Brazilian butt lift / buttock augmentation (gluteal fat grafting (lipofilling); buttock augmentation)
Surgery to reshape or enlarge the buttocks, most often by liposuctioning fat from elsewhere on your body and injecting it into the buttocks, and sometimes by using implants.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A BBL usually moves your own fat (by liposuction) into the buttocks to change their shape; implants are an alternative but bring their own risks.
- It carries the highest death rate of any cosmetic procedure, because injected fat can cause a fatal fat embolism — UK guidance says fat must go only under the skin, never into the muscle.
- Some transferred fat is reabsorbed over 3–6 months, so the result settles smaller than at first and may need more than one session.
- Choose a UK GMC-registered surgeon working in a clinic registered with the national healthcare regulator for that country — the CQC in England, Healthcare Improvement Scotland in Scotland, Healthcare Inspectorate Wales in Wales, or the RQIA in Northern Ireland — and who uses safe technique (including intraoperative ultrasound); be very wary of cheap deals or treatment abroad.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Can improve the shape, projection and proportions of the buttocks
You have too little body fat to harvest for a meaningful, safe transfer.
Expect significant swelling, bruising and soreness. You wear a compression garment and are usually advised to avoid sitting directly on your buttocks...
Written instructions, a compression garment plan and clear sitting restrictions.
Expect significant swelling, bruising and soreness. You wear a compression garment and are usually advised to...
Bruising fades and many people return to desk work, still following sitting restrictions and avoiding strenuous...
Most people gradually return to normal sitting and light exercise as advised. Some firmness and swelling remain.
Swelling settles and the amount of transferred fat that has survived becomes clearer, giving the more settled...
What is a Brazilian butt lift (buttock augmentation)?
A Brazilian butt lift (BBL) reshapes or enlarges the buttocks. Most often the surgeon uses liposuction to remove fat from another area (such as the tummy, waist, back or thighs), processes it, and injects it into the buttocks to add volume and improve the shape. Despite the name, it is mainly a fat-transfer procedure, not a 'lift' of sagging skin. Buttocks can also be enlarged using silicone implants, but implants carry their own problems and are used less often in the UK.
This is one of the few cosmetic operations with a clearly recognised risk of death. If fat is injected too deeply and enters a large vein, it can travel to the lungs (a fat embolism) and can be fatal during or shortly after surgery. UK and international guidance is therefore very specific: fat should be placed only in the layer just under the skin and never into the buttock muscle.
Not all of the transferred fat survives. Some is reabsorbed by the body over the first few months, so the final size is smaller than on the day of surgery, and more than one session is sometimes needed. A BBL changes shape and volume; it does not improve skin quality, cellulite or stretch marks.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Fat transfer vs buttock implants
| Point | Fat transfer | Implants |
|---|---|---|
| Material | Your own fat | Silicone implant |
| Main serious risk | Fat embolism if injected too deep | Infection, shifting, hardening, removal |
| Longevity | Some fat reabsorbs; rest is long-lasting | May need replacing or removing over time |
| Extra benefit | Slims the donor area too | No donor-site liposuction needed |
| Repeat work | May need a second session | May need revision surgery |
Neither option is without risks. Your surgeon should explain which is more appropriate for you and why.
Preparing for your surgery
- See the operating surgeon (a GMC-registered plastic surgeon), who should personally assess you, explain the risks including the risk of death, and obtain your consent — not a salesperson or adviser.
- Expect a two-stage consent process with a cooling-off period of at least two weeks so you are not rushed into a decision.
- Stop smoking and vaping well beforehand; nicotine harms healing and raises the risk of skin and wound problems.
- Tell the surgeon about all medical conditions and medicines, including anything that affects bleeding or clotting.
- Discuss how much fat is realistic to transfer, whether more than one session may be needed, and how much fat may reabsorb.
- Arrange time off work, a lift home, and help at home, as you will be told to avoid sitting directly on your buttocks for some weeks.
