In this guide19 sections
- Key Points
- BBL Pre-Op Checklist: What to Do and When
- What Happens at Your BBL Consultation?
- BBL Requirements: Are You Ready for Surgery?
- Should You Stop GLP-1 Weight-Loss Medication Before a BBL?
- How Long Before a BBL Should You Stop Smoking or Vaping?
- Which Medicines and Supplements Should You Stop Before a BBL?
- Can You Drink Alcohol Before a BBL?
- Do You Need to Stop the Pill or HRT Before a BBL?
- How Is Blood Clot Risk Reduced for a BBL?
- What to Buy Before a BBL: Your BBL Recovery Kit
- How to Prepare Your Home for BBL Recovery
- How Much Time Off Work Do You Need for a BBL?
- Who Needs to Stay With You After a BBL?
- What Should You Eat Before BBL Surgery?
- BBL Day-of-Surgery Checklist
- Frequently Asked Questions
- Brazilian Butt Lift in London
- References
Key Points
- Stop smoking, vaping and all nicotine 4 weeks before and 4 weeks after a BBL. Nicotine narrows small blood vessels, raising wound complications and reducing fat survival.
- Stop aspirin 2 weeks before surgery, and stop anti-inflammatories and bleeding-risk supplements. Fish oil, vitamin E, ginkgo, garlic and St John’s wort all need to stop. Paracetamol is fine.
- Keep your weight stable for at least 3 months. If you take GLP-1 weight-loss medication, the team will advise whether and when to pause it before surgery.
- The oestrogen-containing pill or HRT may need pausing 4 weeks before. Oestrogen raises the risk of blood clots, which is one of the main risks the team plans around.
- Have your BBL cushion ready before surgery day. You cannot sit directly on your buttocks for 2 weeks, so set up your bed, sofa and workspace in advance.
- Arrange a responsible adult to take you home and stay for 24 hours. A BBL is a day case under TIVA: no food for 6 hours beforehand, and clear fluids only until 2 hours before admission.
To prepare for a BBL, stop smoking and vaping 4 weeks before surgery, stop aspirin 2 weeks before, stop anti-inflammatories and supplements that thin the blood, cut alcohol to little or none in the final week, and keep your weight stable. Ask whether the oestrogen pill, HRT or GLP-1 medication needs pausing. Buy a BBL cushion, set up your home for two weeks without sitting, book 1 to 2 weeks off work, and arrange a responsible adult for the first 24 hours.
This guide turns the instructions our pre-operative team gives every Brazilian butt lift patient into one BBL pre-op checklist, with the reasons and research behind each step. Once you are through the operation, our BBL recovery guide takes over week by week.
BBL Pre-Op Checklist: What to Do and When
Most BBL preparation happens in the four weeks before surgery. These are the timings we use; your written instructions may adjust them for your health and medicines.
- At consultation and booking: discuss your goals, medical history and medicines. We recommend a two-week cooling-off period before you book.
- 3 months or more before: hold your weight steady and avoid crash diets.
- 4 weeks before: stop smoking, vaping and every other form of nicotine. Ask whether the combined pill or HRT needs pausing.
- 2 weeks before: stop aspirin, anti-inflammatories and supplements that increase bleeding. Complete any blood tests requested, so there is time to act on the results.
- 1 week before: complete your pre-operative forms, cut alcohol to little or none, buy your BBL cushion, and collect your compression garment and prescribed medicines.
- The day of surgery: no food for 6 hours, clear fluids until 2 hours before admission, and a responsible adult ready to take you home.
What Happens at Your BBL Consultation?
Preparation starts with a face-to-face consultation, and at Centre for Surgery the consultant who assesses you is the consultant who performs your surgery. Virtual consultations are available for a first discussion, and if you are travelling a distance, the consultation and pre-operative appointment can usually be combined.
Your surgeon examines your buttocks, donor areas and skin quality and asks about your weight history, so bring a list of everything you take, including supplements and weight-loss injections. Our guide to choosing your Brazilian butt lift surgeon lists questions worth asking. The most important are about safety:
- Where will the fat be placed? It should go only into the fat layer under the skin, above the gluteal muscle, never into or beneath the muscle.
- Is ultrasound used? At Centre for Surgery every BBL uses real-time ultrasound guidance to confirm the cannula stays in that layer.
