Scared of dying from BBL: What are the chances?

Question

Close to my date I'm starting to see deaths. I just read how one woman died a couple months ago, and then I researched and see that alot of other women died within the last 5 years. Then, a woman in DR just died. I'm healthy, never had any major illnesses, I don't smoke, drink, or any drugs. I think to be healthy. I'm scared but really want this

Kenneth Hughes, MD · Answer

I have performed hundreds of these BBL procedures and never had serious injury or major complication.  It is possible get a fatal pulmonary embolus or a fat embolus.  It is also possible to have lidocaine toxicity or puncture an internal organ.  The risk of all of these is much less than 1%.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Martin Jugenburg, MD · Answer

Thanks for your question...There are always risks with any type of surgery, cosmetic or not. It's important you find a board certified PS with experience in performing BBL. You should also follow your surgeon's post op instructions.You can learn more on our social media (Instagram and Snapchat): @realdrsix.
  
Regards,

Donovan Rosas, MD · Answer

Fat embolus is a very serious and known complication of fat transfer (which has been recently spotlighted in the media). While it is true, injection of donor fat into the infra-muscular plane (within the muscle) increases fat viability this does come with a significant increase in risk. There are large vessels deep to and within the muscle which can be inadvertently injected while grafting leading to a fat embolus. The consequences of such a complication are very serious and life threatening.
At the recent American Society of Plastic Surgeons Hot Topics (2016), data from AAAASF (ambulatory surgical certifying body) was presented, suggesting that BBL/gluteal lipoaugmentation demonstrates a dramatically higher risk profile than other surgeries. The Aesthetic Surgery and Educational and Research Fund is convening a task force as well. The hope is that we will have more concrete guidelines for addressing these very serious complications.
That being said, the safest way to avoid fat emboli is to stay in the subcutaneous plane (at the expense of fat viability)and avoid the deeper muscular plane. If grafting of the deep plane is planned, surgeons should consider blunt cannulas, aspiration prior to injection. Using a supra-gluteal approach to minimize the risk of inadvertent intravascular injection has also been proposed.
With regards to your specific question, according to AAASF data the risk of death from BBL will range from 1:3000 to 1:6000 (subcutaneous grafting will reduce this risk relative to intramuscular grafting). By comparison the risk of fatal complication from abdominoplasty is 1:13,000.
In summary, the procedure can be safely performed, however, they should be performed by a board certified (ABPS) plastic surgeon with experience. These risks should be discussed as well as the strategies being employed to avoid them.

Andrew Gear, MD · Answer

You are correct in noting the recent spate of BBL and even liposuction related deaths in certain locales of the US and overseas.  Every surgical procedure comes with risk, and it is paramount of every patient and surgeon do their best to minimize this risk.  When it comes to BBLs and death, it is most typically due to fat embolism which occurs when overzealous and overly aggressive sub muscular fat grafting is performed in proximity to the gluteal veins.  A paper out of latin america by a collective of surgeons examined this issue and the post-mortem pathology supported the hypothesis of fat embolization.  They recommended fat injection in the subcutaneous plane (fat layer beneath skin) and superficial muscle only.  I follow these basic guidelines, in addition to using a specialty designed blunt tipped cannula and inject only while withdrawing the cannula.  There are other more global issues to consider.  Avoid clinics where you do not meet the surgeon in advance of the procedure with proper pre-operative examination and medical clearance.  Similarly, avoid clinics where you meet the surgeon the morning of the procedure and never see them again but only their nurse.  Avoid clinics that appear to be BBL mills where an excessive number of procedures  are done by one doctor in one day.  Avoid clinics that offer to do too much at once.  The more procedures you do in one setting the more the risk. Avoid non-plastic surgeons who are poorly trained and yet feel inspired to dabble in plastic surgery.  Finally, avoid air travel and/or long car rides within the first week after your procedure.  If you insist on being a medical tourist, for example, and travel overseas in the name of cost savings or theoretically better results, try and stay at least 4-6 weeks to recover through the acute post-operative period.  Good luck.

Tania Medina de Garcia, MD · Answer

Hello dear!!Thanks for the question. It's totally normal to be scared and also to see a lot of negative things when you start doing some research as a good things. But usually when you start seeing or hearing about deaths it become a chain of that kind of information.All doctors (board certified) evaluates their patients very well and do some tests and everything to be sure that you are a good candidate for surgery.I recommend you to seek for a board certified plastic surgeon for a good evaluation and to talk about your goals and concerns. If you look for the right place and right doctor you don't have to be scared, besides the normal.Good luck :)

Daniel Krochmal, MD, FACS · Answer

Thank you for your question.  There is a lot of discussion in the plastic surgery community about how to make BBL safe.  While there is always a risk, that risk is probably smaller if you are going to a well-trained plastic surgeon (an ACTUAL PLASTIC SURGEON, not one who isn't a plastic surgeon but does plastic surgery), at a fully accredited facility.  If you're traveling somewhere to go to a cheap surgeon . . . Best,Dr. Dan KrochmalMAE Plastic SurgeryNorthbrook, IL

Scared of dying from BBL: What are the chances?

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