Brazilian butt lift warning issued

An Inter-Society Gluteal Fat Grafting Task Force has issued a warning to patients and practitioners about the risks associated with gluteal fat grafting. The Task Force analysed deaths from gluteal fat injection ("Brazilian Butt Lift" or "BBL"), stating that the death rate of approximately 1/3000 is the highest for any aesthetic procedure and that in 2017, there were three deaths in the state of Florida alone. 

The Task Force represents plastic surgeons worldwide and encompasses several plastic surgery societies, including the ASPS, the American Society for Aesthetic Plastic Surgery, the International Society of Aesthetic Plastic Surgery, the International Society of Plastic Regenerative Surgeons and the International Federation for Adipose Therapeutics and Science. 

The task force outlined the following suggestions:

1) Stay as far away from the gluteal veins and sciatic nerve as possible. Fat should only be grafted into the superficial planes, with the subcutaneous space considered safest. If the aesthetic goal requires more fat than can be placed in the subcutaneous layer the surgeon should consider staging the procedure rather than injecting deep.
2) Concentrate on the position of the cannula tip throughout every stroke to assure there is no unintended deeper pass, particularly in the medial half of the buttock overlying the critical structures.
3) Use access incisions that best allow a superficial trajectory for each part of the buttock; avoid deep angulation of the cannula; and palpate externally with the non-dominant hand to assure the cannula tip remains superficial.

4) Use instrumentation that offers control of the cannula; avoid bendable cannulas and mobile luer connections. Vibrating injection cannulas may provide additional tactile feedback.
5) Injection should only be done while the cannula is in motion in order to avoid high pressure bolus injections.

6) The risk of death should be discussed with every prospective BBL patient.​​​​​​​7) These are links to three helpful articles:

•Staying Safe During Gluteal Fat Transplantation, Plastic and Reconstructive Surgery, January 2018

•Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force; Aesthetic Surgery Journal, July 2017

•Acceptable Risk: Who Decides? Editorial by Foad Nahai, MD, Aesthetic Surgery Journal, July 2017

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