In light of recent events, I would like to warn against the recklessness of undergoing this procedure simply to enhance one’s image.
Once again, a patient has died during a so-called “Brazilian butt lift”
This time, it’s a 38-year-old influencer and mother of a young daughter at a private clinic in Moscow. (Source: BILD)
Why do deaths keep occurring in connection with buttock surgeries (especially Brazilian butt lifts and fat grafting)?
Most of the reported deaths are related to fat transfers to the buttocks, also known as the Brazilian Butt Lift (BBL). This procedure is considered one of the riskiest cosmetic surgeries in the world.
1. The greatest risk: fat embolism
The main cause of death is a fat embolism.
🔴 What does that mean?
When fat is injected, it can accidentally enter large blood vessels. From there, it travels to:
• the lungs → respiratory arrest
• the heart → circulatory failure
• the brain → stroke
➡️ This complication occurs suddenly and often without warning, and is frequently uncontrollable, even with immediate intensive care.
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2. An anatomically extremely dangerous region
The butt isn’t a harmless area:
• large veins directly beneath the muscle
• strong blood flow
• Very little tolerance for error if the cannula is positioned incorrectly
⚠️ The following injection practices are particularly dangerous:
• into or under the gluteal muscle
• using sharp or overly thin needles
• without visual confirmation
Many deaths are caused precisely by these technical errors.
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3. High pressure & large amounts of fat
In BBLs, very large amounts of fat are often transplanted.
Problems:
• high injection pressure
• fat “seeks out” vascular pathways
• tissue cannot reliably absorb the volume
➡️ The more fat, the higher the risk.
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4. Surgery Abroad & Low-Cost Providers
One relevant factor is medical tourism:
• Time pressure (several BBLs per day)
• lack of follow-up care
• Inadequate anesthesia monitoring
• lack of emergency response systems
But importantly:
❗ Deaths have also been reported in Western countries with specialist doctors.
The risk lies in the surgery itself, not just in “where” it is performed.
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5. Underestimated Risks of Anesthesia
In addition:
• Long surgery times
• Prone position
• Blood loss
• Fluid shifts
• Risk of thrombosis and embolism
The blood vessels are dilated by the anesthesia and blood flow is slowed, making it easier for fat cells to pass through the vessel walls.
In addition, the patient feels no pain, so the surgeon has no feedback,
Especially in cases of:
• Female smokers
• Hormonal contraception
• Obesity
• Pre-existing conditions
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So why do we keep hearing about it?
Because:
• Social media promotes unrealistic body ideals
• Influencers rarely mention the risks
• Results are immediately visible
• Patients often do not assess the risk realistically
Many believe:
“It’s just your own body fat—so it’s natural and safe.”
➡️ Unfortunately, that’s not true.
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Summary for Patients (Clear & Honest)
• Buttock fat grafting has one of the highest mortality rates in cosmetic surgery
• The main cause is fat embolism
• Even when performed correctly, a residual risk remains
• Large volumes = higher risk
• No result justifies death
Important Note
Even with professional execution, modern technology, and careful planning, a residual risk cannot be completely ruled out.
A thorough medical consultation, realistic expectations, and a personalized assessment of the risks are essential prerequisites before deciding to undergo this procedure.
A gentler alternative is the subcutaneous injection of autologous fat cells—that is, processed living fat cells—for buttock enhancement, such as smoothing out dimples or sharpening the contours, performed under local anesthesia using appropriate tissue-sparing cannulas.
If done correctly, this eliminates all life-threatening risks.