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Brazilian butt lifts can be risky, but experts say they don't have to be

“I am happy with the results,” said one woman who got the procedure. “So I don’t regret getting it. I just regret the lack of information that I had, and how I regret being so naive to it.”
Illustration of a person seeing a person who got a BBL surgery on social media, an airplane, hands exchanging money, a buttocks with surgery marks, a surgeon, and a heart rate monitor.
Carolyn Figel for NBC News

After browsing through photos online and getting advice from a friend, Loren Smith of Palmdale, California, decided getting a Brazilian butt lift would be right for her. 

She found a clinic based in Mexico with plenty of positive reviews from satisfied customers, sealing her decision. She would save $15,000 in surgical costs by having the procedure there, as opposed to getting it done in the United States. With $5,500 in cash strapped to her waist, she traveled to Tijuana for the procedure in May 2018. 

But two weeks following the BBL procedure, Smith said, her stomach started to swell and she experienced excruciating pain. She underwent emergency surgery in the U.S. after developing  serious infections. 

Loren Smith post-surgery.
Loren Smith post-surgery.Courtesy Loren Smith

“It took me a long time to recover, and still now, I still have issues,” Smith, 30, said.

Smith is one of 22,000 people in the U.S. who have undergone one of the fastest growing plastic surgery procedures, fueled by celebrities and social media influencers. BBL surgeries involve transferring fat from other areas of the body, such as the abdomen, to the buttocks and thighs. 

But the death of Shacare Williams, an Indianapolis mother who ventured to the Dominican Republic for the procedure in April, has exemplified the risks that can come with the procedure. Its popularity has inspired some seeking a less expensive means to achieve an enhanced body shape to pay for subpar care within the U.S. or venture to other countries like Mexico, where standards for the industry are not as high. The lackluster results among some patients have left them regretting not vetting practitioners enough or going under the knife at all.

Dr. Daniel Del Vecchio, a plastic surgeon with offices in New York City, Boston and London, said the procedure is not inherently deadly. Instead, he said, some providers’ greed and their lack of education about the procedure, as well as the risks some patients are willing to take can contribute to fatalities and medical complications. 

His research finds that deaths from Brazilian butt lifts can be dramatically reduced with better techniques and surgical instrumentation. He said he performs a maximum of three such procedures per day, but that not all plastic surgeons practice the same level of restraint. 

“Now, a typical BBL takes two to three hours to do,” Del Vecchio said. “If a surgeon is doing seven cases a day, that means he’s awake 21 hours, or somebody else is doing part of the surgery for that person.” 

But improvements in safety for the procedure are taking hold, and its mortality rate is projected to decrease over time, according to a 2021 report published by the American Society of Plastic Surgeons shared with NBC News. 

Meanwhile, Del Vecchio proposed new guidelines for safety in the U.S. for Brazilian butt lifts at a symposium on cosmetic surgery in February, including the number of procedures surgeons can perform per day. 

While every cosmetic procedure has potential risks, there are ways patients can prevent putting themselves in a dangerous situation when getting a Brazilian butt lift. Dr. Arturo Ramírez-Montañana, board-certified plastic surgeon and chair of the global survey committee of the International Society of Aesthetic Plastic Surgery, said that the surgery should be performed in a high-quality facility by a board-certified surgeon who follows the proper safety protocols. This includes injecting fat only directly under the skin away from the muscle. This decreases the chance of a fat embolism, which often results in death.

After spending more than $7,200 on her BBL surgery and postsurgical care by a board-certified plastic surgeon in Miami, Raina Wright of Dayton, Ohio, said she can see uneven results in her body. She is considering getting another procedure from a different doctor to compensate. 

While there are those such as Wright and Smith whose experiences were not what they bargained for, some patients are satisfied with their results. Like Wright, Javon Royster, 25, traveled to Miami from Sterling, Virginia, in 2020 for a BBL surgery. After researching for a year, he found a board-certified plastic surgeon known to give natural looking results. In all, he said he spent $10,000 on the procedure and recovery costs.  

“We both are satisfied,” Royster said. “He definitely understood the assignment.”

Before surgery, he said he felt stressed about reducing his body mass index to qualify for the procedure, while also dodging homophobic critiques from others about his decision.

Image: Jayvon Royster post-surgery.
Javon Royster post-surgery.Courtesy Jayvon Royster

He said he thinks most observers think men who get the procedure “want to be women. That’s not really the case. I just feel like if I’m going to do this, it’s going to make me happy.”

Smith still experiences pain related to the complications from her surgery but said it is less frequent. She also said she tried to contact her surgeon, whose identity she is unsure of, but was unable to speak with him directly following the procedure. Instead, the surgeon’s coordinator suggested she return to Mexico and receive a hyperbaric oxygen therapy chamber, which is used to heal infections, which she declined to do.

The company, Bella Bodiez, has not responded to a request for comment from NBC News.

Despite the challenges she faced, Smith said, she doesn’t regret the surgery and said she knows the pain is just something the doctors who treated her in the U.S. said she “had to deal with for the rest of her life.”

“I am happy with the results,” she said. “So I don’t regret getting it. I just regret the lack of information that I had, and how I regret being so naive to it.”

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CORRECTION (May 9, 2022, 12:30 p.m. ET): A previous version of this article misspelled the last name of one of the people who received a BBL procedure. He is Javon Royster, not Foyster.