Diplomates of the American Board of Cosmetic Surgery (ABCS) praised a new Florida law mandating ultrasound guidance and other safety measures for all gluteal fat grafting, or Brazilian butt lift (BBL), surgeries performed in an office setting.

“We commend Florida lawmakers for their measured response to protect BBL patients,” says Mohammad Banki, MD, DMD, FACS, president of the ABCS. “This new set of laws goes just far enough to protect patient safety, without limiting physicians’ rights to practice.”

BBL surgery comes with unique risks—particularly pulmonary fat embolism (PFE)—when performed improperly, says Michael Rodriguez, MD, FAACS, who is an ABCS diplomate, a member of the Florida Society of Cosmetic Surgery, and BBL specialist in Miami. “During fat transfer into the buttocks, surgeons must carefully inject in the subcutaneous plane, or just below the skin,” says Rodriguez. “Injecting more deeply into the gluteal muscles heightens the risk of fat embolism and death.”

Adding to the risk is the rise in popularity of the procedure, which has led to “BBL factories,” with opportunistic surgeons performing numerous procedures in a day, without proper candidate selection and pre-surgical counseling.

The Florida law addresses these risks by codifying best practices for the procedure, including:

  • Ultrasound guidance (or equivalent, medical board-authorized technology) is required to help avoid intramuscular injection.
  • Fat must be injected into the subcutaneous space and not cross the muscle’s overlying fascia.
  • Physicians must meet in person with patients no later than one day before their surgery.
  • The physician may not delegate the fat extraction or injections to someone else.

ABCS Efforts to Promote BBL Safety

To help spread awareness among surgeons and protect patients’ safety, the ABCS will launch a Brazilian Buttock Lift Safety Exam this fall. The exam will be the first ever that is open to all surgeons interested in refining their skills and furthering their commitment to patient safety. Additionally, the ABCS will hold its second national Brazilian butt lift safety course in New Orleans next February.

“Patient safety is paramount in our individual surgeons’ approaches to each patient, and together as a certifying board, we are proud to champion patient safety on a broader scale in as many ways as possible,” says Banki.