Nationwide more than 60,000 people a year in the United States will get a cosmetic surgery procedure called a Brazillian Butt Lift, made popular by celebrities and social media influencers.
BBLs, as they're called, can be dangerous.
The death rate is the highest among any plastic surgery.
A Tampa cosmetic surgeon was disciplined this month by the Florida Board of Medicine because his patient died following a Brazilian Butt Lift procedure.
The ABC Action News I-Team digs into what experts say can cause deaths and talks to a cosmetic surgeon about what can be done to lessen the danger.
In early June, Dr. Joseph Castellano walked out of the Florida Board of Medicine meeting after a disciplinary hearing regarding the death of a patient under his care.
He settled his case, agreeing never to do another Brazilian Butt Lift procedure.
Death after surgery results in a $250,000 malpractice settlement, board discipline
Audrey Torres, 35, a single mother who lived with her 23-month-old son in Wimauma, died after she went to the Castellano Cosmetic Surgery Center on February 20, 2020, to get a Brazilian Butt Lift.
Neither her family nor their lawyers can discuss the case because her estate sued Dr. Castellano and agreed to a confidentiality agreement.
State records show they reached a $250,000 malpractice settlement in the case.
That money will go to support Torres’ young son.
You might recognize Castellano from his billboards dotting high-traffic roads across Tampa Bay for years, advertising his results as “just beautiful."
Dr. Castellano advertised Brazilian Butt lifts on his website and on social media.
“It’s a great option for someone who has a little extra fat, and they want to transfer it to their butt,” Dr. Castellano said in a demonstration video posted in 2016 on his clinic’s Facebook page.
“This patient here, we’re lipo-suctioning her abdomen, love handles, back, inner/outer thighs…. then we’re transferring it all to her butt,” he said.
Torres’ BBL surgery took place nearly four years later at Castellano’s clinic on MacDill Avenue.
According to a Florida Department of Health complaint, complications developed during Torres’ surgery.
She was taken to the hospital, where she died.
An autopsy revealed she died of “fat emboli,”… which is when particles of fat enter the bloodstream and block circulation.
As part of his settlement with the Florida Board of Medicine, Dr. Castellano will receive a letter of concern, pay a $10,000 fine and investigative costs, complete five hours of continuing education, and will be permanently restricted from doing Brazilian Butt Lifts.
Castellano declined an on-camera interview but said in an email, “I cannot comment to the patient's extenuating circumstances, but I do deny all liability in this case.”
Numbers of BBL procedures and deaths rising in Florida
“With the BBL, the main risk that has caused death has been the pulmonary fat embolism,” said Dr. Thomas Su.
Dr. Su is a cosmetic surgeon who owns the Artistic Lipo Cosmetic Surgery Center in Tampa, where he specializes in liposuction.
He’s not involved in Dr. Castellano’s case, but he has been closely following reports about an uptick in BBL deaths in Florida, which he believes are preventable.
“If you inject fat into the butt muscle, the gluteal muscle, there are large veins there, that if the fat were to get into it, go right to the heart and lungs and can kill you very quickly,” Dr. Su said.
That’s what the state believes happened to Torres, citing evidence Castellano injected fat into her muscle in violation of a health department rule passed a year earlier.
That rule came after multiple surgical associations issued a warning in 2018 that BBLs had a mortality rate of 1-in-3,000 — greater than any other cosmetic surgery.
But a recent study showed that after the Florida Department of Health rule went into effect, neither procedures nor deaths declined.
Low-cost, high-volume clinics blamed for most BBL deaths
The Aesthetic Plastic Surgery National Databank shows the number of BBL procedures increased from 3,762 in 2011 to 61,387 in 2021.
“Definitely, the number of BBLs per year has been increasing very rapidly,” Dr. Su said.
He said more BBL procedures are performed in South Florida than anywhere in America.
In Miami-Dade County, you can find dozens of clinics specializing in Brazilian Butt Lifts in strip malls, offering plastic surgery procedures at discounted rates.
A report from the Aesthetic Surgery Journal published this year said 25 women have died from complications related to BBLs in South Florida since 2010.
Of those deaths, 92% occurred in low-budget, high-volume clinics.
“These large clinics, which are high volume, oftentimes require their physicians, their surgeons, to perform 10 to 12 BBLs in a day,” Dr. Su said.
Many patients come from out of town, lured by online marketing and low prices.
We found BBLs advertised online for less than $3,000, a fraction of the cost of the same procedure at a traditional cosmetic or plastic surgery center.
“Don’t budget shop your surgery. You do get what you pay for, and that just invites a lot of risks if you’re doing that,” Dr. Su said.
A proposed Florida Department of Health rule limits doctors to three BBLs a day and requires using ultrasound during the procedure.
This would help prevent doctors from injecting fat directly into muscle.
Dr. Su believes the new rules will save lives.
If you have a story you’d like the I-Team to investigate, email us at adam@abcactionnews.com.
