Plastic Surgery: Before and After4 Nov 2020

What is a BBL?

What is a BBL? A Brazilian butt lift uses liposuction to collect a person's fat, prepares that tissue and transfers it to the buttocks to change volume and shape. Darren M. Smith, MD, a board-certified plastic surgeon in New York City, explains the process, recovery questions and why safety must be part of the decision.

Originally published November 4, 2020. Recovery examples, prices and safety discussion in the recording reflect that period.

ℹ️ Updated safety context

BBL carries significant risks, including potentially fatal fat embolism. The 2022 joint statement from ASPS and partner societies supports fat placement only in the subcutaneous layer above the gluteal muscle fascia, real-time ultrasound monitoring during injection, appropriate surgical credentials and postoperative care. These measures do not eliminate risk. This later guidance supplements the original recording.

Key takeaways

📍 Donor fat planning

The amount and location of donor fat are planned around the patient's anatomy and goals.

🧩 Lipo 360 and BBL

“Lipo 360” describes torso liposuction; adding a BBL is a separate decision about transferring fat to the buttocks.

🔄 Fat graft retention

Transferred fat is living tissue. Not all of it survives, and the eventual volume cannot be predicted by applying one percentage to every patient.

🗓️ Recovery instructions

Sitting, sleeping, clothing and return to work need individualized instructions that protect healing tissues.

⏳ Swelling and final contour

Changes in swelling and retained volume mean the early appearance is not the final result.

🎧 Episode guide

00:00 — Introduction

00:51 — Fat harvest, preparation and transfer

03:29 — Healing and survival of transferred fat

07:53 — Sitting, sleeping and pressure during recovery

09:35 — The original BBL safety discussion

11:21 — How appearance changes during healing

💬 Common questions

Does every BBL include Lipo 360?

No. Dr. Smith says donor areas are chosen with the patient; the torso is a common source, but other areas may be considered. A procedure name does not define the full plan.

Can I sit normally immediately afterward?

The episode emphasizes that positioning depends on where fat was placed. Follow your surgeon's specific instructions; the recording's examples are not a universal sitting or sleeping protocol.

Will all transferred fat remain?

No. The recording describes variable survival of transferred tissue and the possibility of further treatment. Final shape and volume evolve as healing progresses.

🔗 Related information

Read current information about Brazilian butt lift surgery, liposuction, and Lipo 360, or schedule a consultation.

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Educational information, not individualized medical advice. Suitability, risks, recovery and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

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