Brazilian Butt Lift Safety: A Scientific Overview of Risks, Benefits, and Dr. Leonard Grossman’s Technique

The Brazilian Butt Lift (BBL) has rapidly grown in popularity over the past decade, offering patients a way to enhance their body contours using their own fat rather than synthetic implants. This demand has prompted significant innovation in surgical techniques, most notably those pioneered by Dr. Leonard Grossman, a NYC plastic surgeon recognized for introducing the modern BBL technique.

While the procedure is celebrated for its dual benefits—body contouring and buttock enhancement—it also raises important safety questions. Understanding the evolution of BBL safety and advancements made by surgeons like Dr. Grossman is essential for patients considering this transformative procedure.

What Is a Brazilian Butt Lift?

A Brazilian Butt Lift is an autologous fat transfer procedure involving two key steps:

1. Liposuction is used to remove or harvest fat from donor areas such as the abdomen, flanks, thighs, or back.
   
2. The purified fat is reinjected or transferred into the buttocks and hips to improve volume, shape, and symmetry.
   

Unlike buttock implants, a BBL uses the patient’s own living tissue, offering more natural-feeling results and a lower risk of implant-related complications. Moreover, the body contouring effect from liposuction provides a more balanced and aesthetically pleasing figure.

Background on Fat Grafting or Transfer:

In 1993, there were basically two plastic surgeons who saw great potential in fat grafting: Dr. Leonard Grossman and a well-known plastic surgeon affiliated with a major university hospital, whose name shall remain anonymous in this article.

Dr. Grossman insisted on the fat being placed into the level between the muscle and skin, “where god placed it in the first place”. The other plastic surgeon placed fat where there is “better blood supply”. You have seen many people with small or large scars under their buttocks; that’s where the fat was injected, immediately into the muscle or a scarry, large Gluteal vein. Since the other plastic surgeon was better known, his theory of fat grafting was accepted worldwide, until there were problems. Patients had lost tissue, eyesight, and, unfortunately, life to embolizations from intramuscular injections. It took nearly 25 years for the doctors to accept Dr. Grossman’s approach to fat grafting.

BBL Safety: Risks and Innovations

Risks of Brazilian Butt Lift Surgery

While the BBL is generally safe when performed correctly, it has historically been associated with serious risks, particularly fat embolism—a potentially fatal condition in which fat enters the bloodstream and obstructs blood vessels in the lungs or heart. Fat embolism has occurred in approximately 1:3,000 individuals.

Other complications include:

• Bruising and swelling
  
• Infection
  
• Fat necrosis (death of transferred fat cells)
  
• Asymmetry
  
• Fluid collections or seromas
  

Improved Safety Through Technique: Subcutaneous-Only Injections

Leading safety organizations, including the American Society of Plastic Surgeons (ASPS), emphasize that fat must be injected strictly above the gluteal muscle, into the subcutaneous tissue, to avoid the risk of fat entering major veins. This technique has dramatically reduced the incidence of fat embolism when strictly adhered to.

Dr. Leonard Grossman’s Contribution to BBL Safety and Aesthetic Outcomes

Dr. Leonard Grossman, practicing in New York City, is recognized by the ASPS as the originator of the modern Brazilian Butt Lift, where the fat is injected in to the fatty tissue (between the skin and muscle, never in to the muscle). Over his 30-year career, Dr. Grossman has developed a proprietary method that prioritizes fat viability, symmetry, and patient safety.

Key Features of Dr. Grossman’s Technique

1. Preoperative Planning
   Each patient undergoes a detailed consultation to evaluate anatomy, health history, and surgical goals. Planning includes photographic analysis and individualized fat-mapping with the patient’s approval.
   
2. Advanced Liposuction and Fat Harvesting
   Dr. Grossman uses gentle, high-precision liposuction to harvest viable fat while sculpting the body. Fat is typically taken from multiple areas for optimal contouring.
   
3. Fat Purification
   Fat is purified using a closed-system centrifuge to remove oil, blood, and non-viable cells. This process increases graft survival and reduces complications.
   
4. Layered, Subcutaneous Fat Injection
   Dr. Grossman’s hallmark technique involves layering small volumes of purified fat in multiple planes of subcutaneous tissue using blunt cannulas. He avoids muscle penetration entirely, ensuring patient safety and more predictable results.
   
5. Minimized Post-Operative Restrictions
   Unlike traditional BBL protocols, Dr. Grossman’s patients:
   
   • Do not require compression garments
     
   • Can sit and lie down normally immediately after surgery
     
   • Can resume exercise within 10 days
     
   • Often retain nearly 100% of the fat graft
     

BBL Outcomes: Risks vs. Benefits

Benefits

• Enhanced buttock volume and contour using the body’s own fat
  
• Improved waist-to-hip ratio through strategic liposuction
  
• Natural-feeling, long-lasting results
  
• Higher patient satisfaction and confidence
  
• Fewer implant-related risks (e.g., rupture, capsular contracture or displacement of implants)
  

Risks

• As with all surgeries: infection, hematoma, or scarring
  
• Partial fat resorption (typically 20–30% with traditional methods, lower with Dr. Grossman’s approach)
  
• Asymmetry or contour irregularities
  
• Rare but serious risk of fat embolism—significantly mitigated through proper technique

Get the Facts on Brazilian Butt Lift Safety Today!

Frequently Asked Questions

1. How long does a Brazilian Butt Lift last?

With stable body weight and healthy lifestyle habits, BBL results can be permanent. A small percentage of the transferred fat may be reabsorbed in the first few months, but most fat cells that survive beyond this period will remain indefinitely.

2. Is fat transfer permanent?

Yes, assuming the fat cells survive the transfer, they will behave like native fat. Dr. Grossman’s purification and injection techniques promote maximum fat survival.

3. Can I sit after a BBL?

Yes. Unlike conventional approaches that limit sitting for weeks, Dr. Grossman’s technique allows sitting immediately post-op, due to subcutaneous-only injection and controlled grafting.

4. Is a BBL safer than implants?

For many patients, yes. The BBL avoids foreign materials, has fewer long-term complications, and offers customizable, natural-looking outcomes.

5. Who is a good candidate?

Candidates should be in good health, have adequate fat stores, and be non-smokers. Dr. Grossman emphasizes the importance of realistic expectations and compliance with aftercare protocols.

Conclusion: Is the BBL Safe?

Yes—when performed by an experienced surgeon using anatomically sound techniques. With advances in safety protocols and a growing understanding of gluteal anatomy, the Brazilian Butt Lift has evolved into a highly refined and effective procedure. Dr. Leonard Grossman’s technique stands out for combining safety, efficiency, and artistry. His patients benefit from rapid recovery, minimal discomfort, and consistent, aesthetically pleasing results, making him one of the most trusted names in BBL surgery worldwide.