But it can be difficult for doctors to know where exactly they’re injecting; they have sometimes mistakenly injected fat into the gluteal muscle, or right below it. Fat can then travel directly to the heart and into the lungs, obstructing blood flow and causing immediate death.
Concerned about the mortality rate, in 2018 the American Society of Plastic Surgeons (ASPS), the American Society for Aesthetic Plastic Surgery and the International Society of Aesthetic Plastic Surgery, among others, formed the Task Force for Safety in Gluteal Fat Grafting, to develop safety guidelines around the procedure.
Among their recommendations: That doctors stop injecting into the muscle and use bigger instruments. “Those cannulas bend, and if they bend when you put them in the buttock you have no idea where the tip of the cannula is,” said Dr. Luis Rios, a board-certified plastic surgeon in McAllen, Tex., and past president of The Aesthetic Surgery Education and Research Foundation, the research, education and philanthropic arm of the Aesthetic Society. A 2020 follow up study found that 94 percent of doctors are aware of the recommendations.
“When properly done, when carefully done, it is safe,” said Dr. Steven Teitelbaum, a board-certified plastic surgeon in Santa Monica who was involved in drafting the guidelines, but does not perform the surgery. “We know exactly the mechanism that can lead to death, and we know how to avoid it. The surgeon just has to maintain intense focus and concentration.”
Yet people are still dying, most notably at “chop shops”: low cost, high-volume centers typically found in Las Vegas, Los Angeles and Miami — with doctors who may not be board-certified or even surgeons. Over the past eight years, one such doctor, Ismael Labrador, has had eight patients die at clinics he has run, four from botched BBLs, USA Today and Naples Daily News reported. The clinics’ names were changed two times starting in 2016, making it almost impossible for new clients to research him. (Dr. Labrador did not return calls.)
“The problem is not only that these doctors are inadequately trained, but that operating as rogue actors there is no way to either collect their data or send them a warning about the dangers of a procedure,” Dr. Teitelbaum said. “When we started recognizing there was a problem with BBL, we were faced with the problem of figuring out how to find these people to get word out to them, and unfortunately there was no way to do it.”
