BBL Death Rate and Safety Statistics 2026

The BBL death rate is now estimated at about 1 in 15,000, down from about 1 in 3,448 in 2017, when the risk of a Brazilian butt lift (BBL) was first measured on a large scale^[1][2]. Nearly all deaths are caused by fat being injected into or beneath the buttock muscle, and the risk varies hugely with how and where the operation is done. There is no official national count of BBL deaths in the UK or elsewhere, so every figure on this page comes from surgeon surveys, autopsy studies or published case series, and each is referenced.

This guide sets out the BBL statistics that matter: how the mortality rate has changed, how many people have died, why, how many BBLs are performed each year, and what UK bodies advise. If you are considering a Brazilian butt lift in London, it should help you judge the risk for yourself. For complications other than death, such as seroma, fat necrosis and asymmetry, see our guide to BBL risks.

What Is the BBL Death Rate in 2026?

There is no single, exact BBL death rate, because no country keeps a complete register of BBL operations or deaths. The best estimates come from large international surveys of plastic surgeons, checked against autopsy reports and medical examiner records. Here is how the main figures have changed:

• 2017: 32 deaths in 198,857 procedures. In a 2017 task force report from the Aesthetic Surgery Education and Research Foundation (ASERF), published in the Aesthetic Surgery Journal ↗, 692 surgeons reported 198,857 gluteal fat grafting procedures over their careers, with 32 deaths from pulmonary fat embolism and 103 non-fatal fat emboli. The task force concluded that gluteal fat grafting carried a significantly higher death rate than any other cosmetic operation^[3].
• 2017 rate: about 1 in 3,448. A follow-up study later put the 2017 mortality rate at 1 in 3,448^[2]. A US practice advisory issued after the task force report gave a figure “as high as 1 in 3,000”, which is where the most-quoted number comes from^[4].
• 2019: about 1 in 14,952. Two years after the task force recommendations, the follow-up survey of members of two international plastic surgery societies found the BBL mortality rate had fallen to about 1 in 14,952^[2].
• Brazil: about 1 in 20,117. A survey of 853 board-certified Brazilian plastic surgeons estimated a death rate of 1 in 20,117 and a non-fatal fat embolism rate of 1 in 9,530^[5].
• UK estimate: nearer 1 in 15,000. The British Association of Aesthetic Plastic Surgeons (BAAPS) 2022 safety review describes the earlier figures as potentially misleading and estimates the current risk at nearer 1 in 15,000, similar to a tummy tuck^[1].

BBL death rate as a percentage

Converted into percentages, a death rate of 1 in 3,448 is about 0.029%, 1 in 14,952 is about 0.0067%, and 1 in 20,117 is about 0.005%. These are small numbers, but for an elective cosmetic operation in healthy people, any risk of death is significant.

How reliable are BBL statistics?

The 2017 survey was sent to 4,843 plastic surgeons and only 692 replied, about one in seven^[3]. Surgeons who had a death may have been less likely to respond. Taken at face value, 32 deaths in 198,857 procedures is roughly 1 in 6,200, while extrapolations of the same data have produced figures as high as 1 in 2,351, which BAAPS describes as potentially misleading^[1]. What the figures show consistently is the direction of travel: a real and concentrated risk that falls sharply when fat stays out of the muscle.

How Many People Have Died From a BBL?

No country publishes a complete count of BBL deaths, so the numbers come from investigations, autopsy series and government records:

• United States: the 2017 task force confirmed 25 deaths in the previous five years through autopsy reports and interviews with surgeons and medical examiners^[3].
• South Florida: 25 BBL-related fat embolism deaths were recorded between 2010 and 2022. Fourteen of them happened after the ASERF guidelines and Florida’s 2019 “subcutaneous-only” rule, and in every case examined, fat had been injected into the gluteal muscle at several levels^[6]. The same surgeons later reported that BBL deaths in the region had increased since 2019, and that surgeons involved had stated they injected only under the skin when autopsy findings showed otherwise^[7].
• Turkey: of 35 deaths after liposuction-based procedures autopsied in Istanbul between 2022 and 2024, 54.3% had included gluteal fat grafting and 68.6% showed pulmonary fat embolism^[8]. The Foreign, Commonwealth and Development Office says it is aware of 7 British nationals who died in Turkey in 2025 following medical procedures of all types^[9].
• United Kingdom: there is no official national figure for BBL deaths. BAAPS has repeatedly called for tighter regulation of both surgical and filler-based BBLs^[10].

