By Zoe Applegate and Helen BurchellBBC News, Norfolk
Natasha KerrButtock enlargement – also known as Brazilian butt-lift (BBL) – is the fastest growing plastic surgery procedure but also one of the most dangerous. This week, a coroner concluded that 31-year-old Melissa Kerr, who died during an operation in Turkey, did not have enough information to make a safe decision about the procedure. How safe is the procedure and why is it so popular?
What happened to Melissa Kerr?
Mrs Kerr, from Gorleston, Norfolk, died at a private hospital in Istanbul in November 2019 while undergoing the procedure.
A fatal clot traveled to her lungs after injecting fat obtained during a liposuction procedure into her buttocks.
He handed over £3,200 in cash for the operation, but at Norwich Survey Coroner Jacqueline Lake found Ms Kerr did not have enough information to make a safe decision about the procedure.
Mrs. Lake says it will be now writing a “preventing future deaths” report. in the hope that deadly cosmetic surgery tourists “can be prevented through better information”.
BBLs carry the highest risk of all cosmetic procedures – with more than one death occurring in every 4,000 procedures, the survey reported.
Natasha KerrWhat is a Brazilian butt-lift?
BBLs are used to make the buttocks bigger, rounder or lifted.
Surgeons insert silicone-filled implants and/or inject fat transferred from other parts of the body.
Despite the risks, the British Association of Aesthetic Plastic Surgeons (BAAPS) says the procedure is the fastest-growing type of cosmetic surgery, with its popularity increasing by 20% year-on-year.
Last year, VAAPS was issued new guidelines to the following members a four-year moratorium on the BBL due to the high mortality rate.
He now recommends that surgeons only perform a procedure called superficial gluteal lipofilling (SGL). While it uses fat harvested from the body, it is only injected under the skin, while BBLs inject fat deep into the muscles.
He also recommends that surgeons only perform SGL while simultaneously using ultrasound so they can see where the cannulae are going.
Natasha KerrWhy do people want surgery?
Ms Kerr, a psychological wellbeing practitioner at mental health charity Mind, was “self-conscious” about her appearance.
Her twin sister, Natasha Kerr, told the BBC that Melissa – who had two master’s degrees – “became unhappy with her body due to weight gain and after exhausting all other options, she felt there was no option but to have surgery intervention”.
Consultant clinical psychologist Dr Anu Sayal-Bennett, a Chartered Fellow of the British Psychological Society, says she feels the allure of celebrity culture and choreographed social media images is behind the trend for BBLs.
She says celebrities like Kim Kardashian, with their impressively curvy bodies, fuel the trend.
Dr Anu Sayal-Bennett Family“Despite the fact that there is so much about body positivity, there are pressures on women – and men too – to look a certain way,” added Dr Sayal-Bennett.
Plastic surgeons often refer their patients to her as they recognize the importance of psychological projections.
The ethics of these surgeons is such, he says, that if patients don’t meet the criteria, then they won’t be operated on – but he warns that this isn’t the case across the world.
GoogleWhy do people travel abroad for a Brazilian butt lift?
Advertisements for cosmetic surgery clinics in Turkey show glamorous images of women in swimsuits promoting the procedure, alongside special offers for patients combining procedures.
Dr Sayal-Bennett says the ad is “terribly seductive”.
“The glossy ads: you can get your BBL, drink your cocktails and go on your beach holiday and it’s cheap on the price.
“But it’s an illusion – it’s a major surgery.”
BAAPSIt is mainly cost that is the deciding factor, says Dr Nora Nugent, BAAPS vice-president.
“In the UK, the operation can cost between £6,000 and £12,000, but it can be more.
“Advertisements I’ve seen for the procedure in Turkey range from £3,500 to £5,000,” adds Dr Nugent.
“Some people went overseas when surgeons following BAAPS guidelines did not perform the procedure between 2018 and 2022.”
Both experts agree that the glossy images from abroad belie the reality.
“The buttocks are swollen, sore and bruised and where the fat has been removed – which can be in many places – there is also swelling and bruising, explains Dr Nugent.
“You need bandages and compression bandages so you’re not sitting on a beach.”
Both doctors emphasize the importance of aftercare after surgery.
Why is the process so dangerous?
Inquiries have been launched in the UK into the deaths of three women – Melissa Kerr, Abimbola Ajoke Bamgbose, from Dartford, Kent, and Leah Cambridge, from Leeds – who traveled to Turkey for BBL or related procedures.
People have died during BBLs due to the injection of fat into large veins that then travel to major organs.
The high risk of mortality prompted the BAAPS in 2018 to ask its members not to perform the operation.
He found complications ranged from serious bacterial infections, including MRSA, necrosis – where tissue dies – scarring, wound lacerations and abscesses.
In 2018, BAAPS heard how a London hospital had seen a six-fold increase since 2013 in cases requiring urgent follow-up from surgeries carried out abroad.
While Ms Kerr’s research put mortality rates at one in 4,000, Dr Nugent says more recent research has shown it is likely to be between 1 in 13,000 to 15,000.
What should people do before traveling to Turkey?
In an “unprecedented” move BAAPS issued a joint patient safety statement with the Turkish Society of Plastic Reconstructive and Aesthetic Surgeons (TSPRAS) this summer.
The organizations are now urging anyone traveling to Turkey for plastic surgery to follow them new guidelines.
They were removed after the BAAPS found that complications in patients seeking treatment abroad would increase by 35% in 2022.
“We can’t stop people going abroad – insurance and hospital costs in the UK are much higher,” says Dr Nugent.
“But the least we can do is show them what to ask their surgeons for, how the procedure will be performed and details about routine aftercare.”
New advice for any patients going to Turkey includes:
- Check that Turkish surgeons are TSPRAS members and Turkish board certified
- Plastic surgeons should have practiced in their field of specialty for at least five years
- Surgeons should offer an aftercare plan and patients should know their name and how to contact them
- In Turkey it is mandatory that a full consent form is completed prior to travel
What does the Ministry of Health say?
“All cosmetic procedures carry risks which can affect people’s physical and emotional health and safety standards in other countries may not be as high as in the UK,” a spokesman said.
“We encourage anyone considering cosmetic surgery abroad to do their research on the standards and qualifications that apply in the country they are traveling to.
“They should ensure that adequate insurance arrangements are in place and that they have access to appropriate aftercare in the UK in the event of complications.
“Our condolences go out to the family of Melissa Kerr and we will look into the concerns raised in the coroner’s report.”
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