Despite Its Risk, the Brazilian Butt Lift Trend Is Here to Stay

Mila’s Middle Eastern family has always glorified round hips and snatched waists. Her own body didn't fit these ideals, she says, and she was consumed by insecurities.

“I was depressed,” Mila, whose name has been changed for privacy reasons, tells Verywell. “I felt unhappy with myself and who I was becoming, and I couldn't do anything about it.”

Mila lives in California and her family is from Afghanistan.

“In our culture, we have belly dancers, and they're naturally curvy and everybody loves them for that; they admire that,” Mila says. “But then also there's a side of my culture that is like, ‘No surgery.’ If you're born with it, great. If you're not, it's your loss. You don’t have it.”

And in Mila’s eyes, she didn’t have it. 

Dieting and exercise proved futile against biology, Mila adds. When an unplanned weight gain pressed her self esteem lower, and lower, she decided that the shape she wanted was only achievable with surgery.

So she sought out consultations on getting a Brazilian Butt Lift (BBL) procedure in Beverly Hills without telling her family.

The BBL is one of the fastest growing cosmetic procedures—thanks to social media influencers— and is known for its ability to shape-shift a person’s body to have larger buttocks. But the procedure can be pricey and risky. A 2017 study from the Aesthetic Surgery Education and Research Foundation (ASERF) estimated that around 1 in 6,000 BBLs resulted in death. The ASERF reported that after recommending safer surgical techniques, the risk of mortality has dropped to 1 in 14,952.

When Mila finally revealed her plan to her parents, she was getting ready to leave for the surgery. To her surprise, they supported her decision. Her father, whom Mila described as “old school,” offered to drive her to the appointment and built contraptions to help her feel comfortable afterwards.

“‘I'll take you,’” Mila recalls her father saying. “And I think he did say, ‘Don't make yourself look like Kim Kardashian.’”

She has yet to tell her extended family about her transformation. But nearly three months after the surgery, she feels confident and happy in her own skin.

“I just blend in with my culture,” she adds. “Now, I'm that curvy, voluptuous body.”

BBL's Rise in Popularity

Saul Lahijani, MD, lead plastic surgeon at Beverly Hills Institute of Plastic Surgery who conducted Mila’s BBL, began incorporating BBLs into his practice about eight years ago largely because of social media influences and advancements in fat transfer technology. 

“It's a social media and television phenomenon,” Lanhijani tells Verywell. “A lot more people are asking for it and desire to get that hourglass look. The curvature, the waistline, the hips."

The overall BBL look is a smaller waist and larger butt, but how dramatic these changes will appear depends on a person’s natural body. “You have to see the canvas you start with to where you can take that body,” Lanhijani says.

Johnny Franco, MD, FACS, Austin-based plastic surgeon and Realself advisory board member, says social media influencers largely dictate what patients are looking for in a BBL.

The current trend is to have a large butt that’s out of proportion to their body, Franco says. People who want this look may ask for an “athletic BBL” or a “skinny BBL.”

“The vast majority of them are just trying to improve the shape that they already have, they're not trying to change who they are,” Franco adds.

To gauge what type of body a patient wants and if it’s realistic through surgery, he asks patients to bring in “wish pictures” for consultations. Over the last four or five years, fewer patients have brought in photos of celebrities like Kim Kardashian, who has been suspected but not confirmed to have had a BBL. More people have been showing him photos of social media influencers or their “Instagram crush.”

The ‘Skinny’ on Fat Transfer

In contrast to butt implants, which are typically made from synthetic materials like silicone, BBLs make use of the patient’s own fat, which surgeons say can lead to a more natural looking result. 

Butt implants typically need to be removed or replaced every 10 years. But the fat cells that are transferred in the BBL are permanent to that area three months after the surgery, Lanhijani says. The fat can still change size if a person loses or gains weight, but it will stay in the same place.

BBLs can be life threatening. If the fat is placed incorrectly into or below the muscle area, it can cause a pulmonary fat embolism (PFE), in which the fat cells infiltrate the circulatory system and travel into the heart and lungs, and it can result in immediate death. 

In 2017, BBL had significantly higher mortality rates than any other cosmetic surgery at that time.A year later, the ASERF issued guidelines to improve surgery safety, which include warnings to place fat only in the skin layer instead of the muscle.

Although the mortality rate has since dropped among BBLs conducted by board-certified plastic surgeons, some surgeons can practice without proper training or qualifications, according to Vox.

Are There Alternatives to BBL?

Due to safety risks, some experts have advised against the surgery or suggested non-surgical alternatives to butt enhancement.

Jack Craig, a certified personal trainer with Inside Bodybuilding, says his clients are often trying to sculpt their body in a way that meets today’s beauty standards. He recommends focusing on glute-building exercises, using techniques like squats, deadlifts, hip thrusts, and glute bridges, rather than undergoing a BBL.

"The best thing about growing a butt naturally is that the results are easy and cost-effective to maintain,” Craig says. “Even better, there’s likely very little health risk involved.”

But sometimes working out isn’t enough. For Mila, several doctors had suggested dieting and exercise without acknowledging her concerns.

"It was just so painful walking out of those other consultations, feeling judged,” she says.

Emotional Red Flags for Getting a BBL

Franco says that he and his team use initial consultations to look for red flags, where the patients may be seeking out a BBL for “the wrong reasons.” 

“Sometimes we have patients either after a bad breakup or divorce,” Franco says. “Sometimes there's this feeling of ‘I need to change myself so that somebody else will love me.’” 

He often asks patients about their motivation for the BBL during consultations to make sure that they have a realistic expectation of what the surgery can create.

Some patients may struggle with body dysmorphic disorder, a condition in which a person is unhappy with their body and does not see their body as others see it. 

Studies have found that body dysmorphic disorder is more common among cosmetic surgery patients than the general population.

“If people aren’t in a good mental spot, if they're not doing this for the right reasons, it's something that can lead to frustration and disappointment,” Franco says.

BBL Trend May Be Here to Stay

Franco doesn't see BBLs going away anytime soon.

“This idea of an overall 'better’ shape and enhancing figures isn't going to go away,” Franco says. “Fat transfer is just a tool that we're only going to improve in terms of how to make it  predictable, safe, and successful. I think we're only going to keep doing more in the future.”

For Mila, the rise in popularity of the BBL gives her hope. Normalizing BBLs will give her a chance to truly own her surgery and reveal her new body to her extended family with pride.

“Nobody wants to live a life that's not real,” Mila says, adding that she longs to share her experience with her community.

“I know that there's other girls that are going through what I went through,” she adds. “I hope that it happens soon.”