Our guide to BBL in Turkey looks at the UK data on complications after surgery abroad in more detail.

Why Do People Die From a BBL?

Pulmonary fat embolism: the main cause of BBL deaths

Almost all BBL deaths are caused by pulmonary fat embolism. Deep to and within the gluteal muscles run the superior and inferior gluteal veins, which are large and thin-walled. Cadaver studies measure them at about 7.6 mm and 13.7 mm across, compared with about 1 mm for the small vessels in the fat under the skin^[11]. If a cannula passes into the muscle and tears one of these veins, fat can enter the bloodstream and travel to the lungs, blocking blood flow, usually suddenly.

The intramuscular-injection mechanism is supported by every major dataset. In a 2019 survey of 853 board-certified Brazilian plastic surgeons, published in Plastic and Reconstructive Surgery ↗, the risk of death was 16 times greater when fat was injected into the muscle^[5]. The US practice advisory reported that fat had been found within the gluteal muscle at autopsy in every patient who died, and in no death was fat found only in the layer under the skin^[4]. Dynamic studies also show that fat placed beneath the muscle fascia or into the muscle can migrate into deeper compartments where the veins lie, whereas fat placed in the subcutaneous layer does not^[11].

Pulmonary fat embolism statistics

Non-fatal fat embolism is more common than death, and its rate has fallen in step with mortality:

• In 2017, surgeons reported 103 non-fatal pulmonary fat emboli alongside the 32 deaths^[3].
• The incidence of any pulmonary fat embolism fell from 1 in 1,030 in 2017 to 1 in 2,492 in the two years after the task force recommendations^[2].
• The Brazilian survey estimated non-fatal fat embolism at 1 in 9,530 procedures^[5].

Other serious risks

A BBL also carries the risks of any major body contouring operation, including blood clots in the legs or lungs (deep vein thrombosis and pulmonary embolism), bleeding, infection and reactions to anaesthesia. In the Istanbul autopsy series, ordinary pulmonary thromboembolism was the most frequent fatal complication (65.7%), and it was linked to a higher body mass index and to several operations being combined^[8]. Clot prevention, early walking and proper aftercare matter as much as technique.

Warning signs after a BBL: sudden breathlessness, chest pain or coughing up blood need an immediate 999 call. Calf pain or swelling, a fever, or a red, hot incision should be reported to your clinic straight away, or to NHS 111 out of hours.

Are BBLs Safer Now?

Yes, when the operation follows current guidance. The follow-up survey measured how much practice changed after 2017^[2]:

• surgeons injecting into deep muscle fell from 13.1% to 0.8%;
• surgeons using only cannulas of 4.1 mm or larger rose from 4.1% to 29.8%;
• surgeons angling the cannula downwards fell from 27.2% to 4%.

The biggest change since then is real-time ultrasound, which lets the surgeon watch the cannula tip and confirm the fat is going above the muscle fascia. A systematic review and meta-analysis of ultrasound-guided gluteal fat grafting, published in the Aesthetic Surgery Journal in 2025 ↗, pooled four studies with 6,235 patients and found no deaths and no fat embolism. Minor complications occurred in 6.32 per 100 patients, seroma in 2.94, infection in 0.23 and fat necrosis in 0.09^[12]. A 2026 scoping review of nine studies also found no fat embolism or procedure-related deaths, but cautioned that the evidence is mainly non-comparative case series, so ultrasound is a safety tool rather than a guarantee^[13].

Large case series point the same way. A 2026 retrospective series of 7,000 consecutive BBLs performed between 2018 and 2024 with subcutaneous-only injection and blood clot prevention reported no pulmonary fat embolism, deep vein thrombosis or pulmonary embolism^[14]. Our guide to ultrasound-guided BBL explains how the technique works.

Change has not been universal. In a 2023 survey of US board-certified plastic surgeons, 48% of those performing BBLs did not use ultrasound, and around 60% of respondents opposed making it a requirement^[15]. Florida responded in 2022 with an emergency rule requiring a continuous, time-stamped ultrasound video of the fat injection to be kept in the patient’s records^[7]. That gap explains why the statistics differ so much between settings.

How Many BBLs Are Performed Each Year?

