A deep dive into the controversial world of Brazilian Butt Lifts, with Jyoti Matharoo, author of SNATCHURAL: The Guide to a Natural Looking BBL.

Feminism may have advanced, but so have technology and modern medical practices, which means that whilst we may have more autonomy than ever to defy the pressures imposed on our bodies, we’re also hyper-aware. At the same time, we’re enticed by more attainable (and affordable) options than ever to replicate the bodies we see on our social media feeds. Right now, we are in the midst of the BBL era. The look of the moment is a big butt, cinched-in waist and flat tummy combination, fuelled by the pervasiveness of the Kardashians, Nicki Minaj, Cardi B and other stars. The procedure involves transferring fat from elsewhere in the body to the buttocks to make them fuller. It’s become one of the fastest-growing – and most controversial – surgeries in the world, with more than 40 000 surgeries performed by certified surgeons in 2020, according to the Aesthetics Society. Whilst the procedure only takes four hours to complete, it poses a myriad risks and complications.

Under best practice, fat should be injected between the skin and the gluteal muscle, explains Mr Omar Tillo from the Centre for Surgery. That way, the muscle acts as a barrier to stop fat leakage, but that’s not always the case. Some surgeons inject fat directly into the muscle for a better result. “You get more pressure, more blood flow, so more fat tissue will survive in the muscle and increase in volume – the exaggerated look,” he says. “But now we know from studies that isn’t safe.” The butt contains numerous large blood vessels – some “as big as drinking straws”, as one doctor put it – which, if accidentally injected, can result in fat travelling to the heart, lungs or brain, causing a pulmonary embolism. In fact, the number of deaths from BBLs has been reported as one in every 3 000 patients, according to a 2016 study. Yet this hasn’t stopped women from seeking out the procedure.

has emerged as the ‘capital of medical tourism’, where surgeries are cheap and regulations lax. The UK, for example, limits the amount of fat that can be injected, and only single-use instruments are permitted for use. In Turkey, and other popular BBL destinations such as Thailand and Mexico, it’s common for large amounts of fat to be transferred, and surgeons often use reusable cannula fat conduction systems, increasing the risk of infection. Single-use instruments are just one factor driving down the cost of these procedures, attracting customers worldwide. Makeshift clinics and a lack of aftercare treatments also contribute to prices as low as R43 000, compared to the average cost of R130 000 for a BBL in the UK. “You have to wonder where costs are being cut,” says Jyoti Matharoo, author of SNATCHURAL: The Guide to a Natural Looking BBL. “$5 000 (around R78 000) isn’t enough to cover the cost of running an operating room and paying an anaesthesiologist. Doctors aren’t meant to be salesmen, so if one offers you a large promotional discount or operates at an unlicensed facility at odd hours, that surgery could be dangerous.” However, clinics make their money back through economies of scale. Doctors may book back-to-back surgeries, leading to exhaustion and negligent technique. “There are many loopholes and leniency in judicial systems where a dermatologist or paediatrician is allowed to advertise as a board-certified medical doctor and practice in any field without training, even plastic surgery,” Jyoti adds

But for women pursuing the perfect butt, the idea of having their dream body is worth the risk of potentially losing their life. This desire is exacerbated by the influx of picture-perfect, photoshopped bodies infiltrating our collective psyche. Some even perceive it as a way to “photoshop their bodies in real life,” says BBL patient Melissa. Jyoti says: “Girls take these touched-up images they find online to consultations as their inspiration, and then they’re disappointed with the actual result.” The promise of miracle work is another reason for the rise in cosmetic surgery tourism, where doctors are less likely to deny patients’ requests. Even when, against all odds, a surgery is conducted successfully, the intensive aftercare required is a process in itself. And when BBLs take place in completely different countries, patients are usually sitting on long haul flights soon after, when they shouldn’t be sitting down at all for at least two weeks after their procedure. They’re also required to sleep on their stomachs and have to wear a compression suit known as a faja for approximately three months.

Jyoti, who’s undergone two BBL surgeries, believes BBL aftercare is as important as surgery to achieve optimum results. “I wish there had been a BBL Guide like mine to help me prepare because now I see the benefits of doing research. “I’ve known women do things such as work out too early, only do cardio and lose the newly injected fat first, sit too soon without a booty pillow, or smoke, which can slow healing.”

Improper aftercare usually stems from a lack of education as well as postsurgery abandonment from doctors rushing to get through as many patients as possible. But for women who get the body they’ve always wanted, it may be more complex than that. Their postBBL body feels like a fresh start and they’re eager to show it off. “A BBL isn’t just a change in the body; it should be a change in mindset,” says Jyoti. “A new body comes with new attention.”

The hashtag #BBLEffect on TikTok, which has nearly 300 million views, illustrates these psychological effects satirically. The meme portrays the seemingly ‘precious’ persona and mannerisms people adopt once they receive a BBL. Essentially, the BBL Effect alludes to the fact that the procedure isn’t just a body change, but a complete lifestyle and personality overhaul. It may be the first touchpoint for people to live up to the lifestyles of the women whose bodies they were seeking to emulate in the first place. But there’s a fine line between being motivated to boost your confidence and succumbing to insecurity and vulnerability. In today’s digitally driven world, it can be hard to tell the difference, proving the BBL Effect is more than just a light-hearted meme, but a powerful force pervading our minds – and the modern standard of beauty.

This article was originally published in Glamour’s July 2022 Beauty Issue. Grab your digital copy, here.