A 32-year-old woman who visited a Miami surgeon for a buttock lift in Brazil has died after the doctor allegedly injected fat into her muscle, a potentially fatal surgical error.
The woman – identified only as WA – is the subject of a complaint by the Florida Department of Health filed against Dr. Ernesto Torres, a surgeon who practices at Miami Lakes Plastic Surgery.
The complaint claims the doctor injected fat into the patient’s gluteal muscle—a violation of Florida law—which led to her death in May 2023.
The Brazilian butt lift (BBL) is an increasingly popular cosmetic procedure that sees surgeons liposuction – remove – fat from the waist and back and inject it into the buttocks to create a bigger and fuller rear.
However, during or after buttock fat injection, small particles can enter the blood vessels and travel to the lungs. If these particles reach organs, they can block blood flow, affect oxygen levels, and patients can develop respiratory failure that leads to death.
The unidentified woman is the subject of a Florida Department of Health complaint filed against Dr. Ernesto Torres, a surgeon who practices at Miami Lakes Plastic Surgery
While this is the first complaint filed against Dr. Torres, there is a pending complaint from 2022 accusing Miami Lakes Plastic Surgery of various violations, including removing too much fat during a liposuction procedure.
WA was under Dr Torres’ care for back and waist liposuction with buttock fat grafting for a BBL – which usually costs between $8,000 and $10,000.
The Florida complaint alleges that during the procedure on May 26, 2023, Dr. Torres injected fat into the gluteal muscle and the patient’s heart began to beat rapidly and her blood pressure plummeted. Clinic staff called 911 and began CPR on the patient.
However, WA went into cardiac arrest and died.
An autopsy on May 28 “identified the cause of death as bilateral pulmonary fat emboli,” small round particles that clog blood vessels. Bilateral indicates that the emboli were in both of the woman’s lungs.
The autopsy report said there was fat in the gluteal muscles and around the sciatic nerves – the largest nerves in the body that run from the lower back through the buttocks and down each leg to the foot.
This, the report continued, “eventually led to bilateral pulmonary fat emboli.”
Florida Administrative Code states when performing a BBL, the fat can only be injected subcutaneously—just under the skin—and “must never cross the gluteal fascia,” a dense layer of tissue that surrounds and supports the buttock muscles.
The law also provides for intramuscular fat injections [directly into the muscle] or subcutaneous fat injections [underneath the muscle] are “prohibited” and the complaint states that Dr. Torres “violated” that law “in treating patient WA.”
If fat particles are injected into the gluteal muscles, they can enter the bloodstream and travel to the lungs where they form pulmonary fat emboli.
This can lead to reduced blood flow to parts of the lungs and damage the oxygen in the lungs, which reduces the amount of oxygen circulating in the body.
The Florida complaint said the 32-year-old woman was undergoing a Brazilian butt lift at Miami Lakes Plastic Surgery
Although this is the first complaint filed against Dr. Torres, has a pending complaint from 2022 accusing Miami Lakes Plastic Surgery of various violations, including removing too much fat during a liposuction procedure
With insufficient oxygen circulation, patients may experience difficulty breathing and eventually respiratory distress if the lungs are so deprived of oxygen that they are unable to provide life-sustaining levels to the body.
Pulmonary fat emboli can also cause heart failure, organ failure, and severe inflammation in the lungs.
It is vital that the condition is diagnosed early and treated quickly, but it may go unrecognized because signs and symptoms can be subtle. They can include skin rash and bruising, headaches, confusion and either slow or fast breathing.
Treatment consists of steroids, blood-thinning drugs, supplemental oxygen, ventilation, or various procedures that can directly treat clots in the body.
The condition usually occurs after a large bone is broken and affects between 0.5 and 10 percent of cases depending on the cause.
While the administrative complaint against Dr. Torres begins the disciplinary process, it could take years before any decision is made.
The complaint recommends various penalties, including the permanent revocation or suspension of Dr. Torres’ medical license, a restriction on his practice and the imposition of a fine.
The rise of BBL is believed to be due to social media, celebrities and the ‘Kardashian effect’.
A record 28,600 women in the US underwent cosmetic surgery to improve their backs in 2022, according to data, a 54% increase in five years.
While a fat embolism is the most worrying risk of a BBL, other complications include tissue death and fluid retention – where fluid builds up in certain areas and requires further surgery to remove it.
And officials are warning of deadly complications following the rise in people traveling to other countries to have the procedure at a fraction of the cost.
Earlier this year, the CDC said 93 Americans have died after BBL in the Dominican Republic since 2008.
