The BBL is the Most Unpopular Procedure, Data Shows


With plastic surgery and aesthetic treatments on the rise, there’s one surgical option that our readers don’t want. The Brazillian Butt Lift, or BBL, is one of the most controversial surgical procedures in recent memory, and according to our fourth edition of the State of Aesthetics, the most educated consumers have named it the most unpopular procedure for the second year in a row.

We dive deep into the BBL, explore what’s behind its unpopular position and find out what experts think about this hot topic procedure.

State of Aesthetics

If you’re reading this, you’re in great company. NewBeauty readers are the most advanced and educated consumers, and that’s why the State of Aesthetics taps thousands of you to provide a real-time look at the aesthetic industry. Powered by BeautyEngine subscribers, we take a look at what’s popular, how readers choose their treatments, and what you look for in a provider.

See our full report here.

The BBL is Unpopular Among Consumers

With 72% of respondents saying they would never consider a Brazillian Butt Lift, our State of Aesthetics data reveals that the BBL is more unpopular than any other surgery for the second year in a row among educated consumers. In fact, the second-most unpopular procedure, the breast reduction, only garnered 41%.

It’s clear that the BBL is unpopular among educated consumers.

Duxbury, Massachusetts plastic surgeon Christine Hamori, MD notes that requests have dipped at her practice over the years. “I have noticed over the past few years that BBL requests have decreased significantly,” Dr. Hamori says. “Maybe it is related to the semaglutide or ‘skinny shot’ craze where people no longer have fat to move to their buttocks.”

What is a Brazillian Butt Lift?

Designed to transfer fat from areas of the body to the buttocks to create a shapely, fully bottom, the Brazillian Butt Lift is a surgery with a complicated history. For one, the surgery itself has fundamentally changed since it first rose to popularity in the 2010s.

Palo Alto, CA plastic surgeon David Boudreault, MD explains that the previous method involved injecting fat directly into the muscle. “Traditionally, doctors were injecting into the muscle, which would travel into the blood vessels and then the lungs, which caused a pulmonary embolism and people would die,” Dr. Boudreault explains. “After research, all board-certified doctors have a new way of performing the procedure if they want to remain compliant, called the subcutaneous-only gluteal augmentation.”

But it isn’t just the method of surgery that has changed. According to Pittsburgh plastic surgeon Jeffery R. Antimarino, MD, what you would consider a BBL now is also different in approach and goals. “We still consider these procedures a BBL because we’re talking about contouring and changing the shape of the lower body,” Dr. Antimarino explains. “We’re not going for volume; we’re going for shape.”

Is the BBL Safe?

Once considered the most dangerous cosmetic surgery by the American Plastic Surgery Association, the BBL looks very different from 2019. When performed by a board-certified plastic surgeon adhering to the new standard for the procedure, complications have been substantially lowered.

“Typically, when patients have issues, mostly with fat embolisms, that is the result of the surgeon placing fat in the muscles,” Dr. Antimarino explains. “And when they do that, they’re hitting large blood vessels that are very deep. So, when you stay more superficial and towards the skin, there’s really no large blood vessels in those areas. That way, the risk is very small to patients.”

The American Society of Plastic Surgeons also commissioned research on the BBL and codified this safer approach as a formal recommendation. “Recent survey data has suggested that many, many surgeons are changing their technique based on the recommendations of the task force and that the mortality rate is approximately that of the tummy tuck, one in about 15,000,” said Pittsburgh plastic surgeon and ASPS former President, J. Peter Rubin, MD.

Now, to remain compliant, board-certified plastic surgeons must perform the procedure in this manner.

“I’ve been performing the updated version of the procedure for almost six years now and I have never had a complication,” Dr. Boudreault explains. “But it’s really important to ask your surgeon what technique they’re using.”

Is the BBL Trend Over?

Yes and no.

We probably won’t see that 2010s craze again. Some celebrities have had their BBLs removed and we’re seeing a sustained growth of ‘tweakment’ procedures rather than dramatically emphasized forms. That’s not to mention that the BBL has more bad press than most cosmetic procedures, and even its updated, safer technique can’t completely shake that reputation.

That said, there are still those who are seeking contour and shape in this area. “For my part, I see probably two patients a week that are interested in the BBL,” Dr. Antimarino says. “It’s not ever been hugely popular in my area, but it’s still a sustained interest.”

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