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The Brazilian Butt Lift Breakdown: What You Need to Know

Picture of Damita Joy Ferguson, MEd, PharmD, MBA

Damita Joy Ferguson, MEd, PharmD, MBA

Damita Ferguson is a pharmacist with more than 20 years of experience. A graduate of the University of Florida, she has devoted her life to teaching and helping Americans achieve wellness. She believes empowered patients strengthen the healthcare system, and they deserve the care they expect.

Patients who are interested in the BBL have 4 main questions. They are: 1) What factors contribute to achieving the Best Brazilian Butt Lift Ever, 2) Is it safe, 3) Does it last, and 4) How much does it cost?  This article addresses these questions and provides a breakdown of topics every patient needs to know.

How is the Brazilian Butt Lift Done

The process of performing a Brazilian Butt Lift involves three steps: harvesting, processing, and the implantation of fat cells.

Harvesting is the removal of subcutaneous fat tissue from the patient’s body. Processing is the separation of fat cells and stem cells from blood, waste from cells, and oil.  Implantation is the placement of processed fat cells into the butt.

Subcutaneous Fat Layer

Each step is very important because they have a huge impact on the patient’s final result. They also influence how long the implanted fat will last, and the patient’s overall safety. 

Step 1

Fat harvesting is a key part of the Brazilian Butt Lift commonly done with liposuction.  It is the removal of fat in the subcutaneous layer from the back, sides, abdomen, or thighs.  The fat tissue typically consists of mature fat cells, immature fat cells, and stem cells.  These 3 cell types are the target cells that will eventually go into the butt.  The fat tissue also contains blood, waste from cells, oil, and other cell types necessary for life.  CLICK HERE to learn more about liposuction.

Step 2

After successfully removing fat tissue from the body, the processing step begins.  Blood and waste from cells can cause inflammation and destruction of the mature fat cells, immature fat cells, and stem cells.  They can also give the appearance of volume in the short term. This volume will disappear once the body reabsorbs the damaged cells. Therefore, plastic surgeons must separate the target cells. The separation of fat cells from the blood, waste from cells, oil, and other cell types happens in this step.

Step 3

In the final step, referred to as implantation, mature fat cells, immature fat cells, and stem cells are placed into the butt adding volume and a more shapely appearance.  Stem cells can transform into different cell types based on the body’s needs.  Once implanted, they often replace fat cells that do not survive harvesting, processing, or implantation, and other cells necessary for the newly implanted cells’ survival.   

The Best Brazilian Butt Lift Ever

The Best Brazilian Butt Lift Ever is an outcome matching the patient’s preferences for shape, curve, hip-to-waist ratio, and size.  To meet patient expectations, surgeons often ask patients about their preferences in terms of height, width, and projection.  Projection is the length from the pelvis outward.  

5 Key Essentials must be present for patients to get the best results from the Brazilian Butt Lift.   They are: (1) a qualified plastic surgeon, (2) an accredited facility, (3) BMI between 20 to 30, (4) Minimal Excess Skin, and (5) Expectations that match the Shape of the Patient’s Body. 

Choosing a Qualified Plastic Surgeon

Plastic surgeons who completed residencies accredited by the Accreditation Council for Graduate Medical Education have the training to successfully perform these procedures.   According to Villabueva, (2018), proper patient selection, the best instruments, proper patient positioning, surgeon technique, and knowledge of anatomy are critical for safety with the Brazilian Butt Lift. Plastic surgeons trained in plastic surgery residencies certainly have the background to deliver on these necessities.  

Board certification is a bonus because board certified plastic surgeons have proven they have the knowledge, training, skills, and experience to provide the best results.  CLICK HERE to learn more about board certification.

Additionally, board certified plastic surgeons must operate in accredited facilities which adds another layer of safety.  Accreditation ensures the facility has the tools and team necessary to safely and appropriately perform surgical procedures.  CLICK HERE to see a video of a Brazilian Butt Lift performed by a board certified plastic surgeon. CLICK HERE to learn more about facility accreditation.

Proper Patient Selection

Proper patient selection is critical because it is the best way to avoid preventable complications.  

  • Patients who are diabetic, use nicotine products, or have conditions that compromise the immune system have a greater risk for poor wound healing and infections.  
  • Patients who have had recent surgeries or pregnancies, a history of deep vein thrombosis or pulmonary embolism, or use birth control have a higher risk of abnormal blood clotting that can be life-threatening.
  • Patients who are taking blood thinners or some antidepressants, have liver or kidney disease, or have uncontrolled high blood pressure have a higher risk for abnormal bleeding or hematomas. 
  • Patients who have a BMI > 30, have a higher risk for poor wound healing and infections, hematomas, seromas, and abnormal blood clotting.