These questions matter more for a BBL than for most cosmetic operations. A 2017 survey-based task force report in the Aesthetic Surgery Journal ↗ estimated BBL mortality at about 1 in 3,448 and linked fatal fat embolism to fat injected into the deep muscle[1]. After surgeons changed technique in response, a follow-up survey found the estimated death rate fell to around 1 in 14,952[2]. Our article on ultrasound-guided BBL explains how real-time imaging keeps the fat in the safe layer. These checks are hard to verify for surgery abroad, which is one reason the NHS warns about having fat transfer abroad ↗.
Real Centre for Surgery patient, photographed at least six months after BBL surgery. You can see more results in our BBL before and after photos.
Your initial consultation is £100, redeemable against the cost of surgery if you go ahead, and your quote is confirmed in writing afterwards. Our BBL cost guide explains what affects the price. Finance isn’t available for BBL at Centre for Surgery, so the procedure is self-funded. Further consultations before surgery are free.
BBL Requirements: Are You Ready for Surgery?
Your surgeon decides whether a BBL is right for you, but the common BBL requirements are:
- Enough donor fat. A BMI of roughly 23 to 28 usually gives enough fat to harvest. Our guide to the right body weight for a BBL explains why there is no single cut-off.
- A stable weight for at least 3 months, or 6 to 12 months after major weight loss.
- Age 18 or over, not pregnant and not breastfeeding.
- Good general health, with long-term conditions such as diabetes or high blood pressure well controlled.
- Skin that can hold the new volume. Where the buttock skin is very loose, a buttock lift may be recommended instead of, or as well as, a BBL.
Slimmer patients with a BMI below 23 may still be suitable for a skinny BBL, which harvests smaller amounts from more donor sites. A BBL is never performed in the same operation as a tummy tuck at Centre for Surgery; where both are planned, they are staged 3 to 6 months apart.
Should You Stop GLP-1 Weight-Loss Medication Before a BBL?
Tell your surgeon if you take a GLP-1 medicine, by injection or tablet, for weight loss or diabetes. The team will advise whether and when to pause it; don’t stop or restart it without that advice.
Two things matter. The first is anaesthetic safety. GLP-1 medicines slow the rate at which the stomach empties, so food can remain in the stomach longer than usual even after standard fasting. A 2024 multisociety clinical practice guidance in Surgery for Obesity and Related Diseases ↗ recommends an individual decision based on the dose, how recently it was increased and any stomach symptoms such as nausea or bloating, rather than a blanket rule[3].
The second is your result. A BBL depends on stable donor fat. If you are still losing weight on medication, your surgeon may recommend reaching a stable weight first, as continued weight loss after surgery will also shrink the transferred fat.
How Long Before a BBL Should You Stop Smoking or Vaping?
Stop all nicotine at least 4 weeks before your BBL and stay off it for 4 weeks afterwards. That includes cigarettes, vapes, nicotine patches, gum and pouches, and shisha. Nicotine narrows the small blood vessels that new fat relies on, and smoke reduces the oxygen your blood carries.
The evidence is strong. A 2012 systematic review and meta-analysis of 140 cohort studies in the Archives of Surgery ↗, covering 479,150 patients, found that smokers had 3.6 times the odds of tissue necrosis, about twice the odds of delayed wound healing and wound breakdown, and higher rates of surgical site infection than non-smokers[4]. Stopping helps: in a randomised trial of hip and knee replacement patients in the Lancet, those who stopped or cut down 6 to 8 weeks before surgery had far fewer wound complications (5% compared with 31%)[5].
For a BBL this matters twice over. Transferred fat has no blood supply of its own at first and relies on the surrounding tissue until new vessels grow in. Around 50 to 70% of transferred fat survives in a typical BBL, and smoking pushes that figure down, leaving a smaller result or firm lumps of fat necrosis.
Which Medicines and Supplements Should You Stop Before a BBL?
Some medicines and supplements affect clotting and increase bleeding and bruising. Our standard advice:
- Aspirin: stop 2 weeks before surgery. If aspirin was prescribed for your heart or after a stroke, do not stop it without speaking to your surgeon and the doctor who prescribed it.
- Anti-inflammatory painkillers: stop ibuprofen, naproxen and similar medicines unless you are told otherwise.