The International Society of Aesthetic Plastic Surgery (ISAPS) global survey is the main source of worldwide figures. ISAPS reports buttock augmentation as a single category and does not publish a separate figure for BBL, so the numbers below cover buttock enlargement in general.

• 2025: 645,380 buttock augmentations worldwide, 3.6% of all 17,883,610 surgical cosmetic procedures, ranking 11th among surgical procedures^[16].
• 2024: 644,770 buttock augmentations, down 21.5% from 821,232 in 2023^[17].
• By country: in the 2025 country tables, the United States recorded 134,404 buttock augmentations and Brazil 120,195^[16].

These are projections from about 2,900 plastic surgeons who submitted data, scaled up to an estimated 60,400 plastic surgeons worldwide^[16], so they are best read as estimates. They also only cover plastic surgeons, not other practitioners. There is no official UK count, and no published figure for what percentage of women have had a BBL; the ISAPS share of 3.6% of surgical cosmetic procedures is the closest measure of how common BBLs are. For the reasons behind the trend, see why the Brazilian butt lift is so popular.

Is the BBL the Most Dangerous Cosmetic Surgery?

In 2017, gluteal fat grafting had the highest reported death rate of any cosmetic operation^[3], and a 2023 paper still called it the deadliest aesthetic procedure in the United States^[15]. But the danger depends on technique and setting. BAAPS now estimates the risk of a BBL performed to current standards at nearer 1 in 15,000, similar to abdominoplasty^[1]. A quick BBL with fat injected into the muscle at a high-volume budget clinic carries a very different risk from one in which fat is placed only under the skin, with ultrasound confirmation, in a regulated hospital.

If you are weighing up alternatives, our comparison of BBL vs butt implants explains how the risks and recovery differ.

What Makes a BBL More Dangerous?

The research points to the same handful of risk factors again and again:

• Injecting into or under the gluteal muscle, linked to a 16-fold increase in the risk of death^[5].
• Cannulas smaller than 4 mm and a downward angle^[11].
• High-volume, budget clinics with operations of around 90 minutes, where 92% of the South Florida deaths occurred^[6].
• Unregulated settings, such as beauty clinics, hotel rooms or homes^[10].
• Several operations combined, a higher body mass index and smoking^[8][1]; see our guide to body weight and BBL.

BBL Safety in the UK: What BAAPS and the Government Say

UK guidance has changed considerably since 2017:

• October 2018: the BAAPS Council advised its members not to perform gluteal fat grafting until its safety improved^[1].
• 2021 to 2022: BAAPS replaced that advice with superficial gluteal lipofilling guidelines, setting out how trained surgeons should perform the operation; its full safety review and recommendations document is dated 30 September 2022^[1][10]. Surgeons at Centre for Surgery contributed to the development of the ultrasound-guided technique and to these guidelines.
• October 2024: BAAPS called for urgent regulation of all BBL procedures, including filler-based ones, asking that they be limited to suitably trained surgeons in clinics and hospitals regulated by the Care Quality Commission (CQC)^[10].
• August 2025: the Department of Health and Social Care announced that the highest-risk non-surgical procedures, such as non-surgical BBLs, would only be carried out by qualified healthcare professionals at CQC-registered providers^[18].
• October 2026: the government proposed that fillers injected into parts of the body other than the face, including liquid BBLs, be legally defined as cosmetic surgery so that only doctors can perform them. The draft regulations are out for consultation, with the parliamentary process planned for spring 2027^[19].

The key BAAPS recommendations for surgical BBL are^[1]:

• fat injected only into the subcutaneous layer, never into the muscle;
• intraoperative ultrasound to confirm the cannula position, with images or video saved;
• blunt cannulas of 4 mm or more, with fat injected only while the cannula is moving and never angled downwards;
• no more than three BBLs per surgeon per day, to limit fatigue;
• surgery only in strictly regulated healthcare settings, after a cooling-off period of at least two weeks.

BBL Abroad: What the NHS and GOV.UK Warn

In December 2024, NHS England’s national medical director warned against “bargain basement” BBLs abroad, noting that overseas clinics were advertising discounts of 25% and that BBL abroad can cost up to 70% less than in the UK. The health minister’s advice was that “if it feels too good to be true, then it probably is”^[20].

