The Brazilian Butt Lift (BBL) in Malpractice Litigation: A Nationwide Analysis of Legal Documentation & Consequences
In recent years, shifts in beauty standards have led to the explosive popularity of the Brazilian butt lift (BBL), despite its status as one of the most dangerous cosmetic procedures due to the sizable possibility of fat embolism. The high level of risk in this procedure naturally lends itself to the possibility of unwanted outcomes, making litigation regarding BBL procedures an area in need of urgent exploration.
In this manuscript, we seek to examine American malpractice litigation resulting from BBL procedures and explore trends in identified cases and documentation. We emphasize the unique aspects of BBL litigation by positioning the procedure in contrast to standing literature on litigation regarding extensively performed cosmetic procedures: abdominoplasty, blepharoplasty, and rhytidectomy.
Methods/Technique: Our methods to approach the evaluation of post-BBL federal litigation began with the collection of all federal-level legal documentation related to BBL procedures using the WestLaw Database. Collected data across all procedures included the primary liability cited in the case, the training of the surgeon performing the BBL, and the outcome or monetary settlement reached by the court. Descriptive and qualitative analysis of each document enabled comparisons between the types of litigation documented for each surgery, the outcomes of the cases, and the maximum values of monetary settlements or verdicts.
Results/Complications: There were 135 legal documents identified in relation to BBL surgeries spanning from 2011-2022. While the literature on abdominoplasty, blepharoplasty, and rhytidectomy legal documentation regarded only legal disputes between parties, there were 11 different types of documentations on BBL procedures primarily consisting of trial court documents, expert materials, and administrative decisions & guidance. The administrative decisions included 20 documents on 6 separate hearings regarding physician license suspension and revocation, concerning the licenses of surgeons who had performed unsuccessful BBL procedures from 2017-2022.
There were 2 regulatory releases put forward in 2022 regarding BBL procedures. The more recent release explicitly aimed to outline the standard of care for BBLs and legally restricted the location of fat injection to the subcutaneous space, following a 2019 emergency ruling of this restriction. BBL surgeries involved in malpractice lawsuits had up to 5 different types of legal releases relating to one procedure, while other surgeries were limited to 1. Additionally, the maximum verdict identified in the BBL documentation was against the defendant surgeon at $4,016,230.00, the greatest monetary outcome identified across all procedures and cases included in analysis.
Conclusion: The heavily varied and involved litigation on BBL in contrast to other surgeries indicates that the controversy of the procedure is reflected in its legal documentations, particularly considering the influence of the surgery on federal regulations and physician licensure. Our evaluation of BBL legislation found significantly more involved legal proceedings and higher monetary outcome in BBL malpractice lawsuits in contrast to that of other long-standing cosmetic procedures, indicating that the controversy of BBL surgeries translates to more diverse and far-reaching legal proceedings.