Brazilian Butt Lift Surgery: Overview

A Brazilian butt lift (BBL) is a fat transfer procedure performed to achieve a fuller, rounder buttocks without the use of implants. Despite its name, this procedure will not "lift" loose, sagging skin on the buttocks. Instead, a BBL uses your own fat to improve the natural contour and volume of your buttocks.

Only certain patients are candidates for this procedure (for example, you must have adequate, excess fat to transfer), and the recovery process requires that you avoid sitting for two weeks. The procedure is also not without risk.

If you are considering a BBL, gaining as much knowledge as you can about the surgery is a great and proactive first step.

What Is a Brazilian Butt Lift?

A Brazilian butt lift is an elective, cosmetic surgery that involves transferring fat from a separate area of the body to the buttocks. This outpatient procedure is performed by a plastic surgeon under general anesthesia or local anesthesia in a surgical center.

A BBL is usually performed on those who want to improve the shape and volume of their buttocks. Shapelessness of the buttocks may occur from poor tissue elasticity as a result of aging, pregnancy, and weight fluctuations. Genetic factors also play a role.

During a BBL liposuction is performed to remove excess fat from the abdomen, the sides (love handles), thigh, or lower back. The collected fat is then processed and injected back into specific parts of the buttocks to enhance its size and shape. There are no implants involved in this surgical procedure.

As a cosmetic surgery, BBL is not covered by insurance. The average total cost of a BBL ranges from $4,000 to $15,000 and includes your surgeon’s fee, anesthesia fees, facility fees, lab fees, and medications.

Various Surgical Techniques

Due to the increasing number of BBL surgeries performed every year and the risk of a rare but catastrophic complication called a pulmonary fat embolism—when injected fat entering the buttock (gluteal veins) travels to the lungs—plastic surgeons are constantly evaluating their surgical techniques.

To minimize the risk for a pulmonary fat embolism, professional societies like the Aesthetic Surgery Education and Research Foundation (ASERF) have devised a set of recommendations for performing a BBL.

A few examples of these technique recommendations include:

• Avoid injecting into the deep muscle
• Use a single hole injection cannula (≥4.1 mm diameter)
• Avoid downward angulation of the cannula when injecting the fat into the buttocks
• Only inject when the cannula (a thin tube holding the fat) is in motion

Contraindications

Contraindications to a Brazilian butt lift surgery include:

• Lack of excess fat that can be harvested
• Poor or compromising health status
• Unrealistic expectations

Potential Risks

Besides the known risks of anesthesia and the general risks of all surgeries (e.g., bleeding and infection), specific risks associated with a Brazilian butt lift include:

• Seroma (fluid collection beneath the skin)
• Undercorrection (too little fat is harvested or injected into the buttocks)
• Fat necrosis (death of fat resulting in small, firm lumps beneath the skin)
• Scarring
• Sciatic nerve injury
• Deep vein thrombosis (DVT)

As mentioned above, pulmonary fat embolism is the most feared and deadly complication of BBL surgery. Reports suggest the mortality rate due to this complication may be as high as 1 in 3000.

Purpose of Brazilian Butt Lift Surgery

The purpose of a Brazilian butt lift is to improve the contour of your buttocks. With a fuller, rounder buttocks, you may experience a curvier figure and an improvement in the balance between your upper and lower body. You may also experience a boost in your self-confidence and notice that your clothes fit more comfortably or attractively. 

Patients who are good candidates for a Brazilian butt lift include those who:

• Have good skin tone in the hips and buttocks
• Are at a healthy weight
• Have excess fat stores available for harvesting and transferring
• Are willing and able to avoid sitting directly on their buttocks after surgery for several weeks
• Desire a natural-looking, rounded buttock without implants
• Have realistic expectations

If your surgeon deems you a good candidate for a BBL, and you decide to move forward with surgery, you will need to undergo medical clearance from your primary care physician. This usually entails undergoing basic laboratory studies like a complete blood count (CBC) and basic metabolic panel (BMP), and an electrocardiogram (ECG).

How to Prepare

To prepare for your Brazilian but lift, your surgeon may instruct you on the following:

• Stop smoking at least four weeks prior to surgery.
• Stop taking certain medications and herbal supplements that may thin your blood two weeks prior to surgery (e.g., nonsteroidal anti-inflammatory drugs, vitamin E, and fish oil).
• Avoid eating or drinking anything after midnight on the eve of your surgery.
• Arrange for someone to drive you home and stay with you for the first one to three days after surgery.
• Prepare for recovery (e.g., purchase a doughnut cushion, healthy snacks, ready-to-go meals, and cozy, loose-fitted clothing).

