For many years, we would hear the news of BBL deaths coming from Miami. However, in recent years, after studying the risks associated with Brazilian butt lifts, the news has not been so bleak. Abroad, however, deaths continue to rise.
The Centers for Disease Control and Prevention (CDC) just issued a severe warning regarding plastic surgery performed abroad, specifically the risks of Brazilian Butt Lift procedures in the Dominican Republic.
Dominican Republic BBL: A Surge in Deaths
The organization’s investigation revealed that 93 US citizens have died since 2009 while undergoing plastic surgery in the Caribbean nation. According to the study, nearly 20 patients have died in recent years alone. The cause of death? Lipoembolism, which can occur when fat injections are used to enlarge and reshape the buttocks. Newport Beach, CA plastic surgeon Sanjay Grover, MD says it’s imperative that the fat is placed only in the superficial adipose or subcutaneous layer and not in the deeper muscles where there are large veins. “This drastically reduces the chance of any fat entering the bloodstream and reaching the heart and lungs.”
Patients undergoing fat transfer are also at risk of developing blood clots, particularly when undergoing multiple procedures over extended periods. Another potential risk factor is operating on patients with ages or BMIs higher than recommended guidelines.
“Don’t go to the Dominican Republic for your surgery, period, regardless of the type of surgery, unless of course you like to play Russian roulette,” warns Miami plastic surgeon Sean Simon, MD. “The same would be true of the myriad ‘clinic’ well-known and well-known steakhouses in Miami.”
“The BBL procedure is currently the most dangerous cosmetic procedure when you look at the statistics,” says gandolifi. “Over the past 10 years, the Am Society of Plastic Surgery and the Aesthetic Society have done extensive research to help reduce these complication rates. This has led to the implementation of safer techniques and additional technologies that help create a safer process. I truly believe, when done correctly, the risks of this procedure are in line with other plastic surgery procedures. However, when performed by someone who is not well trained, it can be deadly.”
Added protocols
The CDC has emphasized the need for improved surgical protocols and post-operative medical care to mitigate or prevent these risks, especially in cases where prophylactic measures against venous thromboembolism, the condition that occurs when a clot forms in a vein, could have been implemented . Following the CDC’s alarming findings, more than 77 cosmetic surgery facilities in the Dominican Republic were monitored to ensure proper procedures and prevent infections, which have been linked to complications and deaths after surgery.
According to Eugene, OR plastic surgeon Mark Jewell, MD, surgical facilities may not be up to the level of accreditation that exists in the United States. “All of these carry a risk of serious complications and death if the Brazilian butt lift is not performed in a safe manner to avoid deep fat injection through the use of ultrasound imaging,” he says.
While the use of ultrasound imaging is new, surgeons like Miami, FL plastic surgeon Onelio Garcia, MD say it’s a recent finding that probably won’t be used in most places overseas. “The State of Florida, for example, has a law mandating the use of hand-held ultrasound during BBL surgery,” he says. “This removes the blind nature of the procedure and allows the surgeon to visualize the fat grafts being injected into the appropriate subcutaneous space. This is certainly not going to happen in a DR clinic, particularly the high-volume, low-budget clinics marketed to prospective medical tourists.”
Travel tips to consider
“I think the main issue here is that there is no adequate way for American citizens to accurately research doctors or medical facilities in other countries, especially third world countries,” notes Pittsburgh, PA plastic surgeon Jeffrey Antimarino, MD. “Regulations about who can get cosmetic surgery in other countries can be quite different from the standards we require here.”
For US citizens considering plastic surgery abroad, the CDC emphasizes the importance of doing your homework and consulting with a primary care physician well in advance. They also advise seeking guidance from a travel medicine specialist at least a month before travel and allowing enough time between flying to and from a surgical destination to minimize the risk of complications, especially related to blood clots. “It’s not safe to get on a plane right after surgery without proper preparation,” explains McMurray, PA plastic surgeon Simona V. Pautler, MD. “Patients need to be properly counseled before surgery and I don’t think they are properly trained.”
“I encourage individuals to look into credible alternatives here in the US, including board-certified plastic surgeons accredited by the American Board of Plastic Surgery,” notes Dr. Simon. “It is important to note that board certification alone is not enough. Seeking professionals with a proven track record of success and expertise is paramount to a safe and satisfactory outcome.”
“Even with the best surgical techniques and the safest procedures, there can be complications with these procedures,” says Louisville, KY plastic surgeon Chet Mays, MD. “Going to an accredited facility by a board-certified plastic surgeon can reduce the risk of complications. Additionally, if there is a complication, we are trained as board-certified plastic surgeons in how to deal with those complications.”
