Brazilian Butt Lift. I read about deaths related to fat embolism. Is this procedure dangerous?

hello Ava,It is great that you are taking the time to learn more about these risks. There have been a number of deaths from PFE (pulmonary fat embolism), and it is a fact that this procedure carries the highest mortality rate compared to any other cosmetic surgery procedure.  As a patient, your first obligation towards safety is to make sure your surgeon is Board Certified by the American Board of Plastic Surgery , and that the surgical facility is properly accredited. However, even board certified plastic surgeons have had mortalities. So it is incumbent upon you to ask your surgeon to explain how he performs the procedure.   As others have noted, our national society, the ASPS , has been actively investigating the issue. An inter-society Gluteal Fat Grafting Task Force team was formed over a year ago which included 19 Plastic Surgeons worldwide.  Earlier this year and over the summer we (yes, I am a member) issued some preliminary guidance for surgeons to inject only in the subcutaneous regions when injecting into the buttocks. The subcutaneous space is the area immediately below the skin and above the gluteus muscles.  We know with certainty that ALL of the reported deaths did have fat injected into the gluteus muscles.  This is why the Task Force made the recommendation to inject into the buttocks only subcutaneously.
Gluteal Fat Injection is technically a "blind procedure" because you cannot see thru the skin.The only way to ensure that you are not injecting in to the intramuscular plane is to put your cannula tip right up the skin when you inject and inject only small amount while retracting the cannula. Continuous injection methods or pump driven injection methods run the danger of injecting throughout the path of the cannula without knowing what plane (subcutaneous or intramuscular) the path is in.  For this reason, I believe that injecting small amounts in each injection pass manually is the safest technique. 
On the Task Force, we have been discussing these issues and studying autopsy report of the fatalities. Most recently, the ASPS , ASAPS, ISAPS,  IFATS,  and ISPRES societies have conducted two sessions of anatomic cadaver dissections in Miami over the summer months.  We injected fat and monitored it's pathway.  The report will take some time to produce, but much information about safety has been gleaned.
I am not at liberty to share the results of the sessions , but I will tell you that most all of  what I wrote in my December 2017 blog post listed linked below remains highly relevant. I encourage you to keep researching the topic , ask questions, and continue staying informed.I do believe that this procedure can be performed safely and with excellent results if your surgeon can ensure that he is injecting only in the subcutaneous space. Best of luck. Ricardo L Rodriguez MD

When done incorrectly BBL can definitely be unsafe with a death rate around 1:3000. When done by a board-certified plastic surgeon with the fat injected only into the subcutaneous space, not the muscle, and using the cannula angles recommended by the ASAPS/ISAPS then it is much safer. Discuss your concerns in person with your surgeon before you proceed to make sure you are comfortable. Best of luck! 

Hello AvaMassi,
It’s a pleasure to answer your questions! As with every surgery, there are some risks associated with Brazilian Butt Lift (BBL) surgery, such as fat embolism, numbness, and infection, among others. However, an experienced and specially trained plastic surgeon can help diminish those risks significantly. Actually, there is a low mortality rate for BBL of approximately 1 in 3,000, according to statistics issued by the American Society of Plastic Surgeons in March 2018. Research has uncovered a correlation between the fatalities, suggesting that death occurred during cases in which a plastic surgeon injected beyond the subcutaneous fat layer. The importance of selecting a meticulous plastic surgeon with the ability to safely perform the surgery cannot be overstated. Limiting injections to the superficial planes (namely, the subcutaneous space) may be an effective way to minimize the risk of harm. Moreover, careful control of the cannula (the surgical instrument used to transfer fat), as well as cautious placement of access incisions, can help ensure a superficial trajectory for the fat transfer that occurs as far away from the gluteal veins and sciatic nerve as possible. Hope this is helpful! Dr. De La Cruz.