Pre-op: Questions about BBL procedure (photos)

When doing a Brazilian butt lift where is the fat injected into the butt exactly? Without X-ray or visuals how is a doctor able to tell where to place the fat into the butt so that it is not injected directly into a vein? How does an embolism of fat get into the blood stream if it wasn't injected into a vein? What are the risk when performing a butt lift that a patient will have an embolism? What methods before during and after surgery are taking to prevent an embolism ?

Doctor Answers 5

Questions about BBL procedure?

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There are several risks associated with a Brazillian Butt Lift Procedure (fat transfer to buttocks) and the main ones are as follows:
1.  Fat embolus
2.  Infection
3.  Fat necrosis
4.  Skin necrosis
5.  Bleeding from liposuction

There is always a risk associated with every operation, but as a surgeon we try to keep it as minimal as possible.  When injecting fat, I use a blunt cannula and only inject when removing the cannula.  The fat is injected into several layers in the buttocks, including the gluteus maximus muscle and the superficial shape.  The more fat injected into the muscle the more size, the more fat injected into the superficial fat the more shape created.  You can expect to keep about 50-75% of the fat long term.  Note, there is high unpredictability with fat survival and it is different with everybody.  I also give lovenox during and after the operation to prevent blood clots.  Although these risks are present, they should be minimal with the appropriately trained board certified plastic surgeon.

Pre-op: Questions about BBL procedure

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  I use a blunt cannula that has ports for fat release several millimeters below the tip.  I have done over a thousand, but I think that no plastic surgeon can guarantee that the risk of this is 0.

Find a board certified plastic surgeon who performs hundreds of Brazilian buttlifts and liposuction procedures each year. Look for great reviews and great before and after pictures.

Kenneth Hughes, MD

Los Angeles, CA

Pre-op: Questions about BBL procedure.

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Thank you for the question and picture. 

The BBL procedure involves harvest fat from areas of your body where there is excess fat and injecting that fat carefully into the central zone of your buttock. In addition, it involves liposculpting the buttock to facilitate a more rounded look. The common donor sites for this procedure is your posterior waist/flanks, lateral thighs, back, waist, and anterior tummy. Please visit with a board certified plastic surgeon.

BBL and fat injection

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Injection of the fat is placed in mutliple layers of the buttocks duirng the procedure.  Most surgeons lay in small particles of fat as they pull the syringe back out and they use a blunt cannula to minimize the risk of causing an intravascular injection.

Where the Fat is Injected in a BBL

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Most plastic surgeons performing a BBL will inject the fat into the fatty tissues of the buttock which significantly decreases the risk of fat embolism since the fatty tissues are less vascular than the buttock muscle.  By correct positioning of the patient and through their knowledge of the anatomy, the surgeon knows where they are placing the fat.  The "feel" of the tissues as the injecting cannula is being passed is something the surgeon also uses to position the fat grafts.  By using small, blunt tipped cannulas, the risk of entering into a vein or artery is decreased.  Most surgeons also will inject as they withdraw the cannula to avoid accidental vascular injection and they inject very small amounts with each pass.
There are no ways to completely avoid the risk of a fat embolism with any fat grafting procedure, be it to the face, the breast, or the buttock but with careful and precise techniques. these risks can be minimized.  These are great questions to ask your surgeon during your consultation.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.