NHS advice on cosmetic surgery abroad highlights several specific problems^[21]:

• flying soon after major surgery raises the risk of a blood clot, which can be life-threatening, and the NHS advises not flying for 5 to 7 days after liposuction;
• overseas clinics may not offer follow-up care, and there may be no UK professional you can contact if problems arise;
• you should have two consultations before surgery, giving a cooling-off period of normally two weeks in the UK.

For a BBL, travelling home also clashes with the advice not to sit directly on the buttocks for two weeks. Evidence from the United States shows what can happen when patients travel: four public emergency departments in Miami treated 157 women with BBL complications between 2020 and 2023, 123 of them from out of state. More than half (54.8%) needed admission, 7.6% needed intensive care, and one died^[22]. These patients were treated in public emergency departments, far from the surgeons who had operated.

Can a Liquid BBL Kill You?

A liquid or non-surgical BBL uses large volumes of filler injected into the buttocks rather than your own fat. It can cause serious infection, sepsis and other complications, especially when injected in unregulated settings by people without medical training. BAAPS has called for these procedures to be treated as invasive^[10], and the government’s October 2026 proposals would make liquid BBLs a doctors-only procedure^[19]. At Centre for Surgery, the non-surgical butt lift uses hyaluronic acid filler injected by surgeons in a sterile theatre under ultrasound guidance. Our guide to liquid BBL in the UK covers the risks in detail.

How to Lower Your Risk: Questions to Ask Before a BBL

The statistics show that how and where a BBL is done matters more than almost anything else. Before you book, ask:

• Who will operate? Check that your surgeon is GMC-registered, and ask whether the surgeon who assesses you will do the operation.
• Where will the fat go? The only acceptable answer is the layer under the skin, above the muscle.
• Will ultrasound be used throughout the fat transfer?
• Is the hospital registered with the CQC?
• What happens after surgery? Ask who to call and what happens if there is a complication.

Our guide to choosing your BBL surgeon has a fuller checklist, and our guide to preparing for a BBL covers what you can do yourself, including stopping nicotine four weeks before and after surgery. Take time to decide: see our guide to the two-week cooling-off period.

Tap to reveal

Ultrasound-guided BBL at Centre for Surgery, with fat placed only in the layer under the skin. Individual results vary. More results are in our BBL before and after gallery.

Frequently Asked Questions

Brazilian Butt Lift in London

At Centre for Surgery, every BBL is performed by GMC-registered surgeons at our Baker Street hospital, rated Good overall by the CQC. Fat is placed only in the subcutaneous layer above the gluteal muscle, never into or beneath it, under real-time ultrasound guidance on every BBL, using a blunt cannula and expansion vibration lipofilling (EVL). Fat is harvested by power-assisted liposuction or VASER, and the operation is a day case under TIVA (total intravenous anaesthesia), with 1 to 3 hours of monitoring before you go home with a responsible adult. The consultant who assesses you performs your surgery.

For the first 24 hours after surgery you have your surgeon’s direct number, then our team is available from 9am to 6pm, Monday to Saturday. Follow-up appointments are included, and we recommend a two-week cooling-off period before you go ahead. Your initial consultation is £100, redeemable against the cost of surgery if you go ahead. Finance isn’t available for BBL at Centre for Surgery, so the procedure is self-funded. For prices, see our guide to BBL cost in London.

Phone: 020 7993 4849 | Address: 95–97 Baker Street, Marylebone, London W1U 6RN
Contact us to schedule a consultation

