Wilbur Hah
Owner of Beauty MDs, LLC, United States of AmericaPresentation Title:
Gluteal fat transfer on technique and mortality update among ABCS surveyed surgeons
Abstract
Background: The demand for gluteal fat grafting, known as Brazilian butt lift (BBL), has surged in the past decade, making it the fastest-growing cosmetic procedure in the U.S. However, the rise in pulmonary fat embolisms (PFEs) has raised safety concerns. Professional organizations have issued reports to identify causes and recommend safety measures to reduce mortality rates.
Objectives: This study compares current technical approaches and updates mortality rates for gluteal fat grafting among American Board of Cosmetic Surgeons (ABCS) members over the last six years. It also examines if specific technical changes have improved safety.
Methods: An online survey was conducted among ABCS surgeons regarding perioperative techniques and postoperative outcomes for BBLs performed in two different 3-year periods. Initial data were collected in 2019 for 2016-2019, and the survey was repeated in 2022 for 2019-2021. Data included the number of BBLs performed, major infections, PFEs, cannula size, and injection methods.
Results: In 2019, 64 ABCS surgeons reported performing 22,800 BBLs from 2016-2018. More surgeons used a closed system peristaltic pump in the second study (51% vs. 22%). Two cases required in hospital infection treatment in the first survey, while none were reported in the second. In the earlier study, 39% injected fat into the superficial gluteal muscle, with three PFEs reported (two fatal, one nonfatal). In 2022, 85 surgeons reported 12,172 BBLs from 2019-2021. Most surgeons (82 of 85) injected fat exclusively above the muscle, with no PFEs reported.
Conclusions: The study suggests that following current safety recommendations, including injecting fat only in the subcutaneous layer, has reduced the risk of PFEs. The mortality rate was zero when 96% injected above the muscle, compared to a rate of 1:11,400 when 39%injected into the muscle. This highlights the importance of adhering to safety measures to improve outcomes.
Biography
Wilbur Hah MD MBA is a triple board certified cosmetic plastic surgeon. He has practiced for 30 years in Southeast Texas. Dr Hah is the Team Leader of the Safety Developmental Group of World Association of Gluteal Surgeons. He is also a past president of the American Board of Cosmetic Surgery. He is often invited to speak and write on topics of cosmetic surgery and patient safety. He is also a commercial pilot with 3,000 flight hours. He also has special interest in aviation safety. Currently, Dr Hah is studying artificial intelligence, machine learning, and aerial robotics.
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