Brazilian butt lift (BBL)

Buttock fat grafting, known as the BBL (Brazilian Butt Lift), is a plastic surgery procedure in which the buttocks are reshaped using the patient's own fat. The fat is harvested by liposuction from areas such as the abdomen, flanks, back or thighs, then processed and injected into the buttock region.

The procedure has a twofold effect: the areas from which fat is harvested become slimmer, while the buttocks gain a more balanced volume and contour. For safety reasons, the fat is injected only under the skin (subcutaneously), never into the muscle. At Detalii Med, in Baia Mare, the procedure is performed by Dr Marius Pruna and Dr Valeria Pruna.

Buttock fat grafting may be discussed for people who:

• would like fuller, rounder or more projected buttocks;
• have asymmetry or hollow areas on the buttocks or hips;
• have localised fat deposits in other areas from which enough fat can be harvested;
• have a stable weight and good general health;
• understand the limits of the procedure and can follow the post-operative advice.

In very slim people, the amount of fat available may be insufficient, and the doctor may discuss other options.

The procedure can add volume to the buttocks, improve their shape and projection and correct some hollows or asymmetry. Through the accompanying liposuction, the waist and surrounding areas can look more defined.

Buttock fat grafting does not lift significantly sagging skin and does not treat substantial excess skin. The volume that can be achieved is limited by the amount of fat available and by what the tissues can safely receive. Not all the transferred fat survives, and a second stage is sometimes needed.

At the consultation, the doctor discusses the desired shape with the patient and examines the buttocks, hips and the areas from which fat can be harvested. Skin quality, fat distribution and any asymmetry are assessed.

The doctor explains what can realistically be achieved, how the procedure is carried out and what recovery involves, including limits on sitting. Medical history, medication, smoking and the tests needed before surgery are discussed. The patient receives clear information about the risks and the safety measures used.

Through small incisions, the surgeon performs liposuction in the agreed areas. The harvested fat is then processed to separate the fat cells from fluids and debris that are not useful.

The prepared fat is injected into the buttocks through fine cannulas, in small amounts distributed in several layers and directions. Injection is carried out exclusively in the fatty layer beneath the skin, without entering the gluteal muscle. This rule is essential, because injecting into the muscle increases the risk of fat embolism, a rare but serious complication. The operation usually takes two to four hours, depending on the areas treated.

Buttock fat grafting is usually performed under general anaesthesia, administered by the anaesthetist after a pre-anaesthetic assessment. The type of anaesthesia is confirmed at the consultation.

After the procedure, the liposuction areas and the buttocks are swollen, tender and may be bruised. A compression garment is worn over the liposuction areas for the period advised by the doctor, usually several weeks.

Sitting on the buttocks is limited for several weeks, so as not to put pressure on the transferred fat. During this time, the patient sleeps on the front or side and, where needed, uses a cushion that takes the weight on the thighs. Light activities are resumed gradually, and strenuous exercise is usually resumed after several weeks, with the doctor's agreement.

The risks are discussed openly at the consultation and include:

• prolonged swelling, bruising and tenderness;
• infection, seroma or haematoma;
• contour irregularities, asymmetry;
• absorption of part of the fat, lumps, cysts or areas of fat necrosis;
• changes in sensation in the treated areas;
• fat embolism, a rare but serious complication whose risk is reduced by injecting fat only under the skin;
• venous thrombosis and risks related to anaesthesia.

Immediately after the procedure, the buttocks look larger, partly because of swelling. Over the first months, part of the transferred fat is normally absorbed, and the result usually stabilises after about three to six months.

Fat that has integrated behaves like the rest of the body's fatty tissue: it increases or decreases with weight. This is why maintaining a stable weight helps to preserve the result.

A Brazilian butt lift (BBL) reshapes the buttocks with the patient's own fat and contours the areas from which it is harvested. The fat is injected only under the skin, never into the muscle, for the patient's safety. Sitting is limited for several weeks, and the final result is visible after a few months.