BBL infections PLEASE HELP!

Lately I've been coming across many posts about the BBL infections. My question is where are they coming from? The sterility of the surgery center should be 100% as well as the equipment... so does that mean that the room or the procedure wasn't sterile? Any other situations that the patient can get infection from? And also what kind of infections are possible? any cautious advise? Doctors, I would appreciate your answers since many girls been talking about that. Thank you!! Redmimi

Doctor Answers 7

Sterility, Quality Control, Non-Board Certified Plastic Surgeons & Traveling Overseas for Surgery

Hi and great question. I appreciate the time you are spending researching this procedure.  I know tone can get lost in an email.  I am not angry, upset or trying to be negative in the below response.  I am simply being passionate and am concerned about the health and safety of a number of individuals.    

First, infections are a real risk to surgery and they will happen a given % of time.  That is why complications/risks are told in %.  I wish there was some way to avoid any and all risks/complications 100% of the time; but there just is not.  
With the increasing medical tourism, I believe you will see a significant increase in the number of negative complication/risks to surgery.  Why?  Because the very questions you are asking regarding sterility and making sure things are clean and run to protocol are the jobs of certifying entities.  And in many cases at the medical tourism locations they DO NOT EXIST.  Why?  Because they incur a cost and expense.  These costs & expenses then make the surgery more costly.  As individuals try to get increasingly competitive and offer ultra-low surgery costs something needs to get cut expense wise and most of the time that is quality control, additional instruments, and/or the cost of sterilizing medical equipment.  The old phrase, "You get what you pay for" is extremely valid in these points.

The last thing is selecting a Residency Trained and Board Certified Plastic Surgeon.  Why would I bring this up?  Because even within the United States and on these Discussion Boards, I hear people raving about physicians that were Family Doctors or Primary Care Physicians that decided to start doing Cosmetic Surgery.  They have ZERO RESIDENCY TRAINING in Operative Procedure Protocol, Sterile Procedure Protocol, and/or Surgical Technique Protocol.  It is crazy.  What if I decided to be a Nuclear Physicist without any training and run a Nuclear Plant...bad idea with bad consequences.   

I hope that helps. Let me know if you further questions. Best of Luck!

Matthew J Nykiel, MD
Butt Augmentation Specialist
Cosmetic Surgeon
Board Certified Plastic and Reconstructive Surgeon

BBL infections PLEASE HELP!

Hello redmimi,
Thanks for your question.
BBL infections have never happened in my personal practice experience.  That being said, there are several conditions that exist that may enhance the chance of infection.

1. Smoking slows down healing and increases the chance of other complications including infection.
2. Diabetes affects the immune system, and diabetics are more likely to develop post-surgical infections.
3. Poorly nutrition before and after surgery affects how a patient will heal and this can increase the chance of infections.

When I prepare fat grafts before injecting them into the buttocks, I always wash the grafts with saline and antiobiotic irrigation to protect the grafts in those important first few days after surgery.  Microinjections of fat increase the chance that they will get a good blood supply and survive.  If fat doesn't survive, it is more likely to get infected if the body can't absorb it quickly.  Aggressive icing of the buttocks helps lower the metabolism of the fat cells so they can tolerate the time it takes to develop the new blood supply and survive at a higher percentage.
All surgery carries risk, but if your surgeon is well-trained and takes the necessary measures, your chance of developing an infection with BBL surgery is very low.
I hope this helps.
Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

Infections following surgery

Thank you for your question. Unfortunately infections can happen with any kind of surgery and patients who are unhealthy, diabetic and smokers are at much higher risk for infections.  
When someone is deciding to have elective surgery, one should seek out a board certified plastic surgeon that performs the surgeries in an accredited center. Hope this helps. 


Hello, Everyone has complications...BUT there are many non certified "doctors" doing procedures in non accredited facilities these days. I recommend doing your homework, choose a board certified plastic surgeon who operates at an accredited surgery center or hospital. That alone should decrease your odds of having a complication. Good Luck.

BBL infections PLEASE HELP!

Thank you for your question. With every surgical procedure, infections are a risk. As surgeons, we take as many precautions as possible to prevent infections because a post-op infection can be a devastating complication. That being said, there is no such thing as 100% in medicine.

If you are concerned about infections, your best bet is to make sure your procedure is being done by a board certified plastic surgeon (certified by the American Board of Plastic Surgery) and to make sure the procedure is being done at an accredited surgery facility (inspected and certified by either a state agency or surgery facility inspecting institution). You can ask your surgeon about the steps he or she takes to prevent infection, but even in the most cautious of surgeons, the risk of infection is never zero. The only true way to prevent a complication from a procedure is to not have the procedure. 

Best of luck!

BBL infections? What happens?

Hi Redmimi,

Thanks for your question. Infections are a risk anyone takes with any surgery. They do happen. It is uncommon. But now with everyone being on social media and the internet, the 1-5% of people that develop infections seek help online and thus it may seem more likely. 

