BRAZILIAN BUTT LIFT 
Brazilian butt lift (BBL) is the world’s most dangerous cosmetic surgery. Formally known as gluteal fat grafting, BBL is a surgical procedure designed to increase the size of the buttocks, while reducing the size of the waist, resulting in a contoured waist and augmented buttocks. Popularised by celebrities such as the Kardashians, it has gained much public recognition, mired with controversy.
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In 2017, the Aesthetic Surgery Education and Research Foundation (ASERF) formed a Task Force to study BBL complications. “What we found was just absolutely jaw-dropping and shocking. We had determined that this was likely one of the most dangerous operations in the world, and certainly the most dangerous aesthetic procedure ever performed.” Dr Mark Mofid MD, FACS. The study found the death rate associated with BBL surgery to be as high as 1 in 2,351. This is higher than any other cosmetic surgical procedure. As a result, the Florida Department of Health proposed a rule which limits Surgeons to three BBLs a day and requires using ultrasound during the procedure. Unfortunately, high complication rates and deaths related to BBL are still high. A study published in the Aesthetic Surgery Journal (February 2023) revealed that 92% of deaths, occurred in low-budget, high-volume clinics.

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THE DANGERS OF BRAZILIAN BUTT LIFT: COMPLICATIONS
Brazilian Butt Lifts (BBLs) have surged in popularity, yet it’s crucial to recognize the procedure’s heightened risk of complications, even including fatalities, making it the plastic surgery with the highest complication rate. Serious complications often stem from inexperienced and unqualified doctors. Even seasoned specialist surgeons report complications, underlining the intricate nature of the procedure.
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  • FAT EMBOLISM: The gravest risk is fat embolism, where injected fat enters the bloodstream, traveling to the heart and lungs. Deaths can occur swiftly, emphasizing the need for precise surgical skills. Survivors may face prolonged ICU stays and lasting lung issues.
  • NERVE DAMAGE: BBL instruments can damage nerves, and improper fat injection may affect major nerves, impacting sensation and mobility.
  • FAT NECROSIS: Inadequate blood supply can cause fat cell death leading to hard lumps, asymmetry, irregular contours, non-healing wounds, and scarring.
  • INFECTION: Performing BBL in non-sterile conditions elevates the risk of infection and abscesses, including potentially dangerous “superbugs.”
  • BLEEDING: Postoperative bleeding in the large blood vessels of the gluteal region can pose serious risks.
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SCOPE OF PRACTICE
Both AAMSSA and APRASSA (The Association of Plastic, Reconstructive, and Aesthetic Surgeons of Southern Africa) explicitly discourage General Practitioners from performing BBLs. This complex procedure should be reserved for specialist Plastic and Reconstructive Surgeons in sterile surgical theatres. Understanding the high-risk nature of BBL complications is essential for both doctors and prospective patients. Opting for a specialized Plastic and Reconstructive Surgeon in a controlled environment is crucial to minimize risks and ensure patient safety. General Practitioners attending fat grafting workshops do not possess the expertise required for the intricacies of BBL procedures and are not equipped to manage the potential complications.
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WHY BBL SHOULD BE PERFORMED IN A LICENSED SURGICAL CLINIC.
Performing Brazilian Butt Lifts (BBL) in unlicensed clinics or day clinics amplifies the risks associated with this already complex procedure.
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  • COMPROMISED SAFETY AND STANDARDS: Unlicensed clinics may lack the stringent safety standards mandated for surgical procedures. This compromises the sterility of the environment, increasing the risk of infections and complications.
  •  INADEQUATE EQUIPMENT AND FACILITIES: Unlicensed clinics may lack the necessary equipment and facilities required for a BBL procedure, contributing to surgical errors and complications.
  • POORLY TRAINED STAFF: Personnel in unlicensed clinics might not have the specialized training needed for BBL procedures. Inadequate knowledge and skills increase the risk of errors during surgery.
  • POSTOPERATIVE CARE: Day clinics, often focused on quick turnover, might not provide the meticulous postoperative monitoring required. Failure to closely observe patients in the critical hours after surgery can delay the detection of complications, exacerbating their severity.
  • DELAYED INTERVENTION: Complications that arise postoperatively, such as infections, bleeding, or fat embolism, may go unnoticed in clinics lacking vigilant monitoring. Delayed intervention can significantly impact patient outcomes.
  • LEGAL AND ETHICAL CONCERNS: Performing BBLs in unlicensed settings raises ethical and legal concerns. Doctors operating in such environments may face legal repercussions.
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RECOMMENDATIONS FOR PATIENT SAFETY
It is imperative that BBL is exclusively performed by a specialist Plastic and Reconstructive Surgeon, in a licensed and accredited facility, with adequate postoperative monitoring protocols. Patients should carefully research and choose reputable surgeons and clinics, prioritizing those with a proven track record of safety and adherence to regulatory standards. The risks associated with BBL are substantial. Minimising these risks requires a commitment to both medical expertise and proper facility standards.