References

1. British Association of Aesthetic Plastic Surgeons. BAAPS gluteal fat grafting safety review and recommendations. 30 September 2022. baaps.org.uk ↗
2. Rios L, Gupta V. Improvement in Brazilian butt lift (BBL) safety with the current recommendations from ASERF, ASAPS, and ISAPS. Aesthetic Surgery Journal 2020;40(8):864–870. doi:10.1093/asj/sjaa098 ↗
3. Mofid MM, Teitelbaum S, Suissa D, et al. Report on mortality from gluteal fat grafting: recommendations from the ASERF Task Force. Aesthetic Surgery Journal 2017;37(7):796–806. doi:10.1093/asj/sjx004 ↗
4. American Society of Plastic Surgeons. Urgent warning to surgeons performing fat grafting to the buttocks (Brazilian butt lift or “BBL”). Practice advisory. plasticsurgery.org ↗
5. Cansancao AL, Condé-Green A, Gouvea Rosique R, Junqueira Rosique M, Cervantes A. “Brazilian butt lift” performed by board-certified Brazilian plastic surgeons: reports of an expert opinion survey. Plastic and Reconstructive Surgery 2019;144(3):601–609. doi:10.1097/PRS.0000000000006020 ↗
6. Pazmiño P, Garcia O. Brazilian butt lift-associated mortality: the South Florida experience. Aesthetic Surgery Journal 2023;43(2):162–178. doi:10.1093/asj/sjac224 ↗
7. Garcia O, Pazmiño P. BBL mortality in South Florida: an update from ground zero. Aesthetic Surgery Journal 2023;43(3):NP223–NP224. doi:10.1093/asj/sjac325 ↗
8. Buğra A, Şahin HÇ, Öztürk BK, et al. Liposuction associated fatalities in Istanbul from a forensic perspective: an autopsy study. Legal Medicine (Tokyo) 2025;79:102740. doi:10.1016/j.legalmed.2025.102740 ↗
9. Foreign, Commonwealth and Development Office. Turkey travel advice: health (medical tourism). GOV.UK. Accessed October 2026. gov.uk ↗
10. British Association of Aesthetic Plastic Surgeons. The BAAPS calls for urgent regulation of BBL procedures. 23 October 2024 (addendum December 2025). baaps.org.uk ↗
11. Ghadbane C, Saad R, Aad S, et al. Cannula characteristics and mortality risk in gluteal lipofilling: does diameter and tip design matter? A narrative review. JPRAS Open 2026;52:330–336. doi:10.1016/j.jpra.2026.08.037 ↗
12. Milani Reis A, Roca Mora MM, Bicudo Bregion P, Kreutz-Rodrigues L, Camp S, Sharaf BA. Ultrasound-guided gluteal fat grafting: what is the evidence? A systematic review and meta-analysis. Aesthetic Surgery Journal 2026;46(1):57–62 (published online 2025). doi:10.1093/asj/sjaf059 ↗
13. Vázquez-Guerra XC, Alvarez-Lozada LA, Altuzar-Abadía JJ, et al. Ultrasound in gluteal fat grafting: safety tool, standard of care, or emerging evidence? A scoping review. Aesthetic Surgery Journal 2026. doi:10.1093/asj/sjag120 ↗
14. Güzey S, Ergan Şahin A. Brazilian butt lift: what we learned over 7000 patients? Aesthetic Plastic Surgery 2026;50(14):5864–5872. doi:10.1007/s00266-026-05899-9 ↗
15. Finkelstein ER, Wo L, Garcia O, Kassira W. The Brazilian butt lift remains the deadliest aesthetic surgery procedure: are plastic surgeons adjusting their surgical practice to promote safety? Aesthetic Surgery Journal 2024;44(1):NP69–NP76 (published online 2023). doi:10.1093/asj/sjad310 ↗
16. International Society of Aesthetic Plastic Surgery. ISAPS international survey on aesthetic/cosmetic procedures performed in 2025. Published September 2026. isaps.org ↗
17. International Society of Aesthetic Plastic Surgery. ISAPS international survey on aesthetic/cosmetic procedures performed in 2024. Published 2025. isaps.org ↗
18. Department of Health and Social Care. Crackdown on unsafe cosmetic procedures to protect the public. GOV.UK, 6 August 2025. gov.uk ↗
19. Department of Health and Social Care. Cosmetic cowboys crackdown continues with new restrictions. GOV.UK, 21 October 2026. gov.uk ↗
20. NHS England. NHS warns of “bargain basement” BBLs in run up to Christmas. December 2024. england.nhs.uk ↗
21. NHS. Cosmetic surgery abroad. nhs.uk. Accessed October 2026. nhs.uk ↗
22. Lee MB, Goldstein J, Hercz D, Pyle M. Autologous fat transfer procedure complications in four emergency departments in Miami, Florida. Western Journal of Emergency Medicine 2026;27(4):861–868. doi:10.5811/westjem.54037 ↗

Related Articles

• BBL Risks: Is a Brazilian Butt Lift Safe?
• Safe BBL: What Is an Ultrasound-Guided BBL and Is It Safer?
• Is BBL in Turkey Safe? What UK Data Shows About BBL Abroad
• Liquid BBL in the UK: What It Is, How Long It Lasts and Is It Safe?