Complications & Death from a BBL? (Photo)

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% if you are healthy and lab work has been cleared by your plastic surgeon.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

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. While this will likely impact graft viability negatively, it will also lower the risk of a serious complication.
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.

This is a very pertinent question.
As you know, every procedure has its risks. It is the job of the surgeon to go over these risks with you.  And before plastic surgeons operate on their patients, they will perform a history and physical examination. Should any issues show up, like chest pain and shortness of breath, patients are usually referred to an appropriate specialist for further evaluation.
There will also be some things for you to do, before surgery, to decrease your risks. Smokers are placed in a program to stop smoking. Women on birth control pills are asked to stop at least two weeks before and after surgery to decrease the risks of blood clots in the legs and lungs. And Surgeons usually provide a long list of medications or herbal supplements to stop before surgery.
Having a history and physical examination and optimizing yourself before surgery can go a long way to reducing your risks for BBL surgery, especially if you are a healthy 23 year old female.
Now, is there anything about BBL surgery that makes it riskier? To be honest with you, there may be a few things, but these risks are still in the process of being studied and identified. However, a recent task force study from the Aesthetic Surgery Education and Research Foundation (ASERF) identified a few aspects of the BBL procedure that could make it safer. 
Here is a list of some of the things that can be done to make the procedure safer:
    1) If your surgeon is not experienced, consider injecting the fat above the glutteal muscle                       2) Use cannulas larger than 4mm diameter to inject the fat                                                                       3) Surgeon should avoid injecting in a downward fashion (the glutteal veins are deep)                             4) Proper positioning of patient to avoid injecting in the deep veins                                                            5) Use an experienced surgeon familiar with the glutteal region and anatomy
So my advice for you is to find an experienced surgeon. Ask him if he is aware of the task force study and if he implements any of these findings to help make the procedure safer.
Good luck!

In general, the procedure is very safe, but there are rare risks. In general, you are better having the procedure close to home where you can get good follow-up care.  Good luck.

While very rare, it can occur due to either fat embolism (direction injection of fat into a blood vessel) and pulmonary embolism. To be frank however, you already have a butt and a BBL is unnecessary.  You do appear to have rectus diastasis (six pack muscle separation after pregnancy) and a tummy tuck will fix that.  A BBL will not.  I would seek counsel with a board certified plastic surgeon who does both.  It is important to ask your surgeon about their safety record, including complications, hospitalizations, and death.    

Hello dear!!Thanks for the question and provided information as well.As you mentioned, any surgery have those complications, and it's totally normal to feel that scared and worried, but the important thing to do is to relax, think positive and talk with your plastic surgeon about your concerns and goals.Good luck :)