Recently, Brazilian Butt Lifts have been back in the news, this time for the wrong reasons.The Aesthetic Surgery Education and Research Foundation (ASERF) recently formed a Gluteal Fat Grafting Task Force to investigate risks associated with high volume fat grafting to the buttocks. The risk about which they were most concerned was fat embolism, in which fat can enter the bloodstream and travel to the lungs, resulting in sudden death during surgery or shortly thereafter. The task force sent out surveys to surgeons throughout the world; respondents reported 17,519 surgeries with 5 fatal fat embolisms (1/3448). The techniques being utilized during cases which led to fatality were not revealed nor was the relative experience to the injectors. Obviously, techniques being utilized during Brazilian Butt Lift matter as does the experience of the surgeons doing the injection. I have performed hundreds of Brazilian Butt Lifts and have honed techniques designed to optimize safety and cosmetic results for Brazilian Butt Lift patients.

One of the thoughts recently advanced by the ASERF task force is that plastic surgeons should avoid injecting fat within the gluteus maximus muscle or deep to the muscle, as these anatomic planes are richer in large blood vessels and inadvertent fat injection could be more likely to happen in these locations. The task force was quick to point out that it had no data to support this assertion. Although I am not cavalier about injecting fat in deeper anatomic planes, I cannot achieve the same cosmetic results without injecting fat into the plane deep to the gluteus maximus muscle. In my hands, deep injection is necessary to achieve significant anteroposterior projection of the buttocks; think of fat in this plane as the foundation on which a house is built. Intravascular lipoinjection is possible in any anatomic plane. Although it makes sense that vascular injury would more prevalent in the plane deep to the gluteus maximus because of the presence of large vessels, anecdotal reports exist of large volume subcutaneous injections (injections in the plane underneath the skin and superficial to the gluteus maximus muscle) also leading to fat emboli, which is not surprising as the subcutaneous plane also has a relatively rich supply of blood vessels. As is true in all operations, surgeons must be mindful of safe technique when injecting into deep anatomic planes. To me, safe practices include using large bore, blunt (i.e. not sharp) injection instruments to prevent inadvertent trauma to large vessels, ensuring that injections are performed under low pressure, and largely avoiding the inner half of the plane deep to the gluteus maximus, in which virtually all of the large named blood vessels supplying the buttock exist.

Most, if not all, of the reported deaths from Brazilian Butt Lift are though to be the result of syringe based injection of fat; in this technique, surgeons use their hands to push fat into the buttock. This technique not only is more time consuming and fatiguing, but the potential for higher pressure fat injection exists using this older method. As I have mentioned above, low pressure injection is vital to promoting safety and, to that end, I have switched to a closed, automated system with a built in pressure monitor. The rationale behind this is that injections with pressure of less than 10-12 mmHg will be at lower pressure than large peripheral veins and, as such, should not allow fat to be introduced into these large veins. For injections utilizing syringes and cannulas, it’s imperative that the injector utilize slow injections without significant resistance; surgeon experience is vital to ensure that a safe technique is being utilized. For injectors like me, who use a closed, automated system, having a built-in pressure monitor will insure that only low pressure injections occur, thereby preventing inadvertent injection of fat into blood vessels.

It’s important that all patients do their research before having a Brazilian Butt Lift. Full knowledge of the risks and complications is important, just as with any other operation. That being said, in order to avoid unnecessary fear and anxiety, patients should seek out a highly trained and highly experienced plastic surgeon to perform their Brazilian Butt Lift.

Although the scars after Brazilian Butt Left are relatively few and small, ugly scars can detract from your new, beautiful derriere. Unfortunately, scars are a necessary part of surgery and we have yet to discover a magical scar eraser. That being said, with proper care and following a few basic rules, beautiful scars can be had.

Rule #1 – Avoid the Sun

Ultraviolet rays cause scars to darken, and, often times, the damage is permanent. Furthermore, the vast majority of clothing is not enough to protect your scars; enough of the sun’s harmful rays can penetrate your clothes and still affect your scars. If you must go outside, either cover the scars with a bandage / silicone strip or use a broad-spectrum sunscreen with an SPF of 30 or more.

Rule #2 – Avoid hydrogen peroxide, Vitamin E and antibiotic ointments

Hydrogen peroxide is commonly used for cuts and injuries, so many patients think its good for all types of incisions. While it’s good for helping to prevent infection, hydrogen peroxide non selectively denatures all proteins in a scar, including those needed for healing and scar maturation. As such, inflammation tends to last for a longer time and the scars can look worse in appearance.

