Brazilian Butt Lift (BBL): Shaping with Your Own Fat

In short: A Brazilian butt lift (BBL) is a buttock augmentation using your own fat. Fat is removed from the abdomen, flanks, back or thighs by liposuction and transferred only into the subcutaneous layer of the buttocks, with a maximum of 400 to 500 millilitres per side at our practice. BBL surgery takes about 3 to 5 hours and is performed under general anaesthesia at the Berger Klinik in Frankfurt, followed by one night in the clinic. First results are visible after 6 to 8 weeks, the final result after about 3 to 6 months. You need sufficient fat reserves to be a candidate.

A Brazilian butt lift combines two wishes that many women have at the same time: less fat on the abdomen, flanks or thighs and a fuller, rounder bottom. Because your own fat is used, the procedure does not require an implant. At the same time it is real surgery, and technique and experience make a big difference.

For an overview of all body procedures, visit our page on body sculpting in Frankfurt.

What is a Brazilian butt lift?

A Brazilian butt lift is a buttock augmentation with your own fat, carried out in two steps. First, fat is suctioned from areas with sufficient reserves, for example the abdomen, flanks, back or thighs. This is called liposuction, which you can read more about in our article on liposuction in Frankfurt. In the second step, the harvested fat is processed and transferred into the buttocks. This fat transfer is also known as lipofilling.

As a result, your contour changes in two places at once. The areas where fat is removed look slimmer, and the buttocks gain volume and roundness. Because no foreign material is used, the buttocks feel like your own tissue afterwards.

Despite its name, a Brazilian butt lift does not tighten the skin. If the buttocks sag because of excess skin, for example after major weight loss, a buttock lift is the more suitable procedure.

What does BBL mean?

BBL is short for Brazilian butt lift. The term Brazilian buttock lift is used with the same meaning. In German, the procedure is called Po Vergrößerung or Gesäßvergrößerung mit Eigenfett. Whenever people talk about BBL surgery, they mean this combination of liposuction and fat transfer.

Buttock augmentation at our practice: three options

A Brazilian butt lift is one of three ways we can build up the buttocks. Which one suits you depends mainly on how much fat you have and what shape you would like.

• Your own fat, the classic BBL: liposuction and fat transfer in one operation, with one night in the clinic.
• Hyaluronic acid: an injection treatment without surgery and without general anaesthesia, performed as an outpatient procedure at the practice. The result is visible after 10 to 14 days and usually lasts 12 to 18 months.
• Your own tissue including muscle: an operation in which your own tissue, including muscle, builds up the buttocks, usually with 1 to 2 nights in the clinic. The result becomes visible after about 3 to 6 months.

In some cases we combine fat transfer and hyaluronic acid, for example to balance an asymmetry. We do not use buttock implants.

How a Brazilian butt lift works: fat in the subcutaneous layer

For transferred fat to last, it has to take hold at its new location and be supplied with blood from there. Part of the fat does not survive and is broken down by the body in the first weeks. How much takes hold permanently varies from person to person and cannot be predicted exactly in advance.

The layer in which the fat is placed is crucial for safety. Large veins run in and beneath the gluteal muscle. If fat gets there, it can enter the bloodstream. International professional societies therefore recommend placing fat exclusively in the subcutaneous layer during a Brazilian butt lift, meaning the fatty tissue directly beneath the skin.

Our approach: less volume, more safety

Elsewhere, 1 to 2 litres of fat per buttock are sometimes transferred during a BBL. We deliberately work with much smaller amounts, a maximum of 400 to 500 millilitres per side. We place the fat in the superficial fat layers, mainly on the outer and upper parts of the buttocks. This emphasises the curve and creates a soft transition to the hips and thighs.

We consistently avoid deep areas close to large vessels, such as the venous plexus in the inner buttock region. The aim is a shape that suits your silhouette rather than as much volume as possible. How much fat makes sense in your case depends on your fat reserves, your buttock shape and your wishes.

The Brazilian butt lift procedure

Consultation and planning

Every procedure begins with a detailed consultation with Dr. Julia Berkei. She assesses where you have enough fat, how your buttocks are shaped and what you would like. Together you decide whether a Brazilian butt lift is right for you or whether another form of buttock augmentation is a better fit. Existing conditions such as a tendency to thrombosis are also discussed. If you wish, the planned change can be visualised beforehand with a 3D simulation using Vectra.

Preparing for your Brazilian butt lift

• Blood thinners: Blood thinning medication is usually stopped 4 to 5 days before a Brazilian butt lift. Always discuss this with your surgeon first and never stop any medication on your own.
• Smoking: Smoking reduces blood flow and can impair wound healing and fat survival. Ideally, avoid smoking for 4 weeks before and 4 weeks after surgery.
• Sun: Plan the operation so that you have no intense sun exposure or sauna visits in the weeks afterwards.
• Schedule: Keep 2 to 3 weeks around the operation free of work commitments and avoid long journeys sitting down during the first 2 weeks.

