Fixing a Brazilian Butt Lift (BBL) Gone Wrong

The video below shows popping and draining a fat transfer to the buttocks ("Brazilian Butt Lift", or "BBL") that another surgeon performed.

This patient had surgery by another surgeon who did what they called a “360 Lipo” along with what is called a “Brazilian Butt Lift,” or "BBL," which is fat transfer into the buttock area.  

Unfortunately, that was probably the wrong operation for this patient, who needed a real Butt Lift.  

After surgery, she was left with two bulges in her buttock area, so she had surgery to fix that by removing these bulges and converting her to a real Butt Lift by removing some of the skin and tissue above the buttock area.

In the video, the patient’s head is to the left, and the feet to the right.  We are working on the left buttock cheek.  I have made the lower incision for the butt lift – you can see the line to the left, toward the head, which marks the skin and fat I will ultimately remove to lift the butt cheek.  

When the pseudo-capsule (or "pocket") is opened, we can see it is filled with bloody fluid and fat globules.  Ultimately, I will remove this pseudo capsule, but that can be done more precisely if we get it emptied first.

While this patient shows an extreme problem, there are other problems with the BBL procedure, especially when it is carried out poorly.  

The most severe potential problem is death, which can occur on the operating table, and has been reported to occur in one out of 3,000 BBL procedures.  It appears that death occurs with BBL due to fat injection into the muscle of the butt.  While injection into the muscle lets the surgeon get better blood supply to keep more fat alive, the fat can get into the veins and go to the heart, which is not designed to pump fat, and the fat prevents the heart from pumping blood.  That is why it is essential that the fat injected with BBL be kept in the subcutaneous space.  

However, only injecting into the smaller subcutaneous space limits the amount of fat that can get blood supply from each procedure.  If more fat is injected than can be supported by the tissue, large chunks of the fat will die, which is called fat necrosis.  You will see photos online after BBL while the patient is still in the OR, but that is before the fat necrosis has set in.

Once these pseudo-capsules are drained, they will be removed, and the butt lift will be done by removing the skin and fat marked above the incision, to the left.

She just had her surgery, so she is still healing.