All surgeries come with risks, but history and science have exposed factors that can compromise patient safety and outcomes. In cosmetic surgery, plastic surgeons performing cosmetic procedures have an advantage because they can identify patients who are more likely to experience complications before plastic surgery. CLICK HERE to learn more about plastic surgery and you.

Other Essentials

For patients to achieve the volume they desire with the Brazilian Butt Lift, there has to be enough fat available for harvesting. 


A BMI of between 20 and 30, usually provides enough fat for satisfactory results.  Patients with a BMI under 20, generally do not have enough fat available for harvesting to achieve desired results.  Patients with a BMI greater than 30, often do not experience noticeable changes after surgery.

 In addition, a BMI >30, increases the risk for complications.  Plastic surgeons often recommend moving forward with patients who are near or at their ideal BMI.  To calculate your BMI, CLICK HERE.

Extra Skin

The next essential element to the Best Brazilian Butt Lift Ever is the amount of extra skin below the butt.  Ptosis is a word that describes the amount of skin or volume under the butt fold.  According to O’Neill, (2020), patients who have little to no extra skin under the butt fold tend to have the best shape and lift outcomes after a BBL.  Patients with excess skin can have more challenges with achieving the desired shape and lift.  However, it presents an opportunity to discuss skin removal with plastic surgeons as a way forward.  

Body Shape

The final key essential for the Best Brazilian Butt Lift Ever is the shape of the body.  Body shapes are often described as A-Shaped, V-Shaped, Square-Shaped, and Round-Shaped.  CLICK HERE for examples.

The body shape is important because it can make getting to the desired waist-to-hip ratio less or more challenging.  When you think of an hourglass or the famous “coca-cola” bottle shape, it’s easy to see why they can describe a woman’s body shape.  The slim parts of both relate to the waist, and the round, curvy areas relate to the hips. A-Shaped and Round Shaped patients have contours that are similar to the hourglass and coca-cola shapes. Plastic surgeons have more natural contours to work with, which explains why they get more ideal results.


When patients decide to have a BBL, their expectations must match their body type.  In consultations with plastic surgeons, patients should ask to see the before and after pictures of patients with their body type. The real-life pictures will help shape expectations and pave the way for the desired outcome.  

Risks of the Brazilian Butt Lift

The most serious complication associated with the Brazilian Butt Lift is the unintentional injection of fat into the bloodstream during implantation.  It can become a Fat Embolism, which is a lot like a Pulmonary Embolism.

The Danger Zone

Before Brazilian Butt Lifts, qualified plastic surgeons place markings on the butt to outline areas for fat injection and areas to avoid.  The areas to avoid, or the  “danger zones” are the deep muscle zones that contain major blood vessels, nerves, and tissues that are strong and tight for support.

If the cannula, which is the tool plastic surgeons use in liposuction and Brazilian Butt Lifts, goes into the deep muscle layer and causes injury to a major artery or vein, fat can enter the bloodstream and travel to the heart and lungs.  The result can be heart or respiratory failure. They are often fatal.

Fat in the bloodstream can also cause an inflammatory reaction throughout the body leading to brain, kidney, and liver damage, and the breakdown of other tissues in the body.  

Plastic surgeons must have a deep understanding of the anatomy to safely perform this procedure.  This is why training in an accredited plastic surgery residency and board certification are so important.

Techniques plastic surgeons use as they perform the Butt Lift are based on their training and experience, and some choose to inject fat beyond the subcutaneous layer of the skin.  However, it is not recommended because it carries a high risk for the patient.

When plastic surgeons enter this zone, the chances for fat embolism increase and so does the risk of death.  Treatment for fat embolisms is supportive and many patients do not survive.   There is no evidence that Fat Embolisms happen when fat injections occur under the skin, also known as the subcutaneous layer.

Patients Should Also Consider

According to O’Neill, (2020), other complications from the Brazilian Butt Lift include anemia, seroma, blood loss with symptoms, life-threatening infection in the blood, infection at the surgical site, or sciatic nerve damage.  

Anemia and hypovolemia are common in blood loss and can cause serious damage if blood is unable to carry oxygen and nutrients to important organs and tissues. 

