In the past few years, the occurrence and popularity of buttock augmentation procedures has increased dramatically, particularly the Brazilian Butt Lift. During a BBL procedure, liposuctioned fat from the abdomen, back, flank, and thighs are transferred into the buttocks to achieve improved volume, shape and size. While most BBL patient satisfaction is through the roof, as with any type of surgery, sometimes unfortunate risks and complications can arise. One devastating complication, in particular, is a fat emboli which has a relatively high mortality rate of 1:20,000; especially when compared to the liposuction mortality rate of 1:100,000.



CT scan of pulmonary emboli resulting from a fat embolism.

Fat embolism is a phenomenon where fat particles get inadvertently deposited into regional larger vessels that then travel into other organs, obstructing the flow of blood throughout the body; if the blood flow is obstructed to the lungs, termed a pulmonary emboli, death may occur.

As a doctor, my job is to do no harm to my patients, and with this goal in mind we have developed a safer approach to this procedure which helps to minimize the risk of fat embolism.

Minimizing Brazilian Butt Lift Risks

First we identify the major arteries in the gluteal region, such as the superior gluteal artery, inferior gluteal artery, and deep femoral artery, by utilizing bony anatomical landmarks. This is followed by confirmation of these locations using a hand-held Doppler ultrasound at the beginning of surgery. Next, we infiltrate these areas with local anesthetic solution, which results in constriction of the perforating vessels, thus making inadvertent penetration of the vessels less likely. Additionally, we avoid the grafting action of the cannula (a thin tube used in liposuction) to these regions.

It is also important to use a larger 4-5 mm gauge grafting cannula, which has been found to be more protective, in comparison to the smaller 2-3 mm cannulas. And finally, we also make sure to only inject in the subcutaneous tissues and superficial muscles, while avoiding the penetration of deeper muscles, such as the piriformis muscle. With our knowledge of important anatomical landmarks, we strive to avoid major arteries and veins in the gluteal region. By performing this technique with such careful consideration of the vascular anatomy, we aim to minimize the risk of fat emboli complications during this procedure.


A thin tube called a cannula, used to suction and transfer fat.

For more information and to determine if you are a good candidate for a Brazilian Butt Lift, schedule a free consultation with Dr. Mowlavi, Orange County’s premiere buttocks augmentation surgeon.

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