Same is true with Neosporin, bacitracin and other commonly used antibiotic ointments. Allergic contact dermatitis caused by topical antibiotics is extremely common, with most people prone to developing it after prolonged usage. Excessive use of antibiotic ointments can cause prolonged inflammation, and, as such, can lead to worse scars.

Vitamin E has long been touted as a treatment for scars, but multiple studies have shown that it actually has very little effect and one actually found that it may be harmful to the final appearance of scars.

Rule #3 – Pressure is good for your scars

Silicone sheeting and tape that puts pressure on your incision help scars mature faster. Silicone sheets actually modify the static electric field within your scar, which promotes collagen remodeling. It is the gold standard against which all other scar treatments are measured.

Rule 4 – Talk to Dr. Jejurikar if you have questions

If your scars still don’t seem to be doing well, don’t hesitate to talk to us. You may need corticosteroid injections into the scar to reduce its thickness, bleaching creams to lighten it, or a variety of new topical medications that we can recommend to improve your scar. Fractional laser treatments can also dramatically improve the appearance of your scar.

Last week, a high profile arrest occurred in Miami, the result of a young woman having died while having buttock augmentation performed at an illegal clinic. Feel like you’ve heard this before? The details are horrific. The young woman, Suyima Torres, was 28 year old, from West Virginia, and the married mother of two children.

In April 2013, Mrs. Torres underwent buttock injections as part of a butt lift procedure. Ten days after the initial procedure, she returned to the same clinic where additional injection was performed. Immediately after the procedure, she collapsed outside of the clinic and was taken to a hospital, where she died later that day.

According to the released police report, “The victim’s blood contained very large amounts of silicone, an element used for industrial purposes which includes electronics, as well as in glass, cement and ceramics.”

That’s right. Industrial liquid silicone. To be clear, on the list of soft tissue fillers the FDA has approved for soft tissue augmentation, silicone is not included.

The man who performed the injections, Jose Robusto, a 43-year-old Venezuelan national, fled to his native country. He remained there until last week, when he attempted to return to Miami and was arrested. Mr. Robusto was charged by homicide detectives with manslaughter and with illegally practicing medicine. Mr. Robusto is not licensed to practice medicine in the United States or in the state of Florida and, according to police, has confessed to his role in Mrs. Torres’ death.

This isn’t the first time that illegal silicone injections have resulted in arrests in Florida. In 2013 and 2015, individuals in Orlando and Miami were charged and convicted for performing buttock augmentation with industrial liquid silicone. Other arrests have occurred throughout the country for black market butt shots done in beauty parlors, fake clinics, hotel rooms and even private homes. One of the most notorious cases occurred in Miami, when a transgender woman (Oneal Ron Morris) injected patients with a mixture of Fix-a-Flat, cement, silicone, mineral oil and super glue. One patient died after receiving buttock injections with these materials.

What’s the take home message? Although any surgical procedure has risks associated with it, illegal procedures put at an increased risk for catastrophic, life-ending complications. Industrial grade materials belong in machines; not in your body.

If you are interested in buttock augmentation, the safe choice is finding a physician who is certified by the American Board of Plastic Surgery. To learn more, please contact Dr. Jejurikar’s office at 214-827-2814.

Are you getting ready to go to your first consultation for buttock augmentation surgery, whether it’s a Brazilian Butt Lift (BBL) or buttock implants? Have you been scouring the Internet looking at photos of butts you like and butts you dislike? Have you been saving these pictures to your phone? Don’t worry – you’re not alone!

A growing number of patients bring in photos of their desired to buttock shape and size to their preoperative consultations. Dr Jejurikar finds this incredibly helpful. As all of the readers of this blog know, multiple celebrities have desirable buttocks, even though they look dramatically different. Jessica Biel’s butt does not look like J. Lo’s; Beyoncé’s butt doesn’t look like Nicki Minaj’s. You probably have a preference.

Why is this relevant? A picture truly is worth 1000 words. Bringing in preoperative photos helps communicate to your surgeon what you are looking for and what you perceive to be an aesthetic ideal. It does not mean, however, that it is always achievable!

What do I mean? In some cases, patients simply do not have enough fat, or have too tight of a buttock skin envelope, to achieve their desired size. If the skin envelope is too tight, sometimes multiple operations will be required to achieve your desired buttock size. It’s important that you as the patient know this ahead of time, so that there are no unexpected surprises after your initial surgery.

