Behind Fashion

Dr. Kirn and Dr. Al Bayati are Plastic Surgeons devoted to advanced techniques in Cosmetic Surgery of the Face, Breast, and Body.

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Fashion sometimes drives technology in the plastic surgery world. Other times, the availability of new technology drives fashion. Regardless, buttock fat grafting, commonly known as the Brazilian Butt Lift (BBL) has been the plastic surgery procedure with the greatest increase year over year for the last few years. Despite the pop culture attention, BBL represents a relatively small number of procedures. ASPS statistics indicate 20,301 BBL’s were performed in 2017. That’s a 10% increase over 2016. By comparison, there were 300,378 breast augmentation procedures and 346,354 liposuction procedures.

The desire to enhance the buttocks is not new, and alternative treatments including buttock implants and buttock lift procedures have been around for many years. Historically, buttock implants have a multitude of potential problems associated with them and have never gained widespread use. Similarly, buttock lift procedures where skin is removed to pull the buttocks upward, are prone to unsightly scars and healing problems. The BBL, by contrast, is a natural procedure which transfers your own fat to replace lost volume or add volume where it has not previously existed. A major bonus to the procedure is that the liposuction used to harvest the fat provides a further improvement of body contour. Fat may be taken from any body area suitable for liposuction.

Sexy woman with perfectly shaped butt wearing dark gray sweat pants

A big limitation of the BBL is that the patient must have enough fat located in other body areas to serve as donor material for the transfer. It is not possible to use fat from someone else, nor is there currently any practical man-made alternative. An evaluation by a Plastic Surgeon is the best way to determine if you are a candidate for the procedure.

Since BBL is a relatively new procedure in the plastic surgery world, the process is being refined in an on-going manner. A recent technical innovation has been the vibration-expansion concept. The power assisted liposuction system is used for both fat harvest and re-injection. Our practice has used power assisted liposuction technology since the late 1990’s. The liposuctioned fat is collected in a sterile reservoir. Extra fluid from the liposuction is drained off. Then, the process is reversed. The power assisted system moves the cannula back and forth rapidly (vibration) allowing it to glide through the tissue more smoothly and with less trauma. For re-injection, a special flared cannula is used which gently spreads the tissue (expansion) to create a space for the grafted fat. A pump transfers the fat out of the sterile reservoir back through the cannula into the buttocks.

As with other fat grafting procedures, not all of the transferred fat will survive. This is the most unpredictable element of the BBL procedure. Fat survival also tends to be an individual, patient-specific characteristic. Although the BBL is not capable of correcting cellulite or dimpling, they may be somewhat improved. The BBL is a contouring procedure intended to enhance shape or restore lost volume. Grafted fat is fragile and therefore it is important to avoiding sitting on the buttocks for 2-3 weeks after surgery.

The presence of some large blood vessels in the buttock muscles adds an element of risk to this procedure which is not common with other fat grafting procedures. If fat inadvertently enters into one of these large vessels it can travel to the heart or lungs which can cause serious problems or death. As of the time of writing, BBL carries the highest mortality rate of any plastic surgery procedure. As with all surgical procedures, extreme care must be taken during the operation and it is important to seek a surgeon with experience as well as a keen eye to safety. A surgeon certified by the American Board of Plastic Surgery is your best resource to determine if the BBL is right for you.