The procedure with the highest stakes in cosmetic surgery
The Brazilian butt lift involves liposuction of donor areas followed by fat transfer to the buttocks. It has historically carried the highest mortality rate of any cosmetic surgery. This is a published medical fact that changed surgical guidelines worldwide.
Fat embolism: the defining risk
Fat embolism occurs when injected fat enters a blood vessel and travels to the lungs. A 2017 ASERF survey identified elevated mortality rates for this procedure compared to other cosmetic surgeries. Revised safety guidelines issued after 2018 have significantly improved outcomes, but the risk has not been eliminated. Fat embolism is a covered complication under the Aesthetisure program.
Other complications
- Infection. Estimated 1–3%. Deep infections may require hospitalization and surgical drainage.
- Seroma and hematoma. Large collections require aspiration or surgical evacuation.
- Fat necrosis. Transferred fat that loses blood supply, forming firm lumps. May require surgical removal.
- Asymmetry and contour irregularities. Fat absorption is unpredictable.
- Skin necrosis. Tissue death over the injection area.
Sources: Mofid et al., “Report on Mortality from Gluteal Fat Grafting,” ASJ, 2017; ASPS/ASAPS Joint Task Force Safety Advisory.