We do not treat women who are pregnant or breastfeeding, who have a tendency to thrombosis or who have too little fat.

BBL surgery at the Berger Klinik

The Brazilian butt lift is performed under general anaesthesia at the Berger Klinik and takes about 3 to 5 hours, depending on the extent. First, fat is suctioned from the planned areas, for example the abdomen, flanks, back or thighs. It is then processed and placed into the subcutaneous layer of the buttocks using fine cannulas. After the operation you stay one night in the clinic. We see you for your first check the following day.

Recovery and aftercare after BBL surgery

Swelling and bruising are normal during the first days and usually subside on their own. These points matter most for healing:

• Compression garment: Wear it consistently for at least 3 to 4 weeks, 6 weeks are recommended.
• Sitting and lying down: For about 2 weeks, avoid sitting as far as possible and do not lie on your back. Sleep on your front or side. If sitting cannot be avoided, a special BBL pillow takes pressure off the buttocks, but it is even better to genuinely avoid sitting during this time. After that, you increase the load gradually.
• Showering: You may shower carefully again two days after surgery.
• Daily life and work: Most patients feel ready to be seen in public after 10 to 14 days and are able to work after about 2 to 3 weeks.
• Exercise: Avoid physical exertion for 4 to 6 weeks.
• Sauna and sun: Sauna is possible again only once the wounds have healed and after checking with us, usually after about 4 weeks. Avoid direct sun and tanning beds on the treated areas for at least 6 weeks, and use high sun protection afterwards.

Who is a Brazilian butt lift suitable for?

A BBL is an option for women who would like fuller buttocks and have enough removable fat on the abdomen, flanks, back or thighs. Many women appreciate that two areas change in one procedure. A stable body weight helps, because major weight changes can alter the result later. Realistic expectations are just as important: a BBL shapes the buttocks with your own tissue, and how much fat takes hold permanently cannot be planned exactly.

The procedure is not suitable in these cases, among others:

• during pregnancy or breastfeeding
• with a tendency to thrombosis
• with too little fat
• with unrealistic expectations of the result

If you are very slim, there is often not enough fat for a transfer. In that case, buttock augmentation with hyaluronic acid or with your own tissue may be the better option.

Results and longevity of a Brazilian butt lift

Directly after surgery the buttocks are swollen, so the result cannot be judged during the first weeks. After about 6 to 8 weeks the first healing phase is complete and the change is clearly visible. The final result shows after about 3 to 6 months, once the swelling has fully subsided and the surviving fat has stabilised.

BBL before and after: what usually changes

People searching for Brazilian buttock lift before and after photos mainly want to know what changes, how much and over what period. As a medical practice in Germany we are not allowed to show such photos publicly, but we can describe the changes:

• Buttocks: They usually look fuller and rounder because volume from your own fat is added.
• Donor areas: The abdomen, flanks, back or thighs look slimmer because fat was removed there.
• Silhouette: Together, this changes the ratio of waist to hips.
• Timeline: Swelling dominates the first weeks, and the final result shows after about 3 to 6 months.

How noticeable the change is depends on your fat reserves, your starting shape and how much fat takes hold. What is realistic for you is something we discuss together in the consultation.

How long does the result last?

Part of the transferred fat is broken down in the first weeks. The fat that has taken hold stays permanently and behaves like the rest of your fatty tissue, so it also increases or decreases if your weight changes significantly. How large this share is differs from woman to woman. If you would like more volume later, the procedure can be repeated after about 6 to 12 months at the earliest.

With a hyaluronic acid buttock augmentation, by contrast, the body gradually breaks down the material, and the result usually lasts 12 to 18 months.

Risks of a Brazilian butt lift

An honest look at the risks belongs to every decision for a Brazilian butt lift. Like any operation, it has side effects that occur almost always and complications that are rarer but sometimes serious.

What almost always occurs after BBL surgery

Swelling and bruising at the donor areas and on the buttocks are practically always part of recovery after a Brazilian butt lift. They usually subside on their own. The body also always breaks down part of the transferred fat.

Possible complications

• Asymmetry: If more fat takes hold on one side than on the other, the two sides of the buttocks look different.
• Dents and lumps: Irregularities can develop at the donor areas or on the buttocks.
• Wound healing problems: The incision points may heal more slowly or less well than expected.
• Infection: The tissue at the donor areas or on the buttocks can become inflamed.
• Thrombosis: A blood clot can form after surgery, usually in the leg veins. A known tendency to thrombosis therefore rules out the procedure.
• Fat embolism: If fat enters a blood vessel, it can be carried to the lungs and block vessels there. This complication is rare but the most serious one in a BBL and can be life threatening.

Why is a BBL considered dangerous?

Professional societies such as the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC) count buttock augmentation with fat among the aesthetic procedures with the highest risk. The main cause of serious incidents is fat that gets into or beneath the gluteal muscle and from there enters the bloodstream through injured veins.

