January 24, 2020

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Brazilian buttlifting (BBL) or fat grafting of the buttocks is one of my most commonly performed procedures. Ten years ago, it was not the case: boobs were in. Thanks to Kim Kardashian and social media, butts have captured people’s attention. BBL is thus one of the fastest growing segments of plastic surgery. It is a great procedure to incorporate into a Mommy Makeover, converting an otherwise square, matronly, middle aged looking physique into something far more youthful and sexy.

How to Optimize a Brazilian Butt Lift Result

Patients often ask me for tips to on how to optimize their bodies prior to having a BBL. Like any other surgical procedure (like a tummy tuck or breast lift), being healthy is the best course of action. Working out and eating right has no substitute when it comes to optimizing results and improving safety. Study after study in multiple surgical disciplines has borne this out. There is a VERY CLEAR correlation between BMI (essentially height/weight) and complications. There is also a clear correlation between patient satisfaction and BMI. A recent study in The Journal of Plastic Surgerydemonstrated a direct correlation between BMI and patient satisfaction after liposuction. Although no such study exists in regards to BMI and BBL, my experience suggests that with BMI and BBL, satisfaction is inversely related. The higher the BMI, the less satisfied the patient.

BBL is a unique procedure in that you need fat in order to obtain a good result. With aging, pregnancy or bad genetics, fat distribution does change. People can accumulate fat in the wrong places over time despite diet and exercise. These patients are IDEAL candidates for a BBL. Since their limbs and trunk are not too big, any fat placed into the buttocks pops. On the other hand, too much fat does not translate into a better result. I see a fair number of patients who flirt with obesity but want bigger butts to look more feminine. Sadly, this scenario rarely ends well. Their shear body mass (think big, apple shaped stomach, thighs, arms, etc.) camouflages any fat added to the butt. A high BMI also limits the improvement in contour from liposuction due to restrictions on fat removal. Most states, including North Carolina, limit the amount of fat and fluid you take out in one sitting to five liters. Remove more than that, and bad things happen, including hospitalization and death. For larger patients, I often recommend more than one session following optimization of weight through diet and exercise.

Brazilian Butt Lift is NOT for weight loss

BBL is a great procedure. Unfortunately, like liposuction, it is not intended as a weight loss procedure. Too many women are bamboozled by images of miraculous results online where a plus sized gal is chiseled down to nothing (often in some foreign country where no restrictions on liposuction exist). This warps expectations and is not grounded in reality or the safety of patients. Many people have died chasing this vain fantasy overseas. Even if someone goes to the Dominican and gets away with it, they may LOOK better for the short term, but UNLESS their lifestyles changes, they will remain unhealthy and thus suffer all the same consequences later down the road including diabetes, high blood pressure, heart disease and a shortened life. Furthermore, if they continue to overeat and not exercise, their butts will become supersized, making clothing choices and life in general more difficult. The caption image of this blog piece is a prophetic warning along those lines.

So, my best recommendation is to get in shape before a BBL. That being said, I do not go by strict BMI metrics when it comes to patient selection. Some ethnicities have more muscle mass and bulk and thus carry more weight. For example, I have many African American patients with BMIs near 30 but who are healthy and work out on a regular basis. By contrast, similar BMIs on Caucasian women would translate into being scooter bond and on oxygen. Plastic surgery is not a cookie cutter discipline and takes finesse in both its patient selection and execution. That aside, I do however expect a healthy lifestyle and mindset.