When fat is placed into the butt for a BBL, there is higher risk of getting an infection due to the fact that the fat is not alive yet because it does not have blood supply to fight infections. Also, based on the location, there higher chances of getting below the belly button bacteria such as those in feces that can contaminate the surgical incision which even though small can be colonized and the process into deeper tissues since there is a pathway from the fat placement. 

Good hygiene is important, some coverage with antibiotics from your doctors to prevent it. I believe that all certified plastic surgeons use sterile equipment and do the best job possible to prevent infections.

Chose your future surgeon on experience and the ability to know how to handle complications(even though rare) who can give you the result that you expect. Good Luck!

All the best,
Carlos Mata MD, MBA, FACS
@BBL @infections @docmata #drcarlosmata
Board Certified Plastic Surgeon

Infections and BBL's

All surgeries are done using sterile equipment and sterile technique.

There is technically no such thing that's true sterility when operating on something that is alive.

Skin pores have bacteria and even with antiseptic soap scrub some of those bacteria remain alive during the procedure.

Surgical infections are caused by bacteria from the patients themselves.

They're not introduced from surgical instruments or operating rooms.
Liposuction has an exceedingly low infection rates.

One reason for this is bacteria generally do not live well in fatty environments. Hence cooking oils tend to not need to be refrigerated and have a long shelf life's.

Also during liposuction fluid and tissue are continuously being removed so any potential bacteria that is introduced by passing through the skin or skin pores may be present as a high likelihood of being removed back out again. Fat transfer has the opposite effect.

Fat is being introduced at a left inside tissues.

The body typically warrants off invasive bacteria by a very effective immune system.

In order for either our own bodies immune system's or antibiotics to work there has to be an active blood supply to the physical contact of a bacteria potentially causing an infection.

Fat removed during liposuction and reinjected does not have a blood supply.

The grafted fat is therefore serves as a hiding place for bacteria where the immune system and anabiotic's cannot get to it.
On top of this a substantial amount of the grafted fat does not survive and becomes chronic.

Necrotic tissue is an excellent hiding place for bacteria and can serve as a place where infections can take off and immune system cannot control them.

On top of this the grafted fat is ejected deep underneath the skin down into the muscle layers.

This makes detecting early infections difficult.
Surgical infections almost always need to be physically opened and drained.

This can be technically difficult and devastating to do in a deep infection that's far away from the skin.
The incisions made to drain infections cannot be sutured back together I need to be left open.

This will generally leave scars and often contour distortions that can be disfiguring.

surgical technique and surgical judgment are critical in minimizing surgical infections.

This has less to do with sterile instruments and more to do with how the fat is harvested and even more so how it is injected.

The amount of fat and where the fattest placed can help minimize the chance of postoperative infections.

The Internet presence of one media savvy plastic surgeon encouraging 20 happy patients to leave excellent reviews still has a relatively small impact on the perceived success of a certain procedure.

One or two of patients with complications that may be upset and angry with ample time on their hands leaving post on every website can cause a few instances to look like an epidemic.

When things go wrong patients typically don't remind them selves of the consent form signed but are often saying this shouldn't happen and why did it happen to me.

Often patients will say something must've gone wrong because this shouldn't happen.

The truth is it happens. It happens to the very best surgeons. The only surgeons who don't have complications are the ones who are not operating.

If there's a take-home message with this it is the importance of vetting the competency of your doctor. Making sure you're in the hands of a local board-certified plastic surgeon who is trained to first and foremost recognize complications early.  Is trained in treating all complications related to the procedure and has privileges in the hospital where potential complications can properly be treated.

While complications are always possible including serious complications it's important to look at complications in relative terms.
Think of it like this.

Anyone can be struck by lightning or be run over by a bus. Both are often fatal but are also exceedingly rare.

Luckily infection from Brazilians are uncommon but when I do happen can be devastating complications especially when not recognized early or treated appropriately.

Perhaps the worst case scenario is being treated in another country than being alone thousands of miles away without access to your doctor while the infection grows out of control with no doctor available to treat the patient.

discuss a potential complications with a board-certified plastic surgeon before having any procedure.

Well inform patients do better and have an overall higher sense of satisfaction from all cosmetic surgical procedures.

my practice is exclusively devoted to liposuction and fat transfer only.

Of the 2500 procedures are performed in the last five years since I began sub-specializing in these two procedures I have a one serious infection.

That patient required being hospitalized for five days, have a small incision and had a good final outcome.

For the ride patients, Brazilians can give body transformations that are amazing last for a lifetime.

Always get multiple consultations.  

Do your research.  

Make sure you're in the hands of a board-certified plastic surgeon with expertise, experience and a superb online reputation before proceeding with the steps and procedures.


Mats Hagstrom M.D.

Mats Hagstrom, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 17 reviews

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.