How safe is BBL? Should I wait?

Hello, I have done a lot of research on this exact topic. Please see a board certified plastic surgeon for an in person consultation to discuss having this procedure performed. Every surgery procedure has its risk but having the procedures done by an experienced board certified plastic surgeon makes it safer. Of course technology gets better with time, but theres no need to hold off on a procedure that is performed everyday with no issues. Again please see an experienced board certified plastic surgeon. Hope this helps,Dr. Germán Newall Houston Board Certified Plastic Surgeon 

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.
BBL/gluteal lipoaugmentation demonstrates a dramatically higher risk profile than other surgeries. The Aesthetic Surgery and Educational and Research Fund has convened 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 and 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.
According to AAASF data the risk of death from BBL will range from 1:3000 (subcutaneous grafting should reduce this risk relative to intramuscular grafting). By comparison the risk of fatal complication from abdominoplasty is 1:13,000. It is unclear how the relative risk falls with subcutaneous injection vs. intramuscular injection (however, in all likelihood, it is less).
No result is worth risking one's life for. I find that the patients who focus not on the volumization but rather the contouring benefits of the liposuction are happier than those whose sole goal is size. Relatively speaking, the subcutaneous plane is the "safe" plane.
With regards to your specific question, the procedure is clearly high risk. However, as more is learned about the procedure one of 2 things will occur: BBL will become safe or BBL will no longer be performed. It is difficult to say where we will be in 1-2 years. However, the best advice is to be informed of the risks and the measures that can be employed to mitigate these risks.
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.

Thank you for submitting your questions.The pulmonary fat embolism is a mechanical blockage of the pulmonary veins by fat particles. It occurs when injection technique injures a vein and fat particles travel through the venous system and the pulmonary veins to the heart. While not all PFE’s are fatal, many do result in death within the first 24 hours following surgery. Another common sense thing is to make sure your Plastic Surgeon is Board Certified by the American Board of Plastic Surgery. There are many doctors who are performing the BBL who do not even have any type of Surgical Residency, which is utterly mind blowing. The public should beware that there has very recently been an organization founded of 'Gluteal Surgeons'  who accept as members NON Board Certified Plastic Surgeons. I highly recommend you consult with a Board-certified plastic surgeon for maximum results. Best of luck.