- Supplements: stop fish oil, vitamin E, ginkgo, garlic and St John’s wort.
- Paracetamol: safe to take before surgery.
- Prescribed blood thinners: warfarin and other anticoagulants need a specific plan from your surgeon and prescriber.
Keep taking regular prescribed medicines, such as blood pressure tablets, unless told otherwise, and bring the packet of any vitamin or herbal product you are unsure about to your pre-operative assessment.
Can You Drink Alcohol Before a BBL?
Have little or no alcohol for a week before your BBL and a week after. Alcohol affects blood clotting, dehydrates you, adds to the sedating effect of anaesthetic drugs and prescribed painkillers, and slows healing. If you drink regularly, cut down gradually and tell the team honestly how much you drink, so they can plan your anaesthetic safely.
Do You Need to Stop the Pill or HRT Before a BBL?
Possibly. Oestrogen-containing contraception, such as the combined pill, patch or vaginal ring, and oestrogen-containing HRT may need pausing about 4 weeks before surgery. Oestrogen makes blood more likely to clot, adding to the clot risk that surgery and reduced movement already carry.
Your surgeon decides based on your overall clot risk. Progestogen-only methods, such as the mini pill, implant or hormonal coil, carry much less clot risk, but mention every hormone you take. If you pause the combined pill, use condoms until you restart, as pregnancy must be ruled out before surgery.
How Is Blood Clot Risk Reduced for a BBL?
Venous thromboembolism (VTE), a clot in a leg vein or one that travels to the lungs, is a main risk of any body contouring operation, so your personal risk is assessed before surgery. A 2012 American Society of Plastic Surgeons task force report in Plastic and Reconstructive Surgery ↗ recommends scoring every patient with the Caprini risk assessment, which counts factors such as age, BMI, oestrogen use, previous clots and the length of the operation, and matching prevention to the score[6]. In a multicentre study of plastic surgery patients who did not receive blood-thinning injections, the risk of a clot rose steeply with the score, and in high-risk patients more than half of clots appeared after the first two weeks[7].
At Centre for Surgery the risk is reduced with anti-embolic stockings, compression pumps on the legs during surgery and walking from day one. Your part is to tell the team about any previous clot, a family history of clots, recent long-haul travel and hormone use, and not to plan a long flight soon after surgery.
After surgery, call 999 if you have breathlessness, chest pain or cough up blood. Call us, or NHS 111 out of hours, if you have pain or swelling in a calf, a fever, or an incision that becomes red and hot.
What to Buy Before a BBL: Your BBL Recovery Kit
These are the BBL must-haves to have at home before surgery day:
- A BBL cushion or BBL pillow. A firm foam wedge that takes your weight on the backs of your thighs. Have it ready before surgery for the car journey home and whenever sitting can’t be avoided.
- Your compression garment. Worn day and night for 6 weeks over the donor areas, with the buttocks left free. Compression garments and prescribed medication are bought separately; try the garment on beforehand, as it should feel snug. Our guide to the benefits of wearing a compression garment explains why the fit matters.
- Your prescribed medicines, collected in advance.
- Loose clothes that fasten at the front, such as zip-up tops, wide-leg joggers and loose dresses that go over the garment.
- Old towels, dark bedding or waterproof pads. The small liposuction incisions can leak blood-tinged fluid for the first day or two.
- Extra pillows for front and side sleeping, plus a long phone charging cable.
- Easy, high-protein meals so you aren’t cooking for the first few days.
How to Prepare Your Home for BBL Recovery
For 2 weeks you cannot sit directly on your buttocks and need to sleep on your front or side, as pressure squeezes the small blood vessels the new fat depends on. Setting up your home beforehand makes this far easier.
- Your bed: make up a front or side sleeping position with a pillow under your chest and one between your knees. Our guide on how to sleep after a BBL shows the positions that work.
- A place to stand or lie: raise a laptop on a kitchen counter so you can work and eat standing, and clear the sofa for lying on your side.
- Everyday items at waist height: bending and squatting are uncomfortable at first, so move what you need onto counters.
- The toilet: you can use it normally from the first day. Keep visits brief and lean forward to take weight off your buttocks; don’t use a cushion on the toilet. Drink water and eat fibre, as prescribed painkillers can cause constipation.
