Few cosmetic procedures are as controversial as the Brazilian butt lift, colloquially known as the BBL. Over the past half-decade, speculation about which celebrities and influencers might have had their posteriors surgically enhanced became part of everyday conversation, like a social media-era evolution on the breast augmentation boom of the early aughts. Why now, though, is there so much talk of BBL reversal in Hollywood and beyond? As an intensive, transformative, and sometimes dangerous medical procedure, BBLs — or, more accurately, gluteal fat grafting — seemed to be everywhere overnight, but could be vanishing just as quickly.
To make sense of the phenomenon, TZR turned to a top celebrity plastic surgeon. Ahead, everything you need to know about both BBLs and the current rise in reversals.
What Is A BBL?
Dr. Sean Kelishadi, celebrity plastic surgeon and founder of SSK Plastic Surgery, saw the BBL boom really kick off relatively recently, in 2018. Back then, he says, patients would come in asking for larger enhancements, and would often bring in pictures of Kim Kardashian and Jennifer Lopez as references. But even in the few years that the BBL’s gone mainstream, it’s exploded in popularity. According to a report from the International Society of Aesthetic Plastic Surgery, the procedure was performed just under 400,000 times in 2020, a near-20% increase from 2016.
The procedure, he explains, uses liposuction to harvest excess fat from “undesirable areas” — think obliques, stomachs, and thighs — upon which it’s processed and purified and then injected back into the buttocks and hips. “Some people call this process ‘liposculpture,’” Dr. Kelishadi explains, adding that the procedure is often scheduled alongside other surgeries like abdominoplasties and breast augmentations, effectively tailoring the complete silhouette in one go. “The body tends to flow better when your posterior cleavage and curves match your front ones,” he says.
Previously thought of as a more niche procedure, the BBL’s popularity doesn’t come without a downside. All surgeries carry an inherent risk, of course, but BBLs are particularly controversial. The American Society of Plastic Surgeons published a report on the procedure’s mortality rate, which, at 1:3,000, makes the death rate far higher than any other plastic surgery. The danger is largely two-pronged: there’s the complicated nature of the surgery in general, and the frequency with which patients opt for non-certified surgeons, often in unregulated or unhygienic facilities.
These days, Kelishadi says he still sees plenty of BBL requests, but his office specializes in a much more natural and ultimately leaner look — the “skinny BBL,” as it’s often called. After refining the abs and obliques, the smaller amount of fat gathered is then transferred to the posterior. “It actually works wonders because their buttocks already look larger relative to their now smaller waistlines, and then the fat that further enhances them gives it that extra oomph.”
While the cost is largely varied, BBLs typically start around $8,500 and can go all the way up to $15,000 depending on how complicated or involved the individual patient’s circumstances are.
How Do BBL Reversals Work?
According to Dr. Michael Horn, board-certified plastic surgeon and founder of Chicago’s Lakeshore Plastic Surgery, harbingers of the BBL’s...downsizing can be seen both online and in doctor’s offices. “This has been recent across the board in many cities,” he reports, pointing out that in his own Chicago office, there’s been a demand for a more conservative, less extreme look — “Twitter even referred to the ‘end of the BBL era,’” he adds. “When Kim Kardashian debuted a slimmer look last May at the Met Gala in Marilyn Monroe’s famous dress, ‘Kardashian Reverse BBL’ became a term typed into Google as other women aspire to downsize their derrieres.”
Similarly, Dr. Kelishadi says the industry overall has seen a spike in removal requests, particularly over the past year. He explains that celebrities often undergo extreme cosmetic work to get attention or stand out, and that thusly influences the masses. But, Dr. Kelishadi says, it’s only natural that both said celebrities and the world would want to eventually self-regulate and revert back to more natural-looking enhancements.
While the reversal process is, in essence, just liposuction, Dr. Horn says it is not simple. “Even if the added fat is liposuctioned, a patient can risk a derriere that appears saggy, deflated, or even unusual in shape,” he explains, with the possibility of complicating scar issue from the original surgery. “The reality is that no more than 50% of added volume can be suctioned out. In order to improve results, some plastic surgeons will use minimally invasive radio frequency devices to tighten the skin during or after a reversal.” If someone had a more extreme BBL initially, he says, they may need further surgery to excise the overstretched skin. Horror stories about BBLs performed abroad going wrong cover Internet forums and social media, and Dr. Horn says that’s often due to incorrect placement into the muscle. “In this case, the procedure can’t be reversed with liposuction, as it would result in muscles full of holes.”
On the whole, BBL reversals cost what liposuction does, around $5,000 more minor of standard procedures. However, Dr. Kelishadi says, a more involved or corrective procedure can cost much more. “The overall cost is determined by how many areas need liposuction, how much time is required for the facility, and anesthesia fees.” In fact, Dr. Horn says a complex correction or reversal can cost up to $30,000.
As far as recovery goes, the time depends on the complete scope of work but typically looks the same as standard liposuction — about a week or so to return to work, six weeks to get back to physical activities like working out, and up to six months for complete and total recovery.
Why Are People Getting BBL Reversals?
Of course, the cost of cosmetic surgery can extend far beyond finances and even physical recovery time. Dr. Logan Persons Jones, psychologist and founder of Clarity Therapy NYC, says he’s seen plenty of patients reporting an unhealthy body image even after getting a long-awaited surgery, and the reversals can offer a path back to feeling good again.
Dr. Jones explains that cosmetic procedures can create a new baseline for self-perception and can eventually warp it. “You’re no longer looking at your original, natural self when you continue to build upon your new, enhanced look,” he explains. “Over time, this can cause someone to look far different than what they initially intended with the first subtle enhancement.” Despite the inherent risks of all surgical procedures, reversals can often offer a way out. “When it comes to reversal surgeries, whether it’s a reversal surgery to correct a procedure that went awry or maybe it was overdone, it can be healthy for someone to say, ‘Wow I've overdone this. I need to correct it. This is not who I am. This is an exaggerated caricature of who I am.’”
Affirming that social media and celebrity culture does indeed shape how and what society defines as attractive, he also points out that it there’s an intersectionality component that can be overlooked in the larger conversation. “Maybe there's a striving to appear like a certain ideal, whether it's an ideal kind of economic projection or whether it's idealizing some other part of one's identity, like gender, sex or some cultural standards of beauty,” he says, but “it's important that we all evaluate our own relationship with these different parts of ourselves and the intersectionality of these different parts.”
As assorted procedures crest in popularity, it’s only natural for a wave of reversals to follow. In our world of ever-shifting aesthetics, it seems like cyclicality is the only guarantee.