“Brazilian Butt Lift” Performed by Board-Certified Brazilian Plastic Surgeons: Reports of an Expert Opinion Survey

Abstract

Gluteal fat augmentation has increased worldwide and so have major complications. Brazilian plastic surgeons have been performing this procedure for more than 30 years and more often every year. Therefore we performed a study among board certified plastic surgeons, members of the Brazilian society of plastic surgery, in order to evaluate their techniques, identify their preferences, complications and outcomes with this procedure and make some recommendations. An anonymous web-based survey consisting of 16 questions was sent to 5655 members in July 2017. A supplementary survey was subsequently sent in order to obtain more information about major complications. A total of 853 responses were analyzed. The highest percentage of responses in the different categories were: Fat decantation for processing, injection with a 3 mm diameter cannula, via superior incisions, subcutaneously only, with a maximum volume of 200 to 399 ml of fat per buttock. The majority of surgeons received training in this procedure during residency. The most common complications were contour irregularities. The estimated mortality rate was 1:20,117 cases and the rate of non-fatal fat embolism was 1:9,530. The risk of death was 16 times greater when fat was injected intramuscularly. Based on this survey, we recommend injecting fat only subcutaneously, via superior incisions, using 3 mm diameter or more cannulas, and avoid large volumes above 800 ml per buttock. We find that by following these recommendations, this procedure can be safe as any other. More research to establish guidelines and increase its safety is necessary.