Brazilian Butt Lift–Associated Mortality: The South Florida Experience

Abstract

Background Brazilian Butt Lift (BBL) surgery has been the fastest growing aesthetic surgical procedure over the past decade. Unfortunately, by 2017, the surgery was associated with the highest mortality rate of any aesthetic surgical procedure. South Florida carries the highest BBL mortality by far in the nation. Objectives The purpose of this study was to explore the factors involved in making South Florida an outlier, as it relates to BBL mortality. Methods The anatomical findings of the gluteal dissections in 11 post-BBL surgery autopsies (22 hemi-buttocks) were assessed for commonalities. The authors examined the records of patients who died from BBL-related Fat Emboli to determine commonalities. Results All cases had fat grafts injected into the gluteal musculature in multiple different levels. Another commonality in these cases involved the location of where the surgery took place, with the great majority of patients (92%) undergoing surgery at high-volume budget clinics located in South Florida. Short surgical times of approximately 90 minutes, appeared to be the norm for these cases. Conclusions South Florida has experienced 25 BBL related fat emboli deaths from 2010-2022, however 14 of those deaths have taken place after the Aesthetic Surgery Education and Research Foundation (ASERF) guidelines and the Florida Board of Medicine BBL “subcutaneous-only” rule. The working environment at the clinics and the short surgical times for these cases, may be the most important contributors to the BBL mortality in South Florida.

Cosmetic surgery changes for patient safety

“…Of the BBL deaths, 92 per cent were performed at high-volume budget clinics and resulted from short surgical times of approximately 90 mins. 6 No deaths occurred with board-certified plastic surgeons. We must not allow this-the deaths of young women having a major surgical procedure-to happen.…”

“…Anatomical dissections of eleven autopsies (22 buttocks) showed that all had fat injected into the gluteal muscles at multiple levels. 6 The advice is to inject in the subcutaneous plane and not the muscle. Of the BBL deaths, 92 per cent were performed at high-volume budget clinics and resulted from short surgical times of approximately 90 mins.…”

Medical Tourism and Budget Brazilian Butt Lifts: A High Cost to US Healthcare Systems and a Danger to Patients

“… 3 A review of fatal BBL PFE in South Florida from 2010 to 2022 demonstrated that 92% of deaths occurred at high-volume, budget clinics; two-thirds of these cases were performed by American Board of Plastic Surgery certified surgeons. 4 There have been 14 deaths since 2018, with six fatal PFE cases and two nonfatal PFE cases in 2021 alone.…”

Commentary on: Brazilian Butt Lift–Associated Mortality: The South Florida Experience

“… 1 Drs Pazmiño and Garcia’s recent article describing the South Florida experience over the last decade, with particular emphasis on the last 5 years after the widespread dissemination of warnings, reflects on the effective measures proposed by the Task Force to reduce mortality. 2 …”