HealthTransforming Risky Brazilian Butt Lift Surgeries in Florida

Transforming Risky Brazilian Butt Lift Surgeries in Florida

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— A new law targets budget plastic surgery clinics with new safety precautions

by
Sophie Putka, Enterprise & Investigative Writer, MedPage Today
December 23, 2023

In April, we reported on the dangers of Brazilian butt lifts (BBLs), and what makes South Florida a hotspot for BBL-related deaths. In this report, we follow up on what has happened since plastic surgeons began raising concerns about the procedure’s safety and Florida’s medical board intervened. Following a swath of deaths tied to gluteal fat graft procedures — known as BBLs — in Miami, plastic surgeons, physician groups, and Florida’s medical board grappled with how to make the procedure safer. Now, Florida has a law that codifies standards of care for the risky procedure, where fat is suctioned from a patient’s midsection and reinjected into the upper buttocks.
“Our community feels very strongly about this,” Pat Pazmiño, MD, a plastic surgeon and owner of Miami Aesthetic, told MedPage Today. Pazmiño authored a paper showing that BBL deaths were concentrated in South Florida, and is a director with the Florida Society of Plastic Surgeons, which helped recommend elements of the bill. “The last thing that we want is for plastic surgery to get a black eye, and more importantly, [we want] to protect all the patients that receive these procedures.”
In recent years, patients who underwent BBLs have died of pulmonary fat embolism (PFE) — where fat particles enter a blood vessel and block it — at alarmingly high rates.
Concerned surgeons and other experts found that these PFEs were mostly happening when a surgeon deposited fat into the deeper gluteal muscle instead of the subcutaneous fat on its surface, injuring blood vessels or injecting straight into them. The procedure is often performed “blind,” meaning the surgeon cannot see exactly where under the skin their cannula tip ends.
Florida’s Board of Medicine adopted two emergency rules in 2019 and 2022. Both were temporary measures, requiring injection only into the subcutaneous fat layer, the use of ultrasound guidance, and a limit of three gluteal fat grafting procedures per day. The Board had planned to implement permanent rules, but did not adopt them once the bill, HB 1471, passed unanimously.
In a first for plastic surgery, Pazmiño said, the bill mandates certain precautions when performing gluteal fat grafting. It went into effect on July 1. New clinics must have a health department inspection before being registered. Surgeons must meet patients in person at least a day before their scheduled procedure, and can’t perform BBLs on more than one patient at a time. Physicians must also use ultrasound to guide their cannula when fat grafting, and they may not delegate fat extraction or grafting to other staff.
A state law simply packs more punch than a medical board’s rule, Pazmiño said. “I think it raises awareness to everyone that it’s not okay …  » … Read More

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