Mirror, mirror on the wall, who’s the fattest of them all? Brazilian butt lifts are the new beauty craze – even though they’re as popular as they are deadly. But why?
“Damn, she’s fat!” Phrases like this are heard every day in times when Kim Kardashian and co. dominate social media. And what the influencers exemplify will eventually reach society at large. The dream of the perfect Instagram body is expensive: thick lips, big breasts, thin waist and big buttocks. Of course, these body shapes are often impossible to achieve, and that’s where the beauty doctor comes in. However, one beauty procedure is more dangerous than many others: the Brazilian butt lift (BBL).
What is a Brazilian Butt Lift?
Deceptively, the Brazilian butt lift is neither Brazilian nor a butt lift. It is an autologous fat transplant from other areas of the body – such as the abdomen, back or arms – to the buttocks and hips. In itself, the procedure is not particularly dangerous. But when large amounts of fat are transferred – which is often the case with today’s procedures – the situation is quite different. “Fat embolism is a recognized risk associated with fat injections, particularly as used in buttock augmentation,” the researchers wrote in a recent review on the deaths of US patients who underwent cosmetic treatment abroad.
Beauty Over Safety
The review, which appeared on Centers for Disease Control and Prevention: Morbidity and Mortality Weekly Report, shows how dangerous cosmetic procedures can be abroad. Many cosmetic procedures are very expensive, a factor that is often not relevant abroad. Therefore, cosmetic tourism is growing in popularity: “The Dominican Republic is popular for medical tourism because it is close to the United States, has an existing tourism infrastructure, and some doctors from the Dominican Republic advertise in the United States,” the authors of the study state. Patients often undergo multiple procedures away from home in a very short period of time and then travel home newly operated. Post-operative complications must then be treated in their country of origin, often without the doctors or patients themselves knowing exactly what happened.
So the researchers looked at how many deaths there were between 2009-2022 among US citizens who underwent cosmetic surgery in the Dominican Republic – and found a significant increase in recent years. While there was a median of 4.1 deaths per year between 2009–2018, there were already 13.0 cases in 2019–2022 with a peak of 17 cases in 2020. A total of 93 deaths related to cosmetic procedures were reported in the years between 2009–2022. All patients except of one were women with an average age of 40.
What causes beauty deaths?
The review looked at the 29 deaths from 2019-2022 in more detail. Medical data were available for 24 of these cases. All 24 deaths were women, 92% of whom had comorbidities with increased risk for venous thromboembolism. 96% of the women were overweight, two had diabetes. Autopsy reports are available for 20 cases. All autopsy-confirmed deaths could be attributed to intraoperative and postoperative complications. “Most deaths were the result of embolism—lipid embolism (55%) or venous thromboembolism (35%)—for which a large proportion of patients who died had risk factors, including obesity and multiple procedures at the same time,” the study authors . he said.
“Among the deaths due to fat embolism, all patients had undergone liposuction and gluteal fat transfer.” All autopsy-confirmed deaths had therefore undergone BBL – although some patients had also undergone other procedures. But why is autologous fat transplantation so deadly in particular, even though it involves the body’s own substances?
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As the volume of transferred fat increases, the subcutaneous recipient site may become overwhelmed. For this reason, surgeons began to transplant fat deeper and deeper into the gluteal muscles, which are well supplied with blood – and this can lead to fatal complications. “Intramuscular gluteal lipoinjection is associated with mortality caused by damage to gluteal blood vessels allowing macroscopic and microscopic fat embolism. Therefore, buttock lipoinjection should be done very carefully, avoiding injections at deep muscle levels,” says another study on the mortality of BBLs.
The price of beauty
Many patients try to save money by having supposedly cheap cosmetic procedures in other countries where prices are low and waiting times are short. However, some beauty tourists pay a much higher price for their beauty journey. The complications and risks of cosmetic surgery should not be underestimated. Procedures like BBL aren’t a simple beauty fix you can only do on vacation. It is an invasive surgery that carries exactly the same risks as conventional surgery.
Image source: Alex Shuper, Unsplash
