Autopsy results from deceased patients demonstrated two common causes of death after BBL: 1) fat within and under the gluteal muscle, and 2) massive fat emboli. The results were consistent with typical risks associated with the intramuscular fat injection technique.
Intramuscular fat injection is one of the methods used by plastic surgeons along with superficial fat management during the buttock augmentation procedure. While it is mostly performed to ensure there is a greater chance of fat remaining, it requires careful and precise application. Anatomically speaking, important nerves and blood vessels pass through the gluteal region. Thus, injecting the cannula deep into the muscle can injure these key structures and cause injury and complications. It can even lead to cardiac or pulmonary fat embolism (PFE) that can become fatal if not treated promptly. Fat embolism results when the grafted fat is injected into the bloodstream, blocking the major blood vessels of the heart or lungs.
Causes of risks and complications after buttock augmentation surgery
What leads to these risks after the Brazilian butt lift? We have listed some of the most common dangers below:
- When it is performed by an unlicensed practitioner. Training and experience are important when dealing with and performing cosmetic procedures such as buttock augmentation. This is what unlicensed practitioner’s lack. Although they may be familiar with the anatomy of the body, they may not have had the proper training to actually do the procedure. This makes buttock augmentation and other cosmetic procedures unsafe because one wrong step may lead to irreparable errors and may become fatal.
- Use injections such as silicone and fillers instead of fat. Silicones and fillers are approved by the US Food and Drug Administration (FDA) for use in breast enhancement and improving signs of aging. It has not been approved for use in a Brazilian butt lift. Because buttock augmentation is not a low-cost procedure in itself, patients turn to these fat alternatives to improve their buttocks. This is not recommended because these alternatives are not designed to be used in a buttock augmentation procedure. The end results may be unsatisfactory and may require revision surgery or may become a fatal complication if not treated promptly.
- Non-sterile operating area and surgical instruments. Failure to sterilize the operation area and the surgical instruments used may put the patient at risk. It exposes them to infectious agents that can cause complications. Likewise, it may lead to a bad outcome that may need a second surgery to correct it.
- Intramuscular injection of the grafted fat. Intramuscular fat grafting is a common technique for buttock augmentation. However, it is dangerous for patients, especially when the cannula is injected deep into the muscle where nerves and blood vessels lie. Colliding with a blood vessel can cause massive fat emboli, which can be fatal.
Preventing the emergence of Brazilian Butt Lift dangers
Due to the increasing malpractice and increasing mortality due to buttock augmentation, plastic surgeons from around the world through the BBL Task Force have taken the initiative to advise their fellow physicians to evaluate their techniques in performing the Brazilian Butt Lift. Likewise, they encourage patients around the world to learn more about buttock augmentation before deciding to undergo surgery.
The BBL task force also suggests the following measures for plastic surgeons to prevent an increased incidence of problems and deaths during surgery:
- Be aware of the patient’s body. While we are familiar with human anatomy, the body varies from patient to patient. Thus, it is also important to be well acquainted with the patient’s body. This will enable us to develop a better technique for our patient and avoid any injury to the internal structures in the gluteal region.
- Avoid using the intramuscular fat injection technique. Injecting fat into the muscle and beyond increases the chances of injury to the nerves and blood vessels underlying the buttocks. Keep the fat injections within the superficial levels of the buttocks, with the subcutaneous space being the safest place to place the grafted fats? Doing so greatly reduces the possibility of complications from the procedure.
- Use a blunt, pressure-adjusted cannula. Controlling the movement of the cannula as well as limiting the area where the fat will be injected prevents unintended deep passages into the muscles where vital structures lie. Similarly, blunt cannulae reduce the chance of puncturing a blood vessel and injecting fat into the bloodstream.
- Obtain access incisions to ensure that the cannula is kept in a superficial path. This technique allows us to maintain the angle of the cannula at the subcutaneous level. External palpation can also help ensure that the cannula is not tilted at a deep angle while the fat is being injected into the buttocks.
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