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Why This Plastic Surgeon Avoids BBLs: High Complication Risk
12 Dec, 2025
Summary
- Buttock augmentations surged by nearly 63 percent worldwide recently.
- Injecting fat into gluteal muscles increases the risk of fat embolism.
- Many patients regret BBLs due to unmet expectations and reabsorption.
A prominent plastic surgeon, Dr. Sean McNally, has voiced strong reservations against buttock augmentation procedures, particularly fat grafting into the gluteal muscles for Brazilian Butt Lifts (BBLs). He cites a very high long-term complication rate, noting that BBLs have become the most dangerous plastic surgery due to the increased risk of fat embolism when fat is injected into the muscle. This practice is now advised against, with recommendations to use ultrasound guidance for safer fat injection placement.
Despite the inherent risks, buttock augmentations have seen a dramatic surge in popularity, with a nearly 63 percent global increase reported recently. Over 644,000 BBL procedures were performed globally this year alone. However, complications such as fat necrosis, which can lead to lumps, bumps, and serious infection, can arise from intramuscular fat injection. Surgeons now emphasize avoiding injection into the muscle to mitigate these dangers.
