More and more patients today are wanting a little more junk in their trunk, and it’s not always about creating a big booty. Oftentimes, a subtle increase in the size of a person’s derrière can completely change the look of the entire torso. This helps explain why the Brazilian Butt Lift (BBL), or buttock augmentation with fat grafting, remains so popular despite the increased media attention on its potential dangers.
Britain’s equivalent of our Aesthetic Society, the British Association of Aesthetic Plastic Surgeons (BAAPS), recently announced a decision to launch a formal review into the safety of this sometimes controversial procedure. In this episode of No Spin Live, our team of experts weigh in on this decision as well as how the United States has developed a set of guidelines to keep the procedure safe.
BAAPS Announces Formal Review of BBL
BBL has been under a lot of scrutiny as of late due to its potential dangers. In one study, the death rate was as high as 1 in 3,000. Fat embolism is usually the mechanism of death. In reaction to these frightening statistics, BAAPS just announced its decision to launch a formal review into the safety of fat grafting for buttock augmentation. At first, BAAPS planned to ban the procedure all together until PSC member and BBL expert, Dr. Dan Del Vecchio of Boston, MA flew to London to speak. BAAPS then decided on a review to look at more evidence and science.
Despite Numbers, BBL Remains Popular
One of the reasons for a review is that despite these frightening numbers and the increased media attention that they’ve produced, patients still want a BBL. According to the latest statistics from the American Society of Plastic Surgeons (ASPS), there was a 19% increase in buttock augmentation with fat grafting procedures in the past year alone.
The question remains: Is this procedure safe? Dr. William P. Adams Jr. of Dallas, TX discusses how the United States is leading the way in BBL safety with his colleagues Dr. Ned Snyder IV of Austin, TX, Dr. Jason Pozner of Boca Raton, FL and Dr. Lee Thornton of Meridian, MI.
United States Developed Stringent BBL Guidelines
There are probably more BBL procedures performed in the United States than anywhere else in the world, including Brazil. After the study that showed the potential death rate as being as high as 1 in 3,000, the aesthetic societies got together and did cadaver studies on victims to figure out what was going wrong. “We’re all following those guidelines,” explains Dr. Pozner.
In order to provide safe BBL surgeries for patients in this country, plastic surgeons adhere to the following set of guidelines that include:
- inject fat into the superficial planes only
- keep the injections lateral
- use cannulas that offer control
- do not inject large amounts of fat at one time
“I think it’s only a matter of time before other countries evaluate this and catch up,” continues Dr. Pozner.
Technique Matters
The success of these guidelines was one of Dr. Del Vecchio’s main speaking points with his British colleagues. When the fat is injected into the subcutaneous layer, not into the muscle, there is a very low rate of fat embolism. With these current techniques, the death toll is about 1 in 20,000. This brings the procedure in line with other procedures, because surgery is always a risk.
“It’s no different from any other procedure that we do,” explains Dr. Snyder. “Technique matters. I think that’s an important take home point.” Educating both patients and surgeons is vital. Potential BBL patients should also see someone who does a lot of these fat grafting to the buttocks procedures. It makes a difference not just in terms of the aesthetic outcome, but also in terms of safety.
See a Board Certified Plastic Surgeon
“Most of us started with small volume fat injection to the face back in the late ’90’s” shares Dr. Thornton. This progressed to breast cancer reconstruction and then larger volume fat grafting procedures, such as the BBL. Once the death rates started to climb, “We had a task force with ASPS and ASAPS that looked at this pretty quickly and sorted out what we thought was the main reason,” he continues.
The conclusion was that deep, intramuscular injections were the issue, and thus began a mission to educate surgeons. It’s good for the UK that they didn’t just knee jerk ban the procedure, but, instead, are looking at the issue in an organized, practiced way. Dr. Thornton feels that no one other than a board certified plastic surgeon should perform this procedure. That would cut down on the problems very quickly.
Dr. Adams agrees, likening the training of surgeons to the training of commercial airline pilots: “American Airlines doesn’t hire drone pilots to fly their jets.” Why should anyone be allowed to perform a BBL who isn’t qualified or trained to do so? “No question that we should push more for these procedures being limited to the surgeons who are trained for them,” says Dr. Thornton.
Because so much of plastic surgery is not covered by insurance, it can be lucrative. Add to this the fact that the BBL has been so popularized in the press, and it’s a bit of perfect storm. Someone can go on YouTube and actually watch the procedure which may make it seem as if a BBL is not a big deal. This is a problem; there should be stricter regulation. Until then, however, there are the growing safety guidelines that will bring the risk down to manageable levels.
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