Brazilian Butt Lift (BBL)

Brazilian Butt Lift

Surgery performed by Dr. Sarah Elswick

Concepts of beauty have continuously evolved throughout history. With fashion promoting body-revealing attire and the emphasis on fitness and good health, people have sought to reflect these trends by demonstrating youthfulness and vitality in their bodies. Lifestyle, diet, genetics, pregnancy, and the aging process contribute to alterations that result in the loss of the individual’s body image.

Our objective is to provide you with a cutting-edge surgical approach that combines safe and efficient surgical techniques, resulting in a high degree of patient satisfaction. This is exemplified by our approach to a Brazilian butt lift, which transfers fat from one part of the body to the buttocks while sculpting the surrounding areas. Our precise methodology for a BBL is to individualize the surgical technique while optimizing aesthetic outcome, safety, and down-time.

A Brazilian butt lift is a combination of body contouring and fat grafting, which is a way to transfer fat cells from one part of the body to another part of the body. The fat is used to enhance areas where patients would like to improve fullness, smooth contour irregularities, or correct asymmetries.

This is desirable to those who like the idea of using their body’s own tissue. The fat is collected via liposuction, processed, and then injected into the desired location. An essential component of a BBL is contouring the areas around the buttock to optimize the appearance of the entire area. This means liposuction is typically performed in the abdomen, flanks (love handles), back, waist, and/or posterior thigh (banana roll). However, the fat can be harvested from any area with excess or undesirable fat. If a
large volume of fat is required, multiple surgeries may be required.

A BBL can be used as an alternative, or compliment, to buttocks implants. An advantage of using fat instead of an implant is that this is your own living tissue so complications occur much less frequently. You also have the advantage of removing a substantial amount of unwanted fat with liposuction.

The best candidates for a BBL are men or women who have adequate donor sites for their desired results (you must have enough excess fat in your body to transfer to the desired location) and be relatively healthy. This procedure may require several hundred or even 1000 cc (1 liter of fat).

During the consultation your areas of concern, previous treatments, and plans for weight loss should be discussed in great detail. Patients will have long term result from their BBL if their weight is stable and they are at their goal weight. A thorough physical examination of your areas of concern will be performed, including an analysis of the amount of excess fat and the quality of the skin.

Any major medical problems will be evaluated and should be optimized prior to surgery to minimize complications.

Your surgeon will ensure your questions are answered and your goals are understood. Patient expectations are important to discuss at the consultation.

It is important to maintain a healthy diet prior to your surgery to optimize the healing capabilities of your body. Your surgeon will give you specific instructions to prepare for the procedure, including guidelines on diet and medications. Patients using tobacco or other nicotine-containing products must stop at least four weeks before and after surgery. Carefully following these instructions will help your surgery and your recovery proceed more smoothly.

Your surgery can be performed at Columbia Surgery Center (our private outpatient surgical suite adjacent to our office) or at one of the local hospitals. Dr. Elswick has privileges at William Beaumont Hospital of Troy, William Beaumont Hospital of Royal Oak, and McLaren Macomb Hospital. If you have significant medical problems or will be undergoing large volume liposuction, your surgery will be performed at the hospital. A BBL is usually an outpatient procedure unless you have a large amount of fat removed, then you will require an overnight stay in the hospital.

A BBL is performed under general anesthesia.

To begin, liposuction is performed at the donor sites to optimize contour and remove unwanted fat. . To access the fat, several small incisions (typically about ¼” in size) are made. A solution called tumescent is injected in the fatty deposits to help break up the fat, provide anesthetic (numbing of the area), and minimize bruising. After the tumescent solution takes effect, the liposuction cannula is used to break up and remove the unwanted fat. Taking the appropriate amount of fat and blending it with the surrounding tissue is extremely important.

The fat is then processed using various filters to remove excess fluid and unusable fat. It is transferred to syringes and injected into the desired location through small incisions or injection needles in small volume aliquots, which enhances survival of the fat.

Studies show that approximately 60-80% of the fat that is injected survives. There are several reasons for this. Some of the fat that is injected also contains fluid that was utilized during the collection period. Also, the new fat cells must obtain their nutrition from the surrounding tissue where they are injected and not all the cells will have the ability to do so. Hence, your surgeon may slightly overfill the area to compensate for this so you get the desired outcome.