- Children and pets: arrange help with lifting, school runs and dog walking for at least the first week.
Our article on when you can sit after a BBL sets out how sitting builds up from week three.
How Much Time Off Work Do You Need for a BBL?
Plan 1 to 2 weeks off work. Desk work is often possible from about day 7 if you can avoid sitting on your buttocks, for example by standing, working lying on your front or using a BBL cushion with regular breaks. Jobs involving driving or lifting usually need longer.
Other milestones to build into your plans:
- Walking from day one, little and often, to help prevent blood clots.
- Driving after 4 weeks, once you can sit comfortably and make an emergency stop.
- Light cardio, such as brisk walking (not cycling), from week 3.
- Full exercise, including weights, from 6 weeks.
- Follow-up: a nurse-led wound check at 7 to 14 days and a surgeon review at 6 weeks, with further reviews at 3 and 6 months available.
Avoid booking flights or big events in the first 6 weeks. If you are travelling to London from elsewhere, our page on travelling to us for surgery covers accommodation near Baker Street and how follow-up works.
Who Needs to Stay With You After a BBL?
You need a responsible adult to collect you from the hospital and stay with you for 24 hours. You cannot be discharged without one. They should take you home by car or taxi, not public transport, with your BBL cushion on the seat or lying across the back seat.
Anaesthetic effects can last 24 hours, so don’t drive, drink alcohol or make important legal or financial decisions in that time. Help for the first two or three days with meals and the garment is useful. If no one can stay, tell us at consultation: overnight nursing can be arranged for patients staying locally, at an extra charge.
What Should You Eat Before BBL Surgery?
In the weeks before surgery, eat normally and well: protein, vegetables, fruit and wholegrains help wound healing. Avoid crash diets and detox regimes, don’t try to “bulk up” quickly, and drink plenty of water in the final days.
The fasting rules on the day are simple. Stop eating 6 hours before your admission time, and drink only clear fluids, such as still water or black tea or coffee, until 2 hours before. Milk counts as food, so don’t add it to hot drinks, and avoid chewing gum. These timings follow the European Society of Anaesthesiology fasting guidelines ↗, which encourage adults to keep drinking clear fluids until 2 hours before planned surgery rather than fasting from midnight[8]. If you take GLP-1 medication, follow any extra instructions the team gives you, as they may differ.
BBL Day-of-Surgery Checklist
On the morning of your Brazilian butt lift (sometimes called a Brazilian bum lift), work through this list before you leave home:
- Fasting: no food in the 6 hours before admission, and clear fluids only until 2 hours before.
- Medicines: take any regular medicines you have been told to continue with a sip of water.
- Shower as normal, but don’t apply body lotion, fake tan, perfume or make-up. Don’t shave or wax the donor areas or buttocks in the days before surgery, as small nicks can raise infection risk.
- Jewellery: remove piercings and leave valuables at home.
- Clothes: wear loose, dark clothes that fasten at the front and are easy to pull on over the garment.
- Bring: your compression garment, your BBL cushion for the journey home, your phone and charger, and glasses rather than contact lenses.
- Arrive about an hour before your surgery time to complete paperwork and read your consent form.
Your surgeon confirms the plan and marks you standing. A BBL is a day case under TIVA (total intravenous anaesthesia) and usually takes 3 to 4 hours, longer with 360 liposuction. We run regular post-operative pain audits, and combining TIVA with local anaesthetic has minimised or even eliminated the need for strong opioid painkillers for many patients. You are monitored for 1 to 3 hours and go home the same day. You will have your surgeon’s direct number for the first 24 hours, then our clinic line, and our nursing team stays in contact over the first two weeks.
Frequently Asked Questions
What do I need for a BBL?
Before surgery you need a BBL cushion, your compression garment, your prescribed medicines, loose front-fastening clothes, extra pillows for front or side sleeping, and old towels for any fluid leakage. You also need 1 to 2 weeks off work and a responsible adult to take you home and stay for 24 hours.
What not to do before BBL surgery?
Don’t smoke, vape or use any nicotine for 4 weeks before. Don’t take aspirin in the final 2 weeks, or anti-inflammatories and supplements such as fish oil, vitamin E, ginkgo, garlic and St John’s wort. Avoid alcohol in the final week, crash dieting, and eating in the 6 hours before admission. Don’t stop prescribed medicines, the pill, HRT or GLP-1 medication without advice from the team.
