Brazilian Butt Lift – BBL

Brazilian butt lift (BBL) is an augmentation of the buttock region using patient’s own fat tissue.

In this outpatient procedure, Dr Pagkalos performs VASER® Hi-Def liposuction to harvest unwanted fat from other areas of the body, most commonly the thighs, back, abdomen and flanks. After purifying the extracted fat, a technique known as gluteal fat augmentation is used to inject the fat into the butt cheeks (and often the hips) enhancing the size and shape of the buttocks.

BBL has become so popular not only because well shaped buttocks are always desirable, but also because it is essentially two procedures in one. Patients are able to get rid of unwanted fat and, at the same time, reshape buttocks and hips, all without artificial injections or implants. This combination can dramatically contour the body and create a sexy hourglass shape.

Are BBL results permanent?

Like all fat grafting procedures, not all fat will survive long term. Approximately 20-40% of the injected fat will be absorbed by patient’s body during the healing process. Avoiding to put pressure directly on the grafted fat during the recovery period helps preserve as much of the injected fat as possible. 3 months post-OP, one should have a good indicator of the final result, since, from that point on, the risk of losing fat dramatically decreases.

To achieve even better fat survival rates, Dr Pagkalos enriches fat tissue with adipose stem cells.

BBL and Stem cells

Multiple studies have shown that stem cells significantly increase fat tissue survival in BBL. The main source of stem cells is patient’s own fat tissue. Adipose-Delivered-Stem Cells (ADSCs) are multipotent cells which, in BBL, speed up the new-angiogenesis, the formation of new arteries that will vastly bring fresh blood to the newly transferred fat cells.

Additionally, ADSCs’ anti-apoptotic factors secretion boosts fat cells stamina and survival through multiple cell pathways.

How much fat can be transferred during BBL

In order for a patient to see significant difference, an average of 250-300 cc of fat should be transferred per side.

Patients often look for a dramatic volume bump and want the maximum amount of fat that far exceeds 300 cc. However, the volume of fat transferred depends on the capacity of butt’s soft tissues and their ability to support larger volumes of fat. Overfilling can create constriction that leads to greater rate of fat cell death, as transferred fat cells struggle to establish new blood supply.

For patients who opt for an excessive volume increase, Dr Pagkalos suggests a second or even a third procedure in order to secure decent fat survival rates and permanent results.

What makes a BBL dangerous?

A BBL uses a well established plastic surgery technique know as autologous fat grafting which is a consistently safe procedure. The risks associated with BBL is specific to the anatomical region where fat is injected. During the first years of BBL’s massive expansion through the world, unexperienced surgeons were entering into the so-called “anatomic danger zones” where there are a lot of blood vessels and it is very easy to have fat entering the bloodstream and clog major blood vessels.

Immediately after this complications started to emerge, American Society of Plastic Surgeons (ASPS) joined forces with other plastic surgery organizations worldwide to create an international task force to explore BBL’s safety issues.

The task force exposed the flaws to the technique and issued updated guidelines to safely perform the procedure. Since then, plastic surgeons in the US and throughout the world have changed the BBL technique based on the recommendations of the task force and nowadays BBL is considered as safe as a tummy tuck.