The Modern BBL Guide Everyone Should Read Before Booking One

Brazilian butt lifts aren’t disappearing; they’re just starting to look a little different. Kind of like cosmetic procedures as a whole, BBLs are shifting toward a more subtle aesthetic. What was once associated with dramatically exaggerated curves and instantly recognizable “Instagram bodies” is now taking a more natural approach. 

During an episode of GlowLab, board-certified plastic surgeon Michael Salzhauer (better known online as Dr. Miami) breaks down how the procedure has changed over the years, why safety standards have evolved, and what people still misunderstand about getting a BBL. “People want what we call the skinny BBL or the natural BBL,” he explains to host Susan Yara. “They still want the shape, they just don’t want the exaggeration of it.”

The Modern BBL Guide Everyone Should Read Before Booking One

Whether you’ve been curious about the procedure for years or simply wondered why BBLs suddenly look a little different from what they did in 2018, consider this your guide.

First, what is a BBL?

A Brazilian Butt Lift (more commonly called a BBL) is a procedure that removes fat from one area of the body through liposuction and transfers it into the butt and hips.

While many people think the surgery is only about creating a bigger butt, Dr. Miami says the real transformation usually comes from reshaping the body overall. “It’s most helpful for changing people’s shapes,” he explains. “There’s no machine or exercise in the gym that can give a woman hips.”

And according to him, the hips are actually one of the biggest factors behind the hourglass effect people associate with a BBL. While workouts can help build the glute muscles, they can’t redistribute fat in the same way surgery can.

BBLs don’t look the same anymore

One of the biggest takeaways from the episode is how dramatically BBL trends have changed over the years. Around 2015 through the COVID era, exaggerated proportions dominated social media. Patients were often asking for multiple rounds of fat transfer to achieve larger and larger results. “The bigger the better,” Dr. Miami says.

But eventually, the look became so extreme that people started moving in the opposite direction. “The butt didn’t really match the thighs,” he explains. “You could spot the BBL a mile away.”

Now, most patients are asking for what surgeons call the “natural BBL” or “skinny BBL”—still curvy, just less exaggerated and more proportional to the rest of the body. 

Dr. Miami says making a BBL look natural often comes down to balance. “You have to be aware of the width of the thighs,” he explains. “It has to match the legs.”

So where does the fat come from?

The fat used during a BBL is usually removed from areas patients want slimmer, including:

• Abdomen
• Waist and love handles
• Back
• Thighs
• Arms

“The fat cells don’t know they’ve been moved,” Dr. Miami explains. That’s important because some fat survives better than others. According to him, stubborn fat—like love handles—tends to hold onto volume even after it’s transferred elsewhere. “The best fat is the area that’s the hardest to lose,” he says.

How much fat gets transferred?

Dr. Miami reveals the average BBL uses somewhere between 500 and 800 ccs of fat per cheek. But during the peak of the exaggerated BBL trend, much larger transfers were common. “I’ve put up to 2500 cc in each cheek over the years,” he says.

Is a BBL dangerous?

BBLs developed a dangerous reputation over the last decade after several high-profile complications and deaths linked to the procedure, particularly in South Florida. But Dr. Miami says the biggest risk happens when fat is injected too deeply and enters the bloodstream. “If it’s in the wrong place, the fat can go into the bloodstream, and it can kill you,” he explains.

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A post shared by GlowLab® with Susan Yara (@glowlabpodcast)

He says safety standards have changed significantly in recent years, especially in Florida, where surgeons are now legally required to use ultrasound guidance during the procedure to monitor where fat is being injected. 

Dr. Miami also emphasizes the importance of choosing a surgeon who performs the procedure regularly instead of someone offering a wide variety of surgeries occasionally. “You want to go to a surgeon that does pretty much the same operation that you want…every day or multiple times a week for years and years.”

What recovery actually looks like

Recovery is one of the most misunderstood parts of getting a BBL. While patients still need to avoid placing too much pressure directly on the area after surgery, Dr. Miami says some of the extreme recovery products marketed online are unnecessary.

He says most patients simply use a pillow that shifts pressure toward the thighs for the first month—but only for the first month or so. “After the first month, the fat is pretty much set wherever it’s gonna be,” he explains.

Recovery can still be intense, though. Dr. Miami describes BBLs as a “serious operation” involving fluid shifts, blood loss, and close monitoring during the first 24 to 48 hours after surgery. Most patients can return to desk work after about two weeks, though full healing can take several months. “You’re not 100 percent for like six months,” he says.

Can you lose your BBL?

With the rise of GLP-1 medications and major weight loss transformations, Dr. Miami says he’s seeing more patients lose volume in their BBLs over time. “I’ve had patients come in who had BBLs in 2015 and 2016 asking to have butt reductions,” he says.

Because transferred fat behaves like normal fat cells, significant weight loss can reduce the size of the results. But on the flip side, gaining weight after surgery can increase volume in the transferred areas. “The first 5 or 10 [pounds] goes right to your butt,” he says.

Can skinny people get a BBL?

One major limitation of a BBL is that patients need enough body fat available for transfer. “There’s a whole subset of women that want BBLs that just can’t gain the weight for it,” Dr. Miami says.

For very thin patients, alternatives like butt implants or newer cadaver fat products may be discussed, though Dr. Miami says some of those newer options are extremely expensive and still relatively unproven. “That’s an expensive booty,” he jokes.

To get the full scoop on all things BBLs, listen to GlowLab wherever you get your podcasts.

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