The length of the surgery depends upon the number of liposuction donor sites and the volume of fat injected. In general, a BBL takes anywhere from 3 to 5 hours.

Dressings at the fat injection sites in the buttocks typically consist of gauze and tape. It is important to prevent any compression of the buttocks for 6 weeks. Compression can lead to death of the fat cells that were injected into the area or contour irregularities from the fat being molded by external forces. This means that you will be unable to sleep on your buttocks or side or sit directly on your buttocks. There are
special pillows that are made for sitting for patients recovering from a BBL, which place the pressure on the posterior thigh instead of the buttocks.

Dressings at the liposuction sites typically consist of gauze, absorbent pads, large pieces of foam, and a compressive garment or ACE bandages. The compressive garment or ACE bandages should be worn for one month after surgery at which time you can switch to Spanx or another gentle shapeware garment for an additional two weeks (or longer if desired for comfort). The compressive garments are an essential component of the surgery as this minimizes fluid buildup in the liposuction sites, which facilitates skin contraction, limits scarring, and speeds up the healing process.

Moderate discomfort, pain, and numbness at the surgery sites is expected after surgery, which will usually subside in the first few days to weeks after your surgery. You will likely to feel tired and sore for 1-2 weeks after your BBL. Most of your discomfort can be controlled by medication prescribed by your doctor in addition to taking regular Tylenol.

Bruising and swelling is expected after surgery. Generally the major bruising and swelling subsides 2-3 weeks after surgery. However, the final result of your BBL will not be evident until 6 months after surgery.

You should not participate in any strenuous exercise or heavy lifting for 4-6 weeks after surgery. Strenuous exercise includes any activities where your heart rate exceeds 100 beats per minute. We highly encourage our patients to remain active post-operatively, doing activities such as walking. You should not lift anything heavier than 10 pounds (about a gallon of milk). You can slowly work back into your normal activities at 4 weeks post-operatively and should be back to your normal self at 6 weeks post-operatively.

When you can return to work depends on the location and volume of the liposuction, how you are healing post-operatively, and what you do for work. Patients with sedentary jobs can return to work as early as 1-2 weeks post-operatively. Patients with active jobs may require up to four weeks off work.

We highly encourage you to maintain a stable weight, healthy diet, and consistent exercise plan after surgery to maintain your aesthetic outcome.

A BBL helps restore a more youthful appearance by enhancing the volume of the buttocks and sculpting the contour of the surrounding abdomen, back, and thighs. The removal of the excess fat is a bonus to the procedure. This surgery may help your self-esteem and improve your confidence. The scars can usually be placed so that they are well hidden. Once the fat is established at 3-6 months after surgery, it will last forever, but you will continue to follow the normal aging process.

Every surgical procedure involves a certain amount of risk and it is important that you understand these risks and the possible complications associated with them. In addition, every procedure has limitations. An individual’s choice to undergo a surgical procedure is based on the comparison of the risk to potential benefit.

Complications of a BBL can be related to the donor site or the injection site. While not a complication of the surgery, it is a known fact that not all of the fat that is transferred survives; this is accounted for the most common during your surgery. It is also important to realize that your body will continue to age and you will continue to experience loss of soft tissue and boney structures that occurs during the normal aging process.

Generally patients experience more pain at the donor site where the liposuction was performed compared to the injection sites in the buttocks. At the surgical sites, there can be bruising and swelling; most of this will resolve in the first three weeks but the final contour may not be appreciated until 3 to 6 months after surgery. There can also be contour irregularities, divots, lumps, and asymmetry, all of which are minimized with the proper technique. Rarely patients can experience masses at the fat injection sites (known as fat necrosis or oil cysts). While extremely rare, there is also the possibility of injection of fat directly into a blood vessel, which will be discussed in further detail at your consultation. There can also be loose skin after liposuction, which is secondary to poor skin elasticity. This can be treated with non-invasive skin-tightening modalities or via skin excision but ideal if prevented by not removing too much fat.


Offering advanced procedures, our surgical practice is led by first-class surgeons and a highly skilled medical team. Combining education, experience and skill with a focus on both the science and the art of medical aesthetics, we take a holistic approach to each patient’s treatment plan. Patient education, safety and, of course, results, are our utmost priorities.

Call today to schedule your consultation for a more confident tomorrow. (248) 524-0620