The Brazilian Butt Lift Remains the Deadliest Aesthetic Surgery Procedure: Are Plastic Surgeons Adjusting Their Surgical Practice to Promote Safety?

Abstract

The number of Brazilian Butt Lift (BBL) fatalities remains high in the United States (US) despite numerous practice advisories geared towards patient safety and reducing the incidence of fatal pulmonary fat emboli (PFE). This study aimed to evaluate US board-certified plastic surgeon opinion, understanding of BBL-related mortality, and current risk-reducing surgical practices for BBL procedures. An online 18-question survey was distributed via email by the Aesthetic Surgery Education and Research Foundation to national board-certified plastic surgeon members of the American Society of Aesthetic Plastic Surgeons. Survey responses were collected over 21 days on the Qualtrics platform. Survey response rate was 10% (n=178). Of the 77% that performed BBL procedures, 48% (n=80) did not use ultrasound. Approximately 60% (n=102) of all respondents disagreed with placing regulations to require ultrasound, with the most frequent reasoning being it was unnecessary with adequate surgeon experience (45%). Plastics surgeons thought that high-volume budget clinics (n=64) and a lack of regulations by the Board of Medicine placed on individual surgeons (n=31) were the greatest contributors to BBL mortality. Most US plastic surgeons did not use ultrasound for BBL procedures or did not agree that ultrasound should be required, which may partially be the result of unsuccessful educational outreach for risk-reducing practices and training for ultrasound. Regulations by the Board of Medicine placed on individual surgeons, in combination with new legislature targeted at ownership of high-volume clinics, are strongly backed by surgeon respondents that may improve patient safety.