BBL (Brazilian Buttock Lift/Gluteal Fat Augmentation)

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IMPORTANT: Dr. Yazid does not perform primary (first-time) BBL procedures.

This is a deliberate, patient-safety-based decision grounded in published medical evidence and   endorsed by the world's leading plastic surgery organizations. This position   is not a reflection of surgical skill or capability, but of an unwillingness   to accept unnecessary risk of patient death for an elective cosmetic   procedure.

The Brazilian Butt Lift (BBL) — also called gluteal fat grafting — has been identified by multiple major plastic surgery societies as the single most dangerous elective cosmetic surgical procedure performed today. The primary cause of death is pulmonary fat embolism (PFE): a condition in which injected fat enters the large gluteal veins during surgery, travels through the bloodstream, and lodges in the heart or lungs. This complication can be rapidly fatal and can occur even in accredited surgical facilities under the care of experienced surgeons.

While technique improvements and updated guidelines have reduced the mortality rate compared to earlier estimates, no primary BBL carries zero risk of death — and for an elective body contouring procedure, Dr. Yazid believes that risk is not one he is willing to impose on his patients. He has made this decision transparently and stands by it as a reflection of his values as a surgeon and his commitment to patient safety above all else.

The Data: What the Research Shows

The safety concerns surrounding BBL are well-documented in the peer-reviewed medical literature and have prompted extraordinary responses from professional organizations that rarely issue joint emergency advisories. Below is a summary of what the evidence shows:

• Highest mortality of any cosmetic procedure: The American Society of Plastic Surgeons (ASPS), The Aesthetic Society (ASAPS), and the International Society of Aesthetic Plastic Surgeons (ISAPS) have jointly stated that BBL has resulted in an alarming mortality rate — estimated in early studies at as high as 1 in 3,000 procedures — far exceeding the death rate of any other elective cosmetic surgery.

• The cause of death is consistent: Autopsy data from every confirmed BBL fatality has shown fat within the gluteal muscles, vascular injury to the superior or inferior gluteal veins, and massive fat emboli in the heart and lungs. No postmortem examination of a BBL death has ever shown fat confined exclusively to the subcutaneous space.

• Risk improves with technique — but never reaches zero: A 2020 survey published in the Aesthetic Surgery Journal found that when fat was injected exclusively above the muscle (subcutaneous only), mortality rates dropped significantly. However, professional organizations acknowledge that no technique fully eliminates risk, and that surgeons injecting into the muscle faced a greater than 400% increase in fatal and non-fatal fat embolism risk.

• Surgeon fatigue is a documented contributing factor:Analysis of Florida BBL deaths found that the majority occurred at the end of the surgical week, consistent with fatigue-related technical errors. The 2022 Practice Advisory from ASPS/ASAPS/ISAPS recommended limiting surgeons to a maximum of 3 BBL cases per day.

• High-volume budget clinics are disproportionately represented: A published study of South Florida BBL autopsies found that 92% of patients who died had their surgery at high-volume, budget-priced clinics — where financial pressures, rapid case turnover, and inadequate oversight create conditions for fatal errors.

• Medical tourism dramatically elevates risk:Patients who travel internationally for discounted BBL procedures — particularly to countries with limited surgical oversight — face substantially higher complication and mortality rates. The original operating surgeon is unavailable for follow-up care, and complications are often managed by providers unfamiliar with the procedure.

References & Further Reading

American   Society of Plastic Surgeons (ASPS). "Plastic Surgery Societies Issue   Urgent Warning About the Risks Associated with Brazilian Butt Lifts."   2018. www.plasticsurgery.org

ASPS,   The Aesthetic Society, ISAPS. "Gluteal Fat Grafting: A Joint Safety   Statement." August 2022.   www.plasticsurgery.org/for-medical-professionals/publications/psn-extra/news/gluteal-fat-grafting-a-joint-safety-statement

ASPS/ASAPS/ISAPS.   "Practice Advisory on Gluteal Fat Grafting." Aesthetic Surgery   Journal, April 2022. doi.org/10.1093/asj/sjac082

Mofid   MM, Teitelbaum S, et al. "Report on Mortality from Gluteal Fat Grafting:   Recommendations from the ASERF Task Force." Aesthetic Surgery Journal,   2017; 37(7):796-806. doi.org/10.1093/asj/sjx004

Pazmiño   P, Garcia O. "Brazilian Butt Lift-Associated Mortality: The South   Florida Experience." Aesthetic Surgery Journal, 2022.   doi.org/10.1093/asj/sjac224

Multi-Society   Task Force for Safety in Gluteal Fat Grafting. "Urgent Warning to   Surgeons Performing Fat Grafting to the Buttocks." January 2018.   www.plasticsurgery.org/documents/Patient-Safety/BBL/Gluteal-Fat-Grafting-Safety-Advisory_Jan18.pdf

Cuzalina   A, Mostofi P, Hah W. "Gluteal Fat Grafting Technique and Mortality   Update Among Surveyed ABCS Surgeons." Aesthetic Surgery Journal, 2024.   doi.org/10.1177/07488068231215113

How Dr. Yazid Can Help You

Although Dr. Yazid does not   perform primary BBL procedures, he is pleased to offer comprehensive care for   patients who have already undergone a BBL and are experiencing complications,   wound problems, contour irregularities, or other concerns. You deserve   expert, board-certified care regardless of where or by whom your original   procedure was performed — and Dr. Yazid is committed to providing that   without judgment.