In other cases, particularly in regards to women who have had multiple pregnancies or have lost massive amounts of weight, a flat and taut abdominal wall is not going to be achievable with liposuction alone. These patients may require a tummy tuck (abdominoplasty), either at the same time as their Brazilian butt lift, or at a later time. If you happen to be one of these patients, it’s important that you have this conversation with your surgeon prior to your buttock augmentation surgery, so you can determine whether or not enhanced butt size is truly your priority, or if you’re more interested in having the flattest possible abdomen.

All that being said, sometimes your desired look is very achievable. In these cases, a picture really helps demonstrate what your priorities are. For some women, enhanced outer thighs and a curvy, hourglass appearance is really what they are after. In other women, a high round butt is ideal. Pictures really go a long way in helping communicate what look you want Dr. Jejurikar to achieve for you.

If you would like to schedule a consultation with Dr. Sam Jejurikar at Dallas Plastic Surgery Institute, please contact our office at 214-827-2814.

Every year, the American Society of Plastic Surgeons (ASPS) releases data demonstrating the types and numbers of cosmetic surgery procedures performed in the United States. The ASPS is the world’s largest organization of board certified plastic surgeons, with more than 7000 members. It is recognized as one of the leading organizations for plastic surgery in the world. Just recently, the ASPS released procedural data for 2015. Buttock augmentation was the fastest growing type of cosmetic surgery in the United States for 2015. On average, there was a buttock procedure performed every 30 minutes of every day!

A total of 14,705 buttock augmentation with fat procedures (Brazilian Butt Lift) were reported by the ASPS, which was up 28% from the previous year. In the Brazilian Butt Lift, the plastic surgeon performs liposuction, most commonly of the abdomen, love handles and back, and then transfers live fat cells into the buttock, to create a large, rounder and more lifted butt. Far and away, this makes Brazilian Butt Lift the most popular procedure for buttock augmentation. This is not surprising, as Brazilian Butt Lift allows the surgeon optimal control in shaping the patient’s body and butt, all while maintaining a very natural appearance.

Coming in next was Buttock Lift, at a total of 4767 reported cases in 2015. This is up 36% from the previous year. Buttock Lift is a broader category of surgical procedure, and may include Brazilian Butt Lift was fat injection is involved. In other cases, particularly for patients who have undergone massive weight loss, it can represent excision of redundant skin from the lower back to lift and tighten the buttocks, usually with minimal to no change in the overall size of the butt.

Buttock augmentation with implants was also up 36% from the previous year, with a total of 2540 reported cases. With this procedure, a solid silicone implant is placed within the buttock, either within the gluteus maximus muscle (intramuscular) or in front of it (subfascial). Although the results are not as natural as with the Brazilian Butt Lift, this procedure often is the only viable option for petite patients who seek a dramatic change in the size of their butt.

So, just as in the previous year, 2015 was the year of the rear! As the aesthetics in our society continue to evolve, so will the demand for cosmetic surgery to improve the appearance of the buttocks. To learn more about your options, including Brazilian Butt Lift and Buttock Implants, do not hesitate to contact Dr. Jejurikar’s office at Dallas Plastic Surgery Institute at 214-827-2814

Last week marked the 19th annual Dallas Cosmetic Symposium which brought together the best of the best faculty in the field of cosmetic surgery to discuss the controversies and advances in cosmetic surgery via presentations, panels, video, and Q+A sessions with audience participation. Attendees had the opportunity to review the anatomy and perform different cosmetic surgery operations as discussed in the symposium in the laboratory. The focus of the symposium was to produce safe, reproducible, esthetic results in cosmetic surgery.

The Brazilian Butt Lift is a relatively new trend in cosmetic surgery. It has exploded in popularity in the last five to ten years with the help of Kim Kardashian, Jennifer Lopez, and Nicki Minaj. Now women everywhere are paying more attention to their derrieres!  My years of experience and highly specialized practice have qualified me as a specialist on the topic. I was honored to lecture at this incredible event, sharing my knowledge, experience, and techniques for the Brazilian Butt Lift with my esteemed plastic surgery colleagues from around the world.

I developed my appreciation for the procedure several years ago when I was asked to perform it for the first time by a patient who came to my practice in Dallas. As the trend continued to grow, so did the number of requests for the procedure. My practice has continued to mature with the Brazilian Butt Lift now being one of the most common procedures I perform.

Through the years I have continued to refine my surgical approach to the Brazilian Butt Lift.  I developed specific techniques of purifying the fat particles I harvest to ensure viability and decrease chances of post operative infection.  Precise placement of the fat, predominantly in the upper portions of the buttocks, allows for the best possible contour and projection of the buttocks. The volume is often the most variable aspect, as some patients are looking for subtle increase to improve shape while other patients are looking for a more exaggerated result.

I have also learned that the liposuction aspect of the procedure is just as important (if not more) as the fat placement. Eliminating fat around the waist, flanks (love handles) and outer thighs is critical to creating a shapely butt and a more feminine body shape. The ideal female torso has a narrow waist and curvy buttocks; without liposuction, creating this is not possible. The dramatic reduction in the waist, and, to a lesser extent, the saddlebags (outer thighs) enhances the appearance of the buttocks before fat is even injected! Neglecting this will fail to sculpt the curvaceous silhouette that is ultimately desired.

Last week, I was truly honored to share my personal experience performing Brazilian Butt Lift procedures with my colleagues and hopefully taught them them a new approach to this fast growing trend.

For the past several years I have recommended my patients who were interested in having the Brazilian Butt Lift to have this procedure done solo. The reasoning behind this theory is simple. The recovery from a Brazilian Butt Lift is challenging in the sense that it limits your positioning during both sleep and awake hours. Our post operative instructions require patients to remain completely off of their buttocks for a full ten days following surgery. Once these initial days are completed, patients are required sit or lie in a modified position for the next several weeks. This poses a significant challenge for patients who would be recovering from a tummy tuck or breast augmentation at the same time.

The recovery from a tummy tuck requires the patient to recover on their side in a bent position or even on their back. Both of these positions would put too much pressure on the buttocks and the outer thighs, likely compressing the blood flow to the newly transferred fat and thus compromising the final results.

The same goes for the recovery from breast augmentation surgery. If you combined this with the BBL procedure, lying on the buttocks to protect the breast would compromise the fat grafts, and lying on the stomach to protect the buttocks would put pressure on the newly placed implants. This could results in poorly positioned implants leaving you with a dissatisfying result. So how can we combine procedures with the BBL? It seems like a smart idea to combine surgeries to save on costs, only have one recovery period from surgery rather than multiple, and decrease the number of times going under anesthesia.

The solution is the Curve Cure mattress! This is product has been specifically designed to help patients undergoing Brazilian Butt Lift or buttock augmentation and is geared to patients who want to combine multiple procedures. The inflatable, plastic mattress was designed with a centrally located depression to offload pressure from swollen buttocks. A built-in air pump will inflate and deflate the mattress. This will allow a patient recovering from a surgery on the breasts or tummy  along with the buttocks to keep both surgical sites protected while home recovering. It will also be useful for traveling to and from your procedure and post operative visits. These cushions fit in a handbag, allowing it to work perfectly for patients who travel to other cities to have their procedures performed. To learn more, visit CurveCure.com.

Surgery is a big decision. No patient should make the decision without having all of the information up front. It is so important to #doyourhomework and make sure you are in the right hands. Here are a few simple tips to help get the conversation started.

  1. Are you Board Certified and by whom?

You should always be sure that your surgeon is who he says he is. The only person who should be performing your Brazilian Butt Lift is a Board certified Plastic surgeon certified by the American Board of Plastic Surgery. Cosmetic surgery is a booming field and there are many people who will take advantage of a patient’s lack of knowledge when it comes to board certifications by appearing as though they are properly boarded in Plastic surgery, when in reality they are boarded by another entity. This only makes it more challenging to find the right surgeon. A doctor certified in anything but plastic surgery should immediately be removed from your list; this includes “cosmetic” surgeons as well.  Click here to learn the difference between a cosmetic surgeon and a plastic surgeon.

  1. How many BBL surgeries have you performed?

Experience is key when it comes to achieving your desired results. Be sure to ask for an exact number. It is always important to ask the doctor to show you before and after photos. An experienced surgeon will show you several examples of different body shapes as well, letting you see he can work well with different types of women. This may also help you identify with other patients and help set realistic goals.

  1. Is a BBL the same as “butt shots”?

Absolutely NOT! “Butt shots” are illegally performed procedures where they inject silicone or any other substance other than your own fat into your buttocks. This is extremely dangerous and can be life threatening. You should never consent to a procedure of this kind. You should never let cost be the deciding factor over safety.

  1. How is a BBL performed?

BBL procedures should always be performed in an accredited surgery center by an experience board certified plastic surgeon. The procedure typically takes about 3 hours incorporating liposuction of key areas: abdomen, flanks, and back. This allows your surgeon to create a smaller waist and accentuate your curves. The fat is collected into a sterile container where it is cleaned and drawn up into syringes. The fat is then injected into the buttocks in specific areas in a very strategic manner to achieve the best possible results.

These are just a few examples of how to get the conversation started with your surgeon. The more questions you have answered at your consultation, the more informed of a decision you will be able to make,thus ensuring you have put your trust in the right hands.

The last few years have brought about many exciting shifts in the field of cosmetic surgery. It isn’t just expert opinions that drive the changes in the perception of beauty, however. Pop culture plays an integral role in defining what it is that we should consider beautiful. In years past, it was thin frames with stick straight bodies that dominated the magazine covers you would stare at while waiting in line to pay for your groceries. But, with the social media craze, J.Lo and her sheer green dress (you can’t forget that moment) and the overly exposed Kardashian clan, those boyish-framed bodies have taken the backseat to voluptuous, shapely curves.

It is safe to say we are in the height of the bootylicious craze, and there isn’t a single sign that this trend is slowing down. Experts have weighed in that 2016 will only see increases in the number of women seeking to amp up their backsides. In fact, according to a recent survey, about forty-seven percent of plastic surgeons said they received a higher number of buttock related procedure requests from women in 2015 when compared to 2014.

While the trend continues to increase in popularity, the ideals regarding the outcomes of surgery are shifting as well. We can unanimously agree as the Brazilian butt lift has risen to popularity over the years, the goal has more often than not focused on the size. Women requested backsides to be large to simulate that likes of J.Lo, Kim K., and Nicki Minaj. There is no arguing that these women have ample and shapely backsides.

But, what has history told us about all trends from all spans of history? If the majority of people latch on to one particular trend, it has already reached critical mass. Once this type of maximum has been reached, the ideals begin to be redefined.

What does this mean exactly? The trend now will take the focus off of size and place it on shape. It will no longer be about who has the biggest booty but rather who has the best shape. And the celebrity derrière that is heading straight into the spotlight is none other than that of Mrs. Timberlake herself, Jessica Biel. Hers has been referred to as the “ rounded egg”  where a greater emphasis is placed on a smaller waist while the width of the hips will vary by culture. It focuses less on the amount of fat transferred and more on strategy of placement during the operation. We can make it perky, round, petite, and nice – creating sultry, sexier silhouette.

Despite this directional change, there is no debate that the same attention and respect will continue to be paid to the booty.  However, staying ahead of the trend will keep you ahead of the curve.

There’s no doubt that in the last few years curves have made a serious comeback. These days more women are seeking out the enviable silhouette of Jennifer Lopez or Kim K. and her famous sisters. In fact, body contouring procedures continue to rise, and the Brazilian Butt Lift is no exception.  Now more than ever, a shapely behind is high on the list of considerations for what makes a woman attractive today.

Unfortunately for most of us, genetics is not on our side when it comes to having the ideal body shape. Weight gain throughout our trunk camouflaging our shape making many of us may feel more boxy than curvaceous.  Sometimes weight loss will be more pronounces in our buttock region leaving them sad and sagging. It is no secret a shapely behind can boost any woman’s confidence, and often the gym is not the best solution. Thank goodness for modern medicine and all of its advances. A Brazilian Butt Lift may be just what you’re looking for to cure those saggy bottom blues.

A Brazilian butt lift takes fat from areas of concern and transfers it to your buttocks to achieve the desired result of a fuller, shapelier behind. Using traditional liposuction the fat is harvested from areas such as your tummy, sides, and back and collected in a special canister that preserves that fat. Then, it is injected into your buttocks, sometimes on multiple, to create a shapelier silhouette. The result is a smoother, more lifted behind that will look great in your favorite skinny jeans or short shorts.

The added bonus of this procedure is that not only do you create fuller, shapelier buttocks, you accentuate your curves with creating a smaller waist at the same time. The ideal female torso has a narrow waist and curvy buttocks; without liposuction, creating this is not possible.

The procedure is relatively quick, lasting between two and a half and four hours on average, and may be combined with other procedures. For best results, it is recommended to have the procedure performed under general anesthesia by a board certified plastic surgeon.

Recovery time from this procedure is relatively easy, with sitting restrictions for 10 days followed by three weeks of modified sitting precautions. A high calorie diet is also recommended to help ensure your curves stay where they are meant to be. You will be trading in your boxy frame for foxy curves in no time.

Dallas Office:

Dallas Office

Dallas Plastic Surgery Institute
9101 N. Central Expwy.
Suite 600, Dallas, TX 75231
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Tel: 214.827.2814

Plano Office:

Dallas Office

Legacy Plastic Surgery Institute
5425 West Spring Creek Pkwy
Suite 120, Plano, TX 75024
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Tel: 214.827.2814

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