tip: Some workout franchises use “Brazilian butt lift” in the marketing for their exercise regimens. While workouts that target the muscles in your rear can shape and lift it, that toned appearance is very different from the curvy look that a BBL achieves by adding more fat.

Updated May 23, 2023


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4 Alternatives to a BBL—from Implants to a Sculptra Butt Lift
The 5 Biggest Butt Implant Risks
I Got a Brazilian Butt Lift Under Local Anesthesia—and Later Discovered My Doctor Wasn’t a Plastic Surgeon
Don’t Like Your Butt Augmentation? Here’s How to Reverse BBLs, Injections, and Implants