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The Brazilian butt lift (BBL), formally known as gluteal fat grafting, has emerged as a popular cosmetic surgery worldwide. This procedure, aimed at augmenting the buttocks and contouring the waist, has been extensively publicised, often linked with high-profile celebrities. However, its increasing popularity comes with significant risks and controversies, making it crucial for prospective patients to understand the complexities and dangers involved. Dr Debbie Norval, Dr Nerina Wilkinson and Dr Edward Ngwenya elaborate…
Understanding the Brazilian Butt Lift (BBL) Procedure
The Surgical Process Explained
A BBL involves liposuction to remove fat from areas like the abdomen, flanks, or back, followed by reinjecting the fat into the buttocks using a cannula. The procedure requires skill and precision, as the fat is distributed evenly from various small incision points.
Risks & Concerns: The Alarming Reality of the BBL
Study Findings & Regulatory Responses
In 2017, the Aesthetic Surgery Education and Research Foundation (ASERF) launched a task force to investigate BBL complications. Task force member Dr Mark Mofid, MD, FACS, described their findings as “jaw-dropping and shocking”, identifying BBL as potentially the most dangerous aesthetic procedure.
The study highlighted a concerning death rate – significantly higher than any other cosmetic surgery.
As a result, the Florida Department of Health proposed regulations to mitigate risks, including limiting surgeons to three BBLs per day and mandating ultrasound use during the procedure. Despite these measures, high complication rates persist, particularly in low-budget, high-volume clinics.
The Crucial Role of Specialist Surgeons
Why General Practitioners Should Not Perform BBLs
BBLs should be exclusively performed by specialist plastic and reconstructive surgeons in a surgical theatre under sterile conditions. Attendance at fat grafting workshops does not qualify a general practitioner (GP) to safely perform this complex procedure.
Both the Aesthetic and Anti-Aging Medicine Society of South Africa (AAMSSA) and the Association of Plastic, Reconstructive, and Aesthetic Surgeons of Southern Africa (APRASSA) strongly advise against GPs undertaking BBLs.
Complications Associated with BBLs
Understanding the Dangers
BBL surgery, though increasingly popular, carries the highest complication rate in plastic surgery. These complications range from fat embolism – a life-threatening condition – to nerve damage, fat necrosis, infection, and bleeding.
Even experienced surgeons encounter difficulties due to the intricate nature of the procedure. A BBL performed in non-sterile conditions or by unqualified personnel significantly increases these risks.
Why BBLs Should Only Be Performed in Licensed Surgical Clinics
The Risks of Unregulated Environments
Performing BBLs in unlicensed clinics or day clinics substantially increases the dangers associated with this complex procedure. These settings often lack stringent safety standards, the necessary equipment, and adequately trained staff. Additionally, insufficient postoperative care and monitoring in such clinics can lead to delayed detection and intervention in case of complications, thereby worsening patient outcomes.
Recommendations for Patient Safety
Choosing the Right Surgeon and Clinic
To minimise risks, it is imperative that BBL procedures be conducted by specialist plastic and reconstructive surgeons in licensed, accredited facilities with thorough postoperative monitoring protocols. Patients should diligently research and select reputable surgeons and clinics that adhere to safety and regulatory standards.
Final Words
In conclusion, while the Brazilian butt lift offers aesthetic benefits, its associated risks cannot be overstated. The procedure’s popularity does not diminish the need for caution and a thorough understanding of its potential complications. It is essential for individuals considering this surgery to recognise the critical importance of seeking treatment from qualified, experienced plastic and reconstructive surgeons in accredited, sterile surgical environments.
Patients must be informed and vigilant, prioritising their safety over cost or convenience. Choosing a reputable surgeon with a proven track record in BBL procedures and adhering to the highest medical and ethical standards is crucial. Furthermore, patients should engage in open and detailed discussions with their surgeons about the risks, expected outcomes, and postoperative care to make informed decisions.
The medical community – particularly organisations like AAMSSA and APRASSA – continues to advocate for stringent safety protocols and regulatory measures to protect patients. This collective effort towards raising awareness, enhancing surgical standards, and ensuring proper training and qualifications for surgeons performing BBLs is pivotal in safeguarding patient health and well-being.
Ultimately, the decision to undergo a BBL should be made with careful consideration, armed with comprehensive knowledge and a commitment to prioritising safety above all else. Through informed choices and adherence to medical guidelines, the risks associated with this complex procedure can be significantly reduced, ensuring a safer and more positive outcome for patients seeking cosmetic enhancement.
