The buzz in plastic surgery over the past couple of months has been the recent findings of the Aesthetic Surgery Education and Research Foundation’s (ASERF) Gluteal Fat Grafting Task Force. This task force had been formed to investigate risks associated with high volume fat grafting to the buttocks, specifically the risk of fat embolism, which has been the cause of many high profile BBL-related deaths in the media. Fat embolism can be fatal if fat inadvertently enters bloodstream and travel to the lungs, shutting down vital portions of this organ and leading to sudden death during the procedure. The task force did show an increased risk of sudden death secondary to fat embolism after Brazilian Butt Lift compared to other plastic surgery procedures.
In my mind, the vital questions are these: Can Brazilian Butt Lift be performed safely and how can you, the patient, optimize your safety during the procedure?
One of the key limitations of the task force’s findings was failure to disclose the specific techniques utilized during cases which led to fatality or was the relative experience of the surgeons performing the procedures. Knowledge and experience matters when performing Brazilian Butt Lift.
Plastic surgeons need to be vigilant that they are not inadvertently injecting fat into the gluteal blood vessels while performing Brazilian Butt Lift. Certain anatomic planes are richer in large blood vessels and inadvertent fat injection could be more likely to happen in these locations without close attention to buttock anatomy. Specifically, deeper anatomic planes (i.e. deep to the gluteus maximus muscle and along the deeper aspect of these muscles) contain the inferior and superior gluteal vessels, the major blood vessels of the buttock, as well as a rick plexus of veins around the lower spine. That being said, in many cases, if I do not inject fat in deeper anatomic planes, I cannot achieve the same cosmetic results. In these cases, strict adherence to safe technique is essential. These vital techniques using blunt cannulas to inject fat to avoid accidental puncture of large veins, performing all injections under low pressure, and avoiding the regions of the buttock that are rich in blood vessels; for this last part, knowledge of anatomy is obviously essential.
Low pressure injection is particularly important and, to that end, I have switched to an automated injection system with a built in pressure gauze. With this pressure monitor, I can ensure that all fat is introduced at a pressure less than that in our veins, preventing fat from entering the vessels. For those surgeons utilizing older technology (syringes and cannulas), the surgeon needs to utilize slow injections without significant resistance; experience is vital in these cases to ensure that a safe technique is being utilized. For surgeons who use an automated system, having a built-in pressure monitor will insure that only low pressure injections occur, thereby preventing inadvertent injection of fat into blood vessels.
Do your research before having a Brazilian Butt Lift. To avoid unnecessary fear and anxiety, seek out a highly trained and highly experienced plastic surgeon to perform your surgery