BRAZILIAN BUTT LIFT UPDATE

This will be of interest to