Seromas are common after the removal of fat or other tissues in the body.  The open space created sometimes allows fluid to fill the space (seroma) and place pressure on surgical wounds, organs, and tissues in the body.  Seromas can be serious if bacteria enter the fluid, or if the pressure pushes organs and tissues outside of the body.  Seromas can also delay wound healing. 

Sciatic nerve damage can occur if the plastic surgeon moves into the deep muscle tissue and injures the nerve during the procedure. It is the largest nerve in the body.  Damage to the nerve can cause severe pain that can last a lifetime.  

Finally, while infection in plastic surgery procedures is rare, especially when board certified plastic surgeons are performing Brazilan Butt Lifts, they can happen.  If bacteria enter open wounds, patients can experience both skin and systemic infections.  Systemic infections can be life-threatening.  

How Long Do the Brazilian Butt Lift Results Last

The survival of fat cells once implanted and the amount of time the Brazilian Butt Lift lasts is unpredictable. Anywhere from 20% to 50% of fat cells survive long-term after a BBL. The major factors that determine whether a Brazilian Butt Lift will last are the patient’s genetics and the plastic surgeon’s training, experience, equipment, and technique.  Patient compliance with the plastic surgeon’s aftercare instructions also plays a huge part. 

The process of harvesting is key for long-term BBL results.  The fat cells removed from other parts of the body are mature fat cells, immature fat cells, and stem cells.  Every patient who decides to move forward with the procedure will have a different mix of the cell types simply because of genetics.  

Mature fat cells are least likely to survive because they have greater oxygen, nutrient, and energy needs than the other cells.  The process of removing fat cells from the body disrupts the flow of blood carrying oxygen, nutrients, and energy.  For this reason, mature fat cells face more challenges than immature fat cells and stem cells.  These cells do not require the same level of support.  

In addition, stem cells can transform into many different types of cells based on the body’s needs when cells in the body die.  Patients who have more immature fat cells and stem cells available for implantation have a better chance of a BBL that lasts longer than patients who do not.  

Also, the training, tools, technique, and experience of the plastic surgeon can significantly impact the length of time the BBL lasts.  Plastic surgeons who complete the harvesting process without damaging the fat cells needed for implantation deliver the best results. 

The implantation of healthy fat cells is necessary, as damaged cells can add volume immediately after the procedure, then disappear later.  The body eventually reabsorbs the damaged cells.  

Finally, patients have a major role to play after the Brazilian Butt Lift.  Based on experience, plastic surgeons commonly recommend compression garments to decrease swelling, maintain contours, and reduce the risk of complications. 

Certainly, plastic surgeons give recommendations on the length of time patients should avoid sitting on the new Brazilian Butt Lift or applying direct pressure to the area.  Patients must remain 100% compliant to get the results they want.  

Those wanting to add volume after a Brazilian Butt Lift usually have the option of additional procedures.  Most plastic surgeons will recommend a second surgery for large volume requests to reduce the risk of complications and to correct contour irregularities.

How much does it cost?

According to the America Society of Plastic Surgery’s 2020 Plastic Surgery Statistics Report, the average cost of a Brazilian Butt Lift among board certified plastic surgeons was $4807.  This cost may vary based on geographic location, the number of plastic surgeons in the area, and the competition for patients in the area.  The experience, additional certifications, and expertise of the plastic surgeon performing the procedure also influence the cost. 

To Wrap It All Up

The Brazilian Butt Lift (BBL), also known as Buttock Augmentation with Fat Grafting, is growing in popularity among plastic surgery procedures.  According to the American Society of Plastic Surgery’s (ASPS), Plastic Surgery Statistics Report, board certified plastic surgeons performed more than 21,800 Brazilian Butt Lifts (BBL), also known as Buttock Augmentation with Fat Grafting in the United States in 2020. As social media and celebrity posts grow awareness of the procedure, the demand will likely rise.

Patients considering the procedure should first and foremost understand and agree to the risk.  Additionally, patients should have a general understanding of the procedure to encourage great consultations with qualified plastic surgeons.  Finally, patients should have a real understanding of how to provide self-care after the BBL, and realistic expectations for results.  For more information, please consult your plastic surgeon.


This blog is written by a Doctor of Pharmacy, not a Medical Doctor.  All content and information on this website is for informational and educational purposes only, does not constitute medical advice, and does not establish any kind of patient-client relationship by your use of this website.  Although we strive to provide accurate general information, the information presented here is not a substitute for any kind of professional advice, and you should not rely solely on this information. Always consult a professional in the area for your particular needs and circumstances prior to making any professional, legal, medical, and financial decisions.

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