Why in DC Are Doctor's Charging $17,000 and Up for a BBL when My Gastric Sleeve Was That Price?

According to most of the Doctor's on here they say that if done right a BBL is not a very risky procedure. The Gastric Sleeve is pretty risky. All surgery is risky, but I would think a surgeon doing a Gastric Sleeve should charge more than a doc doing a BBL. Why are they 8,000-10,000 in Florida and 17,000-20,000 here in DC. This just doesn't make any sense. I could see US v. Mexico! I really want this done, but DC is outrageous. I really want to understand.

Doctor Answers 5

Why Pay $17K For the Brazilian Butt Lift?

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The cost of surgery isn't based solely on how risky it is.  In most cases, it is based on how long it takes to perform.  The Gastric Sleeve procedure takes about 1-2 hours.  That's 1-2 hrs of your surgeons time, anesthesia time and operating room time.   The Brazilian Butt Lift, when done well, takes 6-8 hours, depending on how much fat you have to remove and how much you want injected into your buttocks.  That again includes surgeon time, anesthesia and operating room time.  I wouldn't rate the Gastric Sleeve surgery being any more risky than Brazilian Butt Lift surgery.
There is no question that some surgeons are performing the BBL much cheaper and in half the amount of time as others.  What most patients don't understand is that your results will also be determined by how long the surgery takes.     
Plastic Surgeons all use similar liposuction machines.  That means that the fat removed comes out at the same rate for all of us. But if you want to have more live fat cells injected, the suction pressure has to be turned down or the fat cells will be killed due to the force of the vacuum pressure.  Therefore, to maximize the number of live fat cells, it takes even longer for the fat to be removed due to the reduced suction pressure.  The amount of fat removed is therefore directly related to how long it is performed.  Also,  fat can only be injected at a certain rate.  Injecting more quickly, results in dead fat cells and a waste of your money. 
The fat removed needs to be purified.  There are many different ways to do this.  Some result in more pure fat cells than others.  The less concentrated the fat cells are when injected, the more liquid you will be receiving and the fewer fat cells.... again lessening your results.

Many surgeons are performing this procedure in about 3-4 hours, removing half the amount of fat you would have removed in 6-8 hours and injecting diluted fat cells.  This will look great initially, but your buttocks will shrink as the fluid gets reabsorbed and the dead fat cells break down over the next few months.  But, look at the bright side...... they do it for you for about 1/2 the price. 
I have performed the Brazilian Butt Lift procedure for about 15 years now.  I have had many patients come to me who have had the procedure done in about 1/2 the time and for 1/2 the price of what I charge, then ask me to re-do it for them using my technique because their results just didn't last more than a few months.

Why in DC Are Doctor's Charging $17,000 and Up for a BBL when My Gastric Sleeve Was That Price?

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            I typically charge much less than $17000 and I am in Los Angeles.  I typically liposuction 5 liters and transfer 1200 cc to 1800 cc per buttock.  The procedure typically takes about 2 hours.  Find a plastic surgeon with ELITE credentials who performs hundreds of Brazilian buttlifts each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Why is a BBL so expensive in some areas?

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I agree with my colleagues as they all raise valid points. Prices will vary from surgeon to surgeon adn from area to area. You cannot equate one surgery to another and try to figure out price that way. A BBL is a complex procedure and takes incredible expertise. The reason why it is "less risky" than your gastric bypass is because it is being done by experienced surgeons who can make your risk low.  There is no insurance contribution here, so the fee you pay will have to cover everything - the anesthesia, the facility, the equipment, the nurses, the medications, the garment, the surgeon fee, and also all the post operative care involved usually for life.  You may want to seek several price estimates from other surgeons, but with this type of surgery, you often get what you pay for.

Buttock augmentation

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Dear citychicdc,

    I can not tell you why they charge that amount, but we live in a competitive society and you can find different range of prices. My question to you is, what is your goal ?  BBL involves 2 procedure - lipo and fat injection. If you are interested only in the butt augmentation, I would suggest to you silicone implants and the cost is half of the price you have quoted. Moreover, fat injection is unpredictable and the fat disappear completely or almost completely after 1 year. Silicone implants do not disappear and they feel and look natural. Consult with a board certified plastic surgeon who is experienced in that procedure. Check the before and after pictures and make sure that you like the results. There is a variety of implants shapes and consistencies and the implants can be placed in different anatomic  locations.

            Best of luck,

                                       Dr Widder


Brazilian Butt Lift Cost- Why is it expensive?

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hello citychic--

I would agree with nearly all of Dr. Markmann's points. In order to get long lasting results, such that a revision, or 2nd procedure is not needed, the surgeon must take great care in these three aspects of the Brazilian Butt Lift procedure. If these are not performed correctly, the fat graft will not last:

  • extraction of fat--Removal of fat must be done under low pressure with a thin cannula. Thin cannulas require more time to remove the fat. Additionally, the surgeon must take out ~ 3-5 times the amount that will be reinjected
  • processing of fat- If you desire LONG LASTING results, only a portion of the fat extracted can be used for the reinjection. We decant and centrifuge the fat to remove adipocyte fat cells that will die if they would be reinjected. If I start with a litre of fat, I will process it down to much less than 1/3 or 1/4 of what I started with.
  • reinjection of fat into buttocks- To yield long lasting results , the injections must be performed in tiny injections at different levels and depths of the buttocks. This is critical to fat graft survival in the buttocks.

Therefore, if you want long lasting results, the procedure really does take 6-8 hours. Additionally, the procedure should be performed in a AAASF / Medicare Certified Surgery Center, ideally with a Board Certified Anesthesiologist. I perform all of my BBL's under Twilight Anesthesia which makes for a much easier recovery than General Anesthesia.

I have performed many 2nd BBL's on patients who initially had the 'quicker/cheaper' version with another surgeon the first time. So, it unfortunately ended up costing these patients a lot more than the $17K to get their final desired result. You should go with a surgeon who can get it right the first time. It's certainly has a big price tag, but the results are fabulous. If any surgeon offers the Brazilian Butt Lift procedure to be done in four hours or less, I would really ask for more details about his technique.

Ricardo L Rodriguez MD

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 98 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.