What to Expect on the Day of Surgery

A Brazilian butt lift procedure takes around three to four hours and generally proceeds in the following manner:

• Arrival: Upon arrival at the surgical center, you will change into a gown and a nurse will place a peripheral IV for the administration of fluids and medications.
• Marking: Your surgeon will come to greet you and mark sites on your buttocks where the fat will be injected.
• Start Anesthesia: You will be taken to the operating room where either general or local anesthesia will be administered. If undergoing general anesthesia, an endotracheal tube will be inserted to assist with breathing during surgery. With local anesthesia, you will be numbed from the waist down and given a sedating medication to help you fall into a light sleep.
• Incisions: After cleaning the skin, the surgeon will make incisions at both the harvest/liposuction site (e.g., abdomen) and the graft site (the buttocks).
• Harvesting/Liposuction: A tube-like device will be inserted and fat will be suctioned out of the harvest incision sites and collected in a special container.
• Transfer: The collected fat will be transferred into individual syringes and then strategically injected into various areas within the buttocks.
• Closure: When the fat transfer is complete, the incision sites will be closed with sutures and covered with a waterproof dressing. A compression garment will be placed over the buttocks.
• Stop Anesthesia: If applicable, general anesthesia will be stopped, and the endotracheal tube will be removed. You will then be taken to a recovery room to wake up.

Recovery

In the recovery room, a nurse will monitor your vital signs (e.g., heart rate and blood pressure) and give you medication for pain and nausea which are common after surgery. When your surgeon gives you the OK, a friend or family member will drive you home.

At home, you can expect to experience pain, bruising, and swelling in your buttocks and liposuction sites. While the pain should last only a few days, swelling may persist for weeks or even months. Your surgeon will give you tips on how to minimize these symptoms.

To ensure a safe and optimal outcome from surgery, you must carefully follow your surgeon's post-operative instructions.

One of the most crucial instructions after surgery is to avoid sitting on your buttocks for around two weeks. This means that you will need to sleep on your stomach or side. If you absolutely need to sit, your surgeon will probably advise you to use a doughnut cushion or a rolled-up blanket underneath your hips.

Besides not sitting, you will need to wear a compression garment (usually provided by the surgeon) at all times on your buttocks for two weeks after surgery. You can remove the compression garment briefly when taking a shower or in order to wash it.

Your surgeon will also likely advise the following after surgery:

• Begin walking around on the second day after surgery.
• Avoid heavy lifting or vigorous activity for two weeks after surgery.
• Avoid driving until you are off prescribed pain medication for at least 24 hours.
• Gently massage the parts of your body where liposuction was performed.
• While showering is OK after surgery, avoid bathing and swimming for two weeks (until your incision sites have fully healed).

When to Seek Medical Attention

Your surgeon will tell you when to call or seek emergency care. General symptoms that warrant immediate attention include:

• Signs of an infection (e.g., fever or redness/tenderness/warmth/abnormal drainage at the incision site)
• Excessive bleeding at dressing site
• Significant or worsening pain
• Chest pain or trouble breathing
• Leg pain or asymmetric swelling

Long-Term Care

Patients are generally highly satisfied with the outcome of their BBL. For many, the boost in self-confidence from surgery serves as a stepping stone to pursuing a desired goal or career or simply achieving a healthier lifestyle.

Going into surgery with realistic expectations is key though—surgery is not a "quick fix" and will not dramatically change your appearance. If you are experiencing depression or anxiety prior to or after surgery, it's important you reach out to your surgeon or primary care physician.

Keep in mind—while the results of a BBL are essentially permanent (provided you do not lose or gain a significant amount of weight), revision BBL surgery may be needed if the primary surgery results in buttock asymmetry or an under-correction.

A Word From Verywell

While a less invasive procedure than obtaining silicone implants in the buttocks, a BBL still carries risks and requires a commitment to recovery.

Be sure to thoroughly research and choose a board-certified plastic surgeon who has ample experience performing BBLs. During your consultation appointment, ask the surgeon about their experience, complication rate, credentials, and portfolio (they should have a photo gallery of before and after pictures from prior patients).