Dangers of Unregulated Brazilian Butt Lift (BBL) Operations

All over the world, doctors and medical practioners have been warning of the dangers of unregulated backstreet Botox and fillers for decades yet the situation has become worse, not better.

While the US has long been plagued with deaths from underground so-called 'pumping parties', where many transgender, who couldn’t afford conventional plastic surgery, had their buttocks injected with substances including industrial silicone in grubby garages and salons, it was impossible to imagine similar things happening to ordinary mothers in urbanized areas, but it does.

Alice Webb, 33, a mother of five young daughters, died in Gloucester Royal Infirmary in the early hours of 24th September, the apparent first British victim of a disastrously botched Liquid BBL, or Brazilian Butt Lift, a form of extreme bottom enlargement using cosmetic fillers.

A brief trawl through TikTok, Instagram and Facebook reveals that hundreds and potentially thousands of unqualified people in the UK – from beauticians to former horse-traders – have seized the opportunity to make money from offering cut-price fillers and Botox from home, garden buildings or via 'aesthetic roadshows' in hotel rooms. And more and more of them are offering BBLs.

The Brazilian Butt Lift was invented in the 1960s by the Brazilian superstar plastic surgeon Ivo Pitanguy whose clients included Frank Sinatra. The original BBL involved liposuction to hoover fat from tummies and thighs which doctors then transplanted to the buttocks to give a more curvaceous look. It was a niche procedure, partly because it was so risky, with studies showing the risk of death could be as high as one in 2,000 operations.

But why precisely is it so dangerous? Dr. Ash Soni is a consultant plastic and reconstructive surgeon who has performed over 3,000 surgical procedures. "It would be easy for me to do this procedure, but I’ve consciously decided not to," he explains. "I’ve done a lot of reconstruction around the gluteal muscles. A lot of care must be taken regarding the buttocks because of the complex anatomy of the area."

Crucially, the buttocks are full of large veins and blood vessels, some as big as a drinking straw. If fat or filler is accidentally injected into a blood vessel it can rapidly reach the heart, lungs or brain, with fatal consequences.

Dr. Soni says: "The fillers are being used in dangerously large volumes and fillers are often even more solid than fat, making them arguably as dangerous or even more so."

In 2018, the British Association of Aesthetic Plastic Surgeons (BAAPS) advised its members to stop offering the procedure. In 2022, it issued new guidance stating that fat should only be injected very superficially and under ultrasound guidance to ensure it wasn’t accidentally pumped into a vein. At the time the organization said the op was the fastest-growing type of cosmetic surgery worldwide, with its popularity increasing by 20 per cent year-on-year.