For many years, we would hear the news of BBL deaths coming out of Miami. In recent years however, after studying the risks associated with Brazilian Butt Lifts, the news stateside hasn’t been as grim. Overseas however, deaths continue to rise.
The Centers for Disease Control and Prevention (CDC) has just issued a stark warning about plastic surgery performed abroad, specifically the dangers of Brazilian Butt Lift procedures in the Dominican Republic.
Dominican Republic BBL: A Surge in Deaths
The organization’s investigation revealed that 93 U.S. citizens have died since 2009 while undergoing plastic surgery in the Caribbean nation. According to the study, nearly 20 patients died in just the last few years. The cause of death? Fat embolism, which can occur when fat injections are used to enlarge and reshape the butt. Newport Beach, CA plastic surgeon Sanjay Grover, MD says it is imperative that fat is only placed in the superficial fatty or subcutaneous layer and not in the deeper muscles where large veins exist. “This drastically reduces the chance for any fat to get into the bloodstream and reach the heart and lungs.”
Patients undergoing fat transfers are also at risk of developing blood clots, particularly when undergoing multiple procedures over extended periods. Another potential risk factor is operating on patients with ages or BMIs higher than the recommended guidelines.
“Do not go to the Dominican Republic for your surgery, period, no matter what type of surgery it is, unless of course you like playing Russian roulette,” cautions Miami plastic surgeon Sean Simon, MD. “The same would go for the myriad of ‘clinics’ aka chop shops in Miami.”
“The BBL procedure is currently the most dangerous cosmetic procedure when you look at the statistics,” says New York plastic surgeon Brad Gandolfi, MD. “Over the last 10 years, the American Society of Plastic Surgery and the Aesthetic Society have done extensive research to help decrease these complication rates. This has led to the implementation of safer techniques and additional technologies to assist in creating a safer procedure. I truly believe when done properly the risks of this procedure are in line with other plastic surgery procedures. However, when performed by someone who is poorly trained it can be deadly.”
Added Protocols
The CDC has emphasized the need for improved surgical protocols and postoperative medical care to mitigate or prevent these risks, especially in cases where prophylactic measures against venous thromboembolism, the condition that happens when a clot forms in a vein, could have been applied. After the CDC’s alarming findings, more than 77 cosmetic surgery facilities in the Dominican Republic were monitored to ensure proper procedures and prevent infections, which have been linked to complications and fatalities following surgery.
According to Eugene, OR plastic surgeon Mark Jewell, MD, surgical facilities may not be at the standard of accreditation found in the United States. “All of this carries risk of serious complications and death if the Brazilian Butt Lift is not performed in a safe fashion to avoid deep fat injection through the use of ultrasound imaging,” he says.
While the use of ultrasound imaging is new, surgeons like Miami, FL plastic surgeon Onelio Garcia, MD says it’s a recent finding that won’t probably be employed in most places abroad. “The State of Florida, for example, has a law that mandates the use of hand held ultrasound during BBL surgery,” he says. “This takes away the blind nature of the procedure and allows the surgeon to visualize that the fat grafts are being injected into the proper subcutaneous space. That is definitely not going to happen in a DR clinic, particularly the high-volume, low-budget ones that advertise to prospective medical tourists.”
Travel Tips to Consider
“I believe the main issue here is that there is no adequate way for American citizens to accurately investigate doctors or medical facilities in other countries, especially in third world countries,” notes Pittsburgh, PA plastic surgeon Jeffrey Antimarino, MD. “The regulations for who can perform cosmetic procedures in other countries may vary distinctly from the standards we demand here.”
For U.S. citizens considering plastic surgery abroad, the CDC stresses the importance of doing your homework and consulting a primary doctor well in advance. They also advise seeking guidance from a travel medicine specialist at least one month before travel, and allowing sufficient time between flying to and from a destination for surgery to minimize the risk of complications, especially related to blood clots. “It is not safe to get on an airplane right after surgery without proper preparation,” explains McMurray, PA plastic surgeon Simona V. Pautler, MD. “Patients need to be counseled appropriately pre-surgery and I don’t think they are being properly educated.”
“I encourage individuals to consider reputable alternatives here in the U.S., including board-certified plastic surgeons accredited by the American Board of Plastic Surgery,” notes Dr. Simon. “It’s crucial to note that being board-certified alone is not sufficient; seeking out professionals with a proven track record of success and expertise is paramount for a safe and satisfactory outcome.”
“Even with the best surgical techniques and the safest procedures, there can still be complications with these procedures,” says Louisville, KY plastic surgeon Chet Mays, MD. “Going to an accredited facility by a board-certified plastic surgeon can lower your risk of a complication. Plus if there is a complication, we are trained as board-certified plastic surgeons how to treat these complications.”