BBL complications are more common than many patients are told before their surgery. Whether you had your procedure locally, out of state, or abroad, Dr. Yazid has the surgical expertise to evaluate and address a wide range of post-BBL concerns. Below is an overview of the types of problems he commonly treats in this setting.

Wound Complications

• Wound opening (dehiscence): Liposuction access sites, injection entry points, or any incision that has separated or failed to heal properly.

• Skin necrosis: Areas of skin overlying the buttocks or liposuction donor sites that have become dark, hardened, or lost their blood supply — a known complication of aggressive liposuction and large-volume fat transfer.

• Infection: Superficial and deep infections of the buttocks, flanks, or abdomen following BBL, including abscess formation requiring drainage.

• Chronic wounds: Non-healing ulcerations or sinus tracts that have persisted for weeks or months following a BBL procedure.

• Suture reactions and foreign body responses:Reactions to sutures, drains, or other materials placed at the time of the original procedure.

Contour Irregularities & Fat-Related Complications

• Fat necrosis: Areas of transferred fat that did not survive and have become firm, nodular, calcified, or painful beneath the skin — a relatively common complication of large-volume fat transfer.

• Asymmetry: Uneven fat survival between sides, resulting in visible size or shape differences between the two buttocks.

• Contour deformities of donor sites: Irregular depressions, waves, or lumpy areas at liposuction sites (abdomen, flanks, thighs, back) resulting from aggressive or uneven liposuction technique.

• Seroma: Fluid collections beneath the skin at either the donor or injection site that have not resolved on their own.

• Skin laxity: Loose or hanging skin at donor sites following aggressive liposuction, which may require surgical correction.

• Overcorrection or undercorrection: Excessive volume resulting in an unnatural appearance, or insufficient volume that did not meet the patient's expectations.

Revision & Corrective Procedures Dr. Yazid Offers

• Wound debridement and closure: Surgical cleaning and closing of open, infected, or necrotic wounds.

• Skin graft or flap reconstruction: For larger areas of skin loss that cannot be closed primarily.

• Excision of fat necrosis: Removal of firm, calcified, or symptomatic areas of non-viable transferred fat.

• Revisional liposuction: Correcting contour irregularities at donor sites using refined liposuction technique.

• Scar revision: Addressing visible, thickened, or symptomatic scars from prior liposuction access sites or incisions.

• Fluid drainage (seroma/abscess): In-office or surgical drainage of fluid or infected collections.

• Body contouring revision: Comprehensive re-evaluation and surgical planning to address shape, symmetry, and aesthetic concerns following a prior BBL.

What to Bring to Your Consultation

To help Dr. Yazid evaluate your situation as thoroughly as possible, please bring the following to your first visit:

• Any operative reports, discharge paperwork, or notes from your original surgeon if available.

• A list of all medications, supplements, and antibiotics you have been prescribed since your procedure.

• Photographs of your concerns, including wound areas, contour concerns, or changes over time — particularly if symptoms are intermittent.

• Information about where your procedure was performed, including the country or state and whether it was performed in an accredited facility.

• Any imaging (ultrasound, CT scan, MRI) that has been performed since your procedure.

If you are currently   experiencing an open wound, signs of active infection (fever, spreading   redness, pus), or any rapidly worsening symptoms, please do not wait for a   scheduled consultation. Call our office immediately or go to the nearest   emergency room. These conditions require prompt attention.

A Note on Medical Tourism & Out-of-State BBL Complications

A significant number of patients who seek BBL revision care had their original procedure performed abroad or at out-of-state discount clinics. This is an increasingly common pattern that Dr. Yazid and plastic surgeons across the country are seeing in their practices. If this applies to you, please know that you will receive the same attentive, expert, non-judgmental care as any other patient. The goal is to help you heal and achieve the best possible outcome from this point forward.

Patients who had surgery outside the United States may not have access to operative records, may have received implanted materials not approved for use in the US, or may have had procedures performed outside accepted safety guidelines. Dr. Yazid is experienced in navigating these situations and will work with you to establish a clear picture of your anatomy and a safe plan for your care.

Contact Our Office

• The Plastic Surgery Center: (732) 380-1666 | 107 Monmouth Road, Suite 202, West Long Branch, NJ 07764 | www.looknatural.com

• Advanced Reconstruction — Hand & Upper Extremity: (732) 210-9234 | 485 Route 35, Shrewsbury, NJ 07702 | www.advancedreconstruction.com

Please note: email and patient   portal messages may take 48-72 business hours to receive a response. For   urgent wound concerns, active infection, or rapidly worsening symptoms,   always call our office directly or go to the emergency room. Do not rely on   email for time-sensitive medical issues.

Medical Disclaimer

The information in this document is provided for general patient education purposes by Mark Yazid, MD, FACS, and does not constitute individualized medical advice or establish a physician-patient relationship. Statistical data and references to published literature are provided for transparency and are accurate to the best of our knowledge at the time of writing; medical evidence evolves continuously and patients are encouraged to review cited sources independently. Dr. Yazid's position on primary BBL procedures reflects his personal clinical judgment and ethical standards and should not be interpreted as a categorical statement applicable to all surgeons or all clinical settings. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately.