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!