The Brazilian butt lift, a dangerous but popular cosmetic surgery performed often in South Florida, may become safer after the state’s Board of Medicine approved an emergency rule on Friday that sets new restrictions for surgeons who conduct the procedure.
The emergency rule, which will take effect by June 17, prohibits surgeons from injecting fat into or below a patient’s gluteal muscles due to the risk of piercing the gluteal vein, which can cause fat clots to travel to the heart and lungs, leading those organs to fail.
During a Brazilian butt lift, surgeons remove fat from a patient’s abdomen and back using liposuction. The fat is treated and then grafted to the buttocks by injection. The rule adopted by the Board of Medicine will require doctors to inject the fat above the muscle and below the skin. Violations of the rule can lead to disciplinary action for malpractice against a doctor’s license.
“When you look at the number of patients who have died from pulmonary embolism from this procedure, this rule will at least put physicians on notice that they’ll be in violation of the medical practice act if they inject below the fascia,” said Dr. Steven Rosenberg, a West Palm Beach dermatologist and chairman of the Florida Board of Medicine.
At least 16 patients have died in the past decade after undergoing a Brazilian butt lift at cosmetic surgery centers in South Florida, said Dr. Onelio Garcia, a Miami plastic surgeon who has studied the procedure. The most recent reported death occurred on May 10 when a 28-year-old woman died after undergoing the procedure at a Miami cosmetic surgery center called MIA Aesthetics.
Garcia told the state medical board in April that he had collaborated with a task force of surgeons on autopsies of Brazilian butt lift patients and in experiments performing the procedure on cadavers. The studies found that the safest way to perform a Brazilian butt lift is by injecting the fat into the subcutaneous tissue.
“With everything we know,” Garcia told the board, “it is below the standard of care to inject in the muscle or below the muscle. There is no safe way to do that.”
The task force studying the procedure is expected to issue specific technical guidelines for surgeons who perform Brazilian butt lifts later this year.
The emergency rule for Florida doctors will go into effect by June 17 or earlier, and will lead to the creation of a permanent rule, said Ed Tellechea, the medical board’s general counsel.
The Board of Medicine, which oversees an estimated 78,000 licensed allopathic doctors or MDs, agreed to the language for the rule during a Thursday meeting also attended by members of the Board of Osteopathic Medicine, which oversees an estimated 8,600 osteopathic doctors or DOs.
The Board of Osteopathic Medicine expects to approve the language during a telephone meeting on June 26.
The emergency rule follows an August 2018 advisory from the American Society of Plastic Surgeons warning doctors not to inject fat into the muscle during a Brazilian butt lift. The advisory states that the procedure has an “unusually high mortality rate … estimated to be as high as 1 in 3,000, greater than any other cosmetic surgery.”