The tragic death of influencer Joselyn Cano and what makes Brazilian Butt Lift surgery so dangerous.

I heard last week about the tragic death of Joselyn Cano, a social media celebrity, who suffered complications from plastic surgery. Although the details still haven’t fully been confirmed appeared that she had had a BBL or Brazilian Butt lift in Colombia. She was only 30 years old and a mom of 2. I am devastated by someone dying from plastic surgery – and my heart breaks for her and her family.

As a plastic surgeon and also someone who is well aware of what is presented on social media – I am always concerned and mindful of how social media can influence people to feel like they need more, force comparisons with images that are often unrealistic, and also desensitize people to plastic surgery procedures. Plastic surgery is real surgery and safety and thoughtful consideration of every procedure are of utmost importance.

When it comes to Brazilian Butt Lift even more caution and consideration must be applied when performing this surgery. It has the highest mortality rate of any plastic surgery – 1 in 3000. Besides death – there are complications like infection, fat cysts, fat necrosis, and permanent disfigurement. The most common cause of death is fat embolism. There are large vessels in and under the butt muscle and if the fat is injected in or near them especially under high pressure, the fat can be sucked up into them – and embolism to the lungs and brain causing death. The technique is critical in this surgery to prevent fat embolism and other complications. Placing too much fat or doing it in a way that isn’t gentle can result in fat necrosis (the fat dies) fat cysts (the fat cells break apart and make oil cysts) which can cause infection or hard lumps of the scar. Why would anyone inject in the muscle or fill the butt with so much fat – usually to get extreme volume.

The safest way to avoid this fatal complication is to place the fat gently in the fat layer over the muscles and take extreme care not to accidentally go too deep. It is also important not to be over aggressive and place too much fat in the butt and hips that may die or be put under too much pressure in order to avoid other complications. I believe it is extremely important to perform all steps of this surgery carefully, precisely, and meticulously to produce smooth and natural-looking results from the donor liposuctioned sites, help ensure maximal fat survival and avoid dangerous complications. Post-op care is also extremely important and is something I take the time to explain and review with my patients. For those of you who want to know more, I have these instructional videos available on my YouTube Channel.

There was a term that I came across called Snapchat dysmorphia. Where over photoshopped bodies or filters on social media were distorting people’s body image ideals. I have often encountered this where patients have shown me images of what they want to look like and the photos are obviously photoshopped showing exaggerated narrow waists, extremely large butts, or breasts that look completely different from their anatomy, or overly smoothed skin. As a surgeon, it’s important for me to help patients understand that those are just altered images. There is a limit to how much fat can be harvested safely and how much fat can be injected safely.

Recommendations for having a safe surgery.

  1. Do your research and make sure your plastic surgeon is Board Certified by the American Board of Plastic Surgery. This means that they have completed an accredited training program in Plastic Surgery and passed all certification exams. This is different from all other boards including Cosmetic Surgery, or other Specialty Surgery where the doctor may not have done any training in plastic surgery.
  2. Although your doctor may not require it – I always have all my patients get a complete History and Physical, lab work and medical clearance from their primary care doctor or internist. Depending on the age and medical history, for some patients, I also require an EKG, chest x-ray, stress test, additional lab work, psych clearance or hematology work up. I believe strongly in proper workup prior to surgery to endure a safe surgery and also have any necessary specialists coordinate care. Do not lie or hide any family or personal medical history from your surgeon – that will only increase your chances of a serious complication and it’s never worth risking your health or lift for elective plastic surgery.
  3. Ask about potential risks and what your surgeon does to try to prevent them – I always discuss and consider all potential risks of surgery with my patients. I am constantly thinking about how to prevent any complications and all my surgical planning and techniques take these into constant consideration.
  4. Look carefully at the before and after photos when considering a surgeon. Look for cannula marks or irregularities or skin discoloration or alterations that are indicative of over-aggressive liposuction. The lower back and flank areas are usually the most telltale areas. Look carefully at the butt – if there was cellulite before there will be cellulite after and if the after are too smooth they were most likely photoshopped. Make sure the photos are high resolution in good lighting and medical photos. Do not use ones posted by patients on social media as a reference or any that are grainy or photoshopped.
  5. Don’t do too much at once – although it may seem convenient to do multiple surgeries all at the same time I would encourage you to focus on one surgery at a time. I know a lot of surgeons will combine large surgeries such as breast, tummy tuck, BBL, even leg lifts all at the same time. Increasing the total surgery time greatly increases the chance of serious complications like getting a blood clot or extensive fluid shifts. Also, having surgery on opposite sides of the body like tummy and butt or breast and butt makes it almost impossible to properly care for each surgery site post-op since you will always be lying on one. Also – Be kind to your body, each site requires a lot of energy and care to heal.
  6. Realistic expectations – understand and appreciate your own unique body. There are limitations to what can be changed safely based on your anatomy – take the time to understand what is realistically possible on your own body instead of comparing it with others.