ultraBBL: Brazilian Butt Lift Using Real-Time Intraoperative Ultrasound Guidance

Abstract

Gluteal augmentation via fat grafting is a powerful body contouring technique that can create impressive results not obtainable with implants or liposuction alone. This procedure is very technique dependent and because of the too frequent fatal complications, it has been recommended that surgeons avoid intramuscular injection and only fat graft in the subcutaneous space above the deep gluteal fascia. The subcutaneous space, however, is a thin curving dome that ranges in thickness from 1 cm at the outer hips to 3–4 cm at the central gluteal dome. This creates a difficult target for gluteal surgeons who do not use intraoperative imaging. Real-time intraoperative ultrasound-guided fat grafting during a Brazilian butt lift (ultraBBL) allows the surgeon to consistently avoid an intramuscular injection and manipulate the two distinct subcutaneous gluteal spaces. With ultrasound, the surgeon can target either the deep or superficial gluteal spaces to precisely control fat graft volume and distribution, create projection, and correct superficial irregularities. The surgeon can also create ultrasound video of the entire procedure to document that they remained above the deep gluteal fascia at all times and analyze how their fat graft placement affected their ultimate clinical results. Recent advances in ultrasound technology have made real-time intraoperative ultrasound an affordable tool than can not only make a Brazilian butt lift more accurate and powerful, but safer, as well.