What disqualifies you from getting a BBL?
You may not be suitable if you are under 18, pregnant or breastfeeding, still losing or gaining weight, have too little donor fat, have poorly controlled medical conditions, or have a high personal risk of blood clots. Continuing to smoke also rules out surgery. Very loose buttock skin may need a buttock lift instead.
What should you not do 2 weeks before surgery?
Two weeks before surgery, stop aspirin and avoid anti-inflammatory painkillers such as ibuprofen, along with supplements that increase bleeding. Keep off nicotine, avoid sunburn on the treatment areas, and don’t start any new diet or weight-loss medicine. Complete any requested blood tests so the results are back in time.
Can I take vitamins before BBL surgery?
Some vitamins and supplements need to stop, especially vitamin E, fish oil, ginkgo, garlic and St John’s wort, as they can increase bleeding or interact with medicines. Bring the packets of everything you take, including multivitamins, to your pre-operative assessment so the team can check them, and don’t start new supplements in the weeks before surgery.
Should I gain weight before a BBL?
Usually not. Surgery works best at a stable weight you can maintain, ideally held for at least 3 months. Fat gained quickly before surgery is often lost again afterwards, and the transferred fat shrinks when your weight falls. Your surgeon will tell you at consultation whether you have enough donor fat.
How do you use the bathroom after a BBL?
You can use the toilet normally from the first day. Keep visits brief and lean forward to keep weight off your buttocks; a cushion isn’t used on the toilet. Prescribed painkillers can cause constipation, so drink plenty of water, eat fibre and walk regularly.
What is the age limit for a BBL?
You must be 18 or over. There is no fixed upper age limit: suitability depends on your general health, skin quality and clot risk rather than your age alone. Older patients may need a more detailed pre-operative assessment, and looser skin can mean a buttock lift is also recommended.
Brazilian Butt Lift in London
Brazilian butt lift surgery at Centre for Surgery is performed by GMC-registered surgeons at our CQC-regulated private hospital on Baker Street, rated Good overall by the CQC. Every BBL places fat only in the layer above the gluteal muscle under real-time ultrasound guidance, and our pre-operative team sends written instructions tailored to you. We recommend a two-week cooling-off period, and further consultations before surgery are free. Your initial consultation is £100, redeemable against the cost of surgery if you go ahead.
Phone: 020 7993 4849 | Address: 95–97 Baker Street, Marylebone, London W1U 6RN
Contact us to schedule a consultation
References
- 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 ↗
- 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 ↗
- Kindel TL, Wang AY, Wadhwa A, et al. Multisociety clinical practice guidance for the safe use of glucagon-like peptide-1 receptor agonists in the perioperative period. Surgery for Obesity and Related Diseases 2024;20(12):1183–1186. doi:10.1016/j.soard.2024.08.033 ↗
- Sørensen LT. Wound healing and infection in surgery: the clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Archives of Surgery 2012;147(4):373–383. doi:10.1001/archsurg.2012.5 ↗
- Møller AM, Villebro N, Pedersen T, Tønnesen H. Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet 2002;359(9301):114–117. doi:10.1016/S0140-6736(02)07369-5 ↗
- Murphy RX Jr, Alderman A, Gutowski K, et al. Evidence-based practices for thromboembolism prevention: summary of the ASPS Venous Thromboembolism Task Force Report. Plastic and Reconstructive Surgery 2012;130(1):168e–175e. doi:10.1097/PRS.0b013e318254b4ee ↗
- Pannucci CJ, Bailey SH, Dreszer G, et al. Validation of the Caprini risk assessment model in plastic and reconstructive surgery patients. Journal of the American College of Surgeons 2011;212(1):105–112. doi:10.1016/j.jamcollsurg.2010.08.018 ↗
- Smith I, Kranke P, Murat I, et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. European Journal of Anaesthesiology 2011;28(8):556–569. doi:10.1097/EJA.0b013e3283495ba1 ↗
Related Articles
- BBL Recovery and Aftercare: A Week-by-Week Guide
- When Can I Sit Normally After a Brazilian Butt Lift?
- How to Sleep After BBL
- BBL Risks: Is a Brazilian Butt Lift Safe?