That is why we transfer fat exclusively into the subcutaneous layer, limit the amount to a maximum of 400 to 500 millilitres per side and avoid deep areas rich in blood vessels. The procedure is in the hands of an experienced specialist in plastic and aesthetic surgery and embedded in our B Safe safety concept. We discuss all risks with you in detail during the informed consent consultation.

What the cost of a Brazilian butt lift depends on

There is no flat rate for a Brazilian butt lift, because every procedure is based on your individual findings. These factors determine the effort involved:

• how many areas are suctioned and how large they are
• how much fat is transferred
• how long the operation takes
• general anaesthesia and the overnight stay in the clinic
• compression garments and aftercare appointments
• whether other procedures are combined

After the examination you receive a cost plan tailored precisely to your treatment. As a BBL is an aesthetic procedure, statutory and private health insurers usually do not cover the costs.

Brazilian butt lift in Frankfurt: how we work

Our main practice is located at Goethestraße 25 in the heart of Frankfurt, and consultations take place at our practice annex on the Fressgasse. The Brazilian butt lift is performed by Dr. Julia Berkei herself, specialist in plastic and aesthetic surgery. Surgery takes place under general anaesthesia at the Berger Klinik, where you also spend the night after the procedure.

If you would like to change several areas of your body after pregnancy, read our article on the mommy makeover in Frankfurt.

FAQ: Frequently asked questions about the Brazilian butt lift

Is a BBL dangerous?

A Brazilian butt lift is an operation with serious risks. The most serious is fat embolism, which usually occurs when fat gets into the gluteal muscle. Placing fat exclusively in the subcutaneous layer, limiting the amount and providing careful aftercare reduce this risk. We inform you thoroughly beforehand.

How much does a BBL cost?

The cost of a Brazilian butt lift depends on how many areas are suctioned, how much fat is transferred and how long the operation takes. Anaesthesia, the overnight stay and aftercare are also included. After the examination you receive an individual cost plan.

How long does BBL surgery take?

BBL surgery takes about 3 to 5 hours, depending on the extent. It is performed under general anaesthesia at the Berger Klinik. After a Brazilian butt lift you stay one night in the clinic and are able to work again after about 2 to 3 weeks.

How much fat is transferred during a BBL?

We transfer a maximum of 400 to 500 millilitres of fat per buttock, and only into the subcutaneous layer. Elsewhere, 1 to 2 litres per side are sometimes common. The smaller amount gives a natural shape and lowers the risk of complications.

When can I sit again after a BBL?

After a Brazilian butt lift you should avoid sitting as far as possible and not lie on your back for about 2 weeks, so that hardly any pressure rests on the transferred fat. A BBL pillow can help if sitting cannot be avoided, but it is best to genuinely not sit. After that, you increase the load gradually.

Is the result of a Brazilian butt lift permanent?

Part of the transferred fat is broken down in the first weeks, and how much varies from person to person. The fat that has taken hold stays permanently and behaves like the rest of your fatty tissue. The final result is visible after about 3 to 6 months.

BBL with fat or with hyaluronic acid: what is the difference?

In a BBL with fat, fat is suctioned and transferred into the buttocks, and the fat that takes hold stays permanently. Buttock augmentation with hyaluronic acid requires no surgery, the result is visible after 10 to 14 days and usually lasts 12 to 18 months.

What if I am too slim for a BBL?

If there is not enough fat for a transfer, we offer two other options: buttock augmentation with hyaluronic acid without surgery, or building up the buttocks with your own tissue including muscle. We do not offer buttock implants. Which option suits you is clarified during the examination.

Is a BBL a buttock lift?

Despite its name, a Brazilian butt lift does not tighten the skin; it adds volume with your own fat. If the buttocks sag because of excess skin, for example after major weight loss, a buttock lift is the more suitable procedure.

Can a BBL be combined with other procedures?

Yes. A BBL is often combined with a tummy tuck, further liposuction or a breast augmentation with your own fat, for example as part of a mommy makeover. Whether a combination makes sense for you is something we discuss in the consultation.

Conclusion: an informed decision about a Brazilian butt lift

A Brazilian butt lift shapes the buttocks with your own fat and also changes the areas where fat is suctioned. It is an operation under general anaesthesia with one night in the clinic and several weeks of aftercare, and it has risks you should know about. Whether the procedure suits you or another form of buttock augmentation is better, we clarify in a personal consultation. You can book a consultation in Frankfurt directly online.

Sources

• German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC): press release on buttock augmentation with fat, 5 July 2019. dgpraec.de
• American Society of Plastic Surgeons and other professional societies: Gluteal Fat Grafting Safety Advisory, June 2019. plasticsurgery.org

Author: Livia Berkei, Resident Physician in Plastic and Aesthetic Surgery
Medically reviewed by Dr. Julia Berkei