- Ask specifically whether the surgeon injects only under the skin and uses intraoperative ultrasound to keep the cannula in the safe layer.
What happens
Under general anaesthetic or sedation, the surgeon first uses liposuction to remove fat from one or more donor areas through small cuts. The fat is processed to separate out usable fat cells.
The fat is then injected into the buttocks through small entry points using a blunt cannula. Following UK and international safety guidance, fat should be placed only in the layer just beneath the skin (the subcutaneous space) and must never cross into the buttock muscle, because injecting into or below the muscle is where fat can enter large veins and travel to the lungs. Many surgeons now use ultrasound during the operation to confirm the cannula stays in the safe layer.
The operation usually takes a few hours. You wear a compression garment afterwards, and most people go home the same day or after one night.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- You have too little body fat to harvest for a meaningful, safe transfer.
- You smoke or vape and are unwilling to stop, given the high impact on healing.
- You have a bleeding or clotting disorder, or significant medical conditions that raise anaesthetic and clot risk.
- You want a very large result that could only be achieved by unsafe, high-volume or intramuscular injection.
- Your main concern is loose, sagging skin or skin texture, which a BBL does not address.
Delay surgery if…
- You are not at a stable weight, or are planning significant weight loss or pregnancy.
- You have an active infection or skin problem in the donor or buttock areas.
- You feel rushed and have not had a genuine cooling-off period of at least two weeks.
- You have unresolved questions about technique, risk or aftercare.
- You cannot arrange the time off and help needed to follow the sitting and recovery restrictions.
Alternatives to discuss
- No surgery — accepting your natural shape or using clothing/shapewear.
- Targeted exercise and strength training to build the gluteal muscles.
- Liposuction of the waist alone to improve proportions without fat transfer.
- Non-surgical options, understanding these are limited and that injectable 'liquid BBL' fillers carry their own serious risks.
- Buttock implants where there is too little fat, accepting their separate risks.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Can improve the shape, projection and proportions of the buttocks
- Uses your own fat, so there is no implant in the fat-transfer version
- Liposuction of the waist, back or tummy can improve your overall contour at the same time
- Results from surviving fat tend to be long-lasting
- Can restore volume lost after weight loss or with age
Risks & complications
- Bruising, swelling and soreness in both the buttocks and the liposuction (donor) areas
- Numbness or altered sensation that usually settles
- Some of the transferred fat reabsorbing, so the result shrinks over the first months
- Lumpiness, firm areas or small contour irregularities
- Asymmetry between the two sides
- Infection needing antibiotics, or a fluid collection (seroma) needing drainage
- Areas of fat that do not survive and form firm lumps or oil cysts (fat necrosis)
- Wound-healing problems, especially with implants or in smokers
- Needing a further procedure to improve shape or remove an implant
- Blood clots in the legs or lungs (DVT/PE)
- Fat embolism — fat entering a vein and travelling to the lungs, which can be fatal
- Death — BBL has the highest reported death rate of any cosmetic procedure
- Serious infection
- Damage to deeper structures during injection
The defining danger of this operation is fat embolism, which can be fatal. The risk is strongly linked to technique: injecting fat into or beneath the buttock muscle is far more dangerous than placing it just under the skin. Ask your surgeon directly how they avoid this — UK guidance is that fat must be placed only in the subcutaneous layer, never intramuscularly, and that intraoperative ultrasound should be used to confirm this. Be extremely cautious about very cheap BBLs, high-volume 'mega' results, and surgery abroad where standards and aftercare may be uncertain.