Visit www.aprassa.co.za to locate a board-certified APRASSA surgeon near you in South Africa.
To report any unsafe practice or if you have any queries, please feel free to contact AAMSSA at info@aestheticdoctors.co.za
Find a doctor practising aesthetic medicine in South Africa by visiting www.aestheticdoctors.co.za
Disclaimer: This article is published solely for informational purposes and should not be considered a substitute for professional medical guidance.
MBBCh (Rand) Dip Pall Med (cUK) M Phil Pall Med (UCT) Adv Dip Aesthetic Med (FPD)
Dr Debbie Norval graduated as a medical doctor from the University of the Witwatersrand, in 1991. Post graduate training includes a Diploma in Palliative Medicine through the University of Wales, Masters of Philosophy from the University of Cape Town, an Advanced Diploma in Aesthetic Medicine through the Foundation for Professional Development and a City and Guilds Diploma in Adult Teaching and Training.
Dr Norval is the convenor of the Johannesburg Aesthetic Doctors Journal Club and sits on the scientific committee of the Aesthetic Medicine Congress of South Africa (AMCSA). She is the Past President of the Aesthetic and Anti-Aging Medicine Society of South Africa (AAMSSA) and serves on the International Advisory Board of CMAC (Complications in Medical Aesthetics Collaborative).
“Dr Debbie Norval Aesthetics” is a busy clinical practice in Parktown North, Johannesburg.
Please note Dr Debbie is not taking on new patients at this time.
MBChB FCS (Plast SA) Plastic and Reconstructive Surgeon
Dr Nerina Wilkinson is an Aesthetic Plastic Surgeon with over 20 years of clinical experience. Recognised by her peers and industry experts as a facial specialist with surgical, skin science, and aesthetic experience, she occupies a unique position when it comes to holistic facial rejuvenation techniques. Her innovative treatments combine surgical and non-surgical modalities and are based on in-depth scientific knowledge and her experience.
She is also the founder and director of Dr Nerina Wilkinson + Associates. Her private Aesthetic Couture Clinic is based in the prestigious V&A Waterfront. Here, she has assembled a group of clinicians and skin care specialists, each of them experts in their field, to be able to deliver the highest standards of care and state-of-the-art, evidence-based procedures. She is an active researcher in the field and has pioneered industry-changing minimally invasive rejuvenation techniques such as the StemCell4DLift™, EyeLight360™, and Natural-Lift™.
Using her detailed knowledge and surgical experience, she trains medical staff in the latest aesthetic treatments and how to deliver them with optimal, yet safe results. Dr Nerina Wilkinson is frequently invited to present her work at Plastic Surgery Conferences, educational forums, and women’s events and has also been highly represented in the media throughout her career where her opinion on current matters in Plastic Surgery and Aesthetic medicine is often sought.
Memberships:
- Association of Plastic and Reconstructive Surgeons South Africa (APRASSA full member)
- International Association of Aesthetic Plastic Surgeons (ISAPS full member)
- Fellow of the College of Surgeons South Africa (CMSA)
- AAMSSA (Aesthetic and Anti-Ageing Medicine Society of South Africa|). Active Board Member since 2012
Bsc (Wits). MBBCh (Wits). FCS (SA). FC Plast Surg (SA) MMED General Surgery (UP). MMED Plastic Surgery (UP)
Dr Edward Ngwenya is a Plastic and Reconstructive Surgeon, Senior Lecturer (University of Pretoria) as well as a Non-Executive Board Director (South African Medical Association - SAMA). He has a Bachelor of Science (BSc) and Medical degree (MBBCh) from the University of the Witwatersrand, and achieved a Fellowship in Surgery [FCS(SA)] and a Master of Medicine in General Surgery (MMed Surgery) from the University of Pretoria, for which he received the Golden Key award – an award bestowed only to candidates who graduate in the top 15% of the country. He further specialised in the field of Plastic and Reconstructive Surgery [FCPlast Surg (SA) and Master of Medicine in Plastic Surgery (MMed Surgery)], which is his current vocation.
Having a double surgical speciality, Dr Ngwenya is thus skilled in diverse surgical procedures and knowledgeable as an authority in his field. His interests include, but are not limited to, Breast Surgery (Cosmetic and Reconstructive), Body contouring (body shaping procedures), Onco-plastics (Cancer surgery), and Aesthetic Surgery.
Dr Ngwenya is a member of APRASSA, ISAPS and serves as a committee member of AAMSSA.