Bacterial infections linked to ‘Brazilian butt lift’ surgeries in Florida

The dangers of the “Brazilian butt lift” in Florida are well documented, with dozens of deaths due to surgeries where fat is injected into patients’ buttocks and enters the bloodstream, causing fatal blockages.

But a recent report by a Center for Disease Control and Prevention expert highlights the potential for another complication: contamination.

The report, released in January, described a state investigation into a cosmetic surgery clinic in South Florida. The area is known as a destination for cheap office butt lifts that are quickly passed on to patients — with sometimes fatal results.

Early last year, federal authorities told the Florida Department of Health that one of the clinic’s patients, who lived out of state, had been infected with a bacteria.

The state launched an investigation and found that a total of 15 patients — all women — had contracted Mycobacterium abscessus, a single-celled organism that is resistant to many antibiotics. It is found in water and soil and is known to contaminate medical equipment. It can lead to painful and swollen skin, boils, fever, chills and muscle aches.

One person was hospitalized, but no deaths were reported. Eleven of the patients lived in other states, including four from California. The median age was 33 and 20% were black. They visited the clinic from August to December 2022.

All underwent liposuction, a procedure in which fat is removed from parts of the body. Twelve had Brazilian butt lifts.

The clinic was closed after health officials discovered all the cases. The state visited another facility with the same staff and found gaps in cleaning practices and disinfection of surgical devices. No location was named in the report.

The report said the state will develop additional training for plastic surgery clinics to help prevent future cases.

Katharine Saunders, who works at The Florida Department of Health, on a two-year Centers for Disease Control and Prevention grant, presented the research findings Tuesday at a disease detective conference in Atlanta.

The Tampa Bay Times spoke with Saunders to learn more about the outbreaks and get her advice on how cosmetic surgery patients in Florida can reduce their risk of infection.

He declined to name the clinics. A spokesman for the state health department said the agency does not confirm or deny the existence of a doctor’s license or epidemiological investigations.

The interview has been edited for clarity and length.

Was the exact source of infection identified in the cases you investigated?

No. We were able to identify the organism — the pathogen, which was Mycobacterium abscessus. We are unable to say exactly where the source of the contamination was.

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Is mycobacterium abscessus prevalent in soil and water throughout Florida?

Yes so it is a kind of non-tuberculous mycobacterium, which is found in soil, dust, natural water sources. It is common in Florida. I couldn’t speak for how much it has seen in other states. … We don’t have a lot of basic data.

With this particular investigation, it was challenging because many of these patients were out of state…identifying it as a cluster from this unit took some time.

What stood out to you about the demographics of those affected?

It is somewhat typical (of) what we would expect from a population seeking cosmetic surgery. I think what stood out most about this research was the geographic distribution…how there were so many patients who had come from other states to Florida just to have these procedures.

If patients are planning to undergo cosmetic surgery in Florida, is there anything they can do to minimize their risk of developing one of these infections?

Yes, there is actually a checklist published by the American Society of Plastic Surgeons that has some great questions for patients to review and ask their provider and facility. … These are things like whether the facility is licensed and registered with the state, what the certifications and experience of the providers are.

[A Centers for Disease Control and Prevention spokesperson later provided the checklist. It’s specific to breast reduction procedures but can be applied to any cosmetic surgery, according to Saunders. The advice is on page 10 of this document.]

Watch for signs of infection (after surgery) … redness, swelling at the site of surgery, pain, fever. (If they develop symptoms), they should definitely go to their provider and get checked out right away and let them know they had surgery.

What will the new education for health professionals affect?

We really want to focus on hand hygiene, basic infection prevention control, and also reprocessing surgical devices, so that’s disinfecting and sterilizing any surgical instruments that are going to be reused.

During your research, did you look at marketing and how patients were attracted to this facility?

I can’t speak to these specific patients, but in general, yes, we have seen that these clinics will offer deals or cash-only deals. They also have “convalescent homes” (for) out-of-state patients. … We see social media playing a role as well. Celebrities who encourage or advertise I guess, for these facilities.

This is interesting. When you say “rehab house” …

(It’s) similar to a hotel, but caters to surgical patients. … They can stay there for a few days after the operation, while they do the immediate follow-up to recover before flying home.

If someone is traveling out of state and leaves Florida … and starts experiencing symptoms, what should they do then? Contact a primary care provider? Nothing else;

They should definitely be seen by their primary care provider in their home state. But I would also encourage them to go back to the cosmetic surgery clinic to let them know as well.

Clusters of these infections are considered reportable … so I guess if a surgery gets multiple reports from patients, then they should (tell) the state health department, right?

Correctly. The difficulty is if surgery centers don’t know that patients have (went home) and have complications. … They don’t know what to report, and then we can’t come in and help with prevention measures.