Published figures to discuss
Reported risks vary with technique, volume transferred and how complications are recorded. The single most important factor for the most serious risk — fatal fat embolism — is whether fat is placed safely under the skin or dangerously into or beneath the muscle. Figures below are cautious and source-based; published estimates have changed over time as technique has improved.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Death from fat embolism (older estimate) | Reported as high as about 1 in 2,351 in earlier US task-force data | This early figure prompted major safety changes and, in the UK, advice against the procedure at the time. | BAAPS — Gluteal Fat Grafting Safety Review and Recommendations (PDF)baaps.org.ukPublished figure |
| Death from fat embolism (revised estimate) | Estimated nearer 1 in 15,000 with safer technique, similar to abdominoplasty | Per BAAPS; still the highest death rate among cosmetic procedures, and dependent on subcutaneous-only injection. | BAAPS — Gluteal Fat Grafting Safety Review and Recommendations (PDF)baaps.org.ukPublished figure |
| Fat reabsorption | A variable proportion of transferred fat is reabsorbed over months | Exact survival varies between people; more than one session is sometimes needed. | Guide sourcesClinical context |
| Clot/VTE or pulmonary embolism unrelated to fat injection | Uncommon but serious | Risk rises with long operations, travel, immobility, hormones, BMI and personal clot history; aftercare must include a clot-prevention plan. | BAAPS — Gluteal Fat Grafting Safety Review and Recommendations (PDF)baaps.org.ukSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery involves both the buttocks and the areas where fat was removed by liposuction, so you may feel sore and bruised in several places. A key feature is that you are usually told not to sit directly on your buttocks for several weeks to protect the transferred fat.
- Bruising and swelling in both the buttocks and the liposuctioned areas
- Looking bigger at first, then settling smaller as swelling goes and some fat reabsorbs
- Tightness from the compression garment
- Numb patches and firm areas that soften over weeks to months
- Tiredness in the first week or two
Aftercare
- Wear the compression garment exactly as instructed.
- Avoid sitting directly on your buttocks for as long as your surgeon advises, using a recommended cushion if needed.
- Keep mobile to lower the risk of blood clots, and stay well hydrated.
- Take pain relief as advised and keep wounds clean and dry.
- Avoid smoking and strenuous activity until cleared.
- Go to all follow-up appointments so healing and shape can be checked.
- Know who to contact, day or night, and seek urgent help for breathing problems, chest pain or signs of infection.
- Compression garment ready and fitted
- BBL/donut cushion for sitting
- Time off work booked (often 2–3 weeks)
- Someone to drive you home and help at home
- Pain relief and any prescribed medicines collected
- Clinic's 24-hour emergency contact saved
- Plan for how you will sleep (front or side)
Scars and how they heal
The cuts are small — entry points for the liposuction cannula and for injecting fat — and usually fade to small marks. With implants, the scar is larger and placed in or near the buttock crease, and wounds in this area can be slower to heal. Bruising over the liposuctioned areas is common in the early weeks.
⚠ Get urgent help if…
- Breathlessness, chest pain or coughing during or soon after surgery — call 999, as this can signal a fat embolism or blood clot
- A swollen, hot or painful calf
- Fever, spreading redness, increasing pain or smelly discharge from a wound
- Heavy or persistent bleeding
- A wound opening up, or an implant area becoming red, hot or very painful
- Feeling very unwell, faint or confused
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A BBL can change the shape and projection of the buttocks and improve overall proportions, especially when combined with liposuction of the waist. Because some transferred fat is reabsorbed, the final result is smaller than on the day of surgery and is usually clearer by around three to six months. It changes volume and shape only — it does not improve skin texture, cellulite or stretch marks, and a 'lift' of genuinely loose, sagging skin needs a different operation.
Results vary between people and cannot be guaranteed. A responsible surgeon will aim for a natural, safe result rather than the largest possible size, and will be honest about what is achievable for you.
The fat that survives the first few months generally lasts for years, although your buttocks still change with weight changes and age. Significant weight loss can shrink the result, and weight gain can enlarge it. Some people choose a second session to add more volume. Implants do not last indefinitely and may need replacing or removing over time.
Combining with other procedures
A BBL is often combined with liposuction of the waist, back, tummy or thighs, both to harvest fat and to improve the overall shape. Combining it with other major operations at the same time can add to anaesthetic and clotting risk, so your surgeon should discuss whether staging procedures is safer for you.
Follow-up & long-term care
You should be reviewed in the early weeks to check healing, the donor areas and the developing shape, with later review once swelling settles and the surviving fat volume is clearer. You should have a named contact and a clear plan for who to call urgently, particularly given the risk of clots and fat embolism.
- Keep your weight stable to help maintain the result.
- Attend any review appointments offered.
- If you have implants, follow advice on long-term monitoring and possible future surgery.
- Discuss any new lumps, pain or shape changes with your surgeon.
Revision and secondary surgery reality
- A second fat-transfer session is sometimes needed because some fat reabsorbs.
- Contour irregularities, lumps or asymmetry may prompt revision.
- Implants may need adjustment, replacement or removal over time.
- Revision of buttock surgery can be more complex than the first operation.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Written instructions, a compression garment plan and clear sitting restrictions.
- A named contact and a 24-hour route to urgent help, given the clot and embolism risk.
- Early review of wounds, donor sites and developing shape, then later review once fat survival is clear.
- Honest discussion about whether a second session is needed and what it would involve.
- Clear guidance on warning signs needing 999, especially breathlessness or chest pain.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The surgeon's fee and their experience with safe gluteal fat grafting
- Anaesthetic and the type of anaesthesia used
- Theatre and facility fees, including use of intraoperative ultrasound
- How many areas of liposuction are needed to harvest the fat
- Whether implants are used instead of, or alongside, fat transfer
- Compression garments, follow-up appointments and any second session
- The clinic's policy and fees if a complication or revision is needed
- The operating surgeon's fee and GMC registration
- Anaesthetist and facility/theatre fees
- What is included if fat reabsorbs and a second session is wanted
- Compression garments and number of follow-up visits included
- The cooling-off period and cancellation/refund policy
- What happens, and who pays, if a complication or revision is needed
- 24-hour emergency contact and arrangements for urgent care
On the NHS? A Brazilian butt lift is a cosmetic procedure and is not funded by the NHS; it is offered privately, and you should still expect proper consent, regulation and aftercare.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Consent taken by a salesperson or adviser rather than the operating surgeon.
- The risk of death and fat embolism not clearly discussed.
- No genuine cooling-off period, or pressure from time-limited offers.
- Promises of a specific large size without explaining fat reabsorption and safe-volume limits.
- No clear plan or named contact for emergencies and complications.
Marketing red flags
- 'Bargain' or heavily discounted BBLs, or packages combined with travel abroad.
- Adverts implying the procedure is quick, easy or low-risk.
- Influencer or social-media promotion that trivialises the risks (against ASA/CAP rules).
- Claims of guaranteed size or 'snatched' results with no mention of fat embolism.
- Pressure to book the same day or to choose a larger result than is safe.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Do you inject fat only under the skin, and do you use ultrasound during surgery to keep out of the muscle?
- What is my personal risk, including the risk of fat embolism and blood clots?
- How much fat do you expect to transfer, how much may reabsorb, and might I need more than one session?
- Are you recommending fat transfer or implants for me, and why?
- What is your experience and complication rate with this operation, and who looks after me if something goes wrong?
- What are the limits — what can this not change about my shape or skin?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is a BBL safe?
Can I get a BBL on the NHS?
Why do people say I should avoid having a BBL abroad?
Will all the fat stay?
Can a BBL get rid of cellulite or loose skin?
What is the most important question to ask?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Surgical fat transfer (incl. BBL) BAAPS — Gluteal Fat Grafting Safety Review and Recommendations (PDF) ASPS — Gluteal fat grafting safety advisory (PDF) NHS England — warning over 'bargain basement' BBLs RCS England — Professional Standards for Cosmetic Surgery GMC — guidance for cosmetic interventions ASA/CAP — marketing of cosmetic interventions CQC — Care Quality Commission (England) Healthcare Improvement Scotland — independent healthcare (Scotland) Healthcare Inspectorate Wales (Wales) RQIA — Regulation and Quality Improvement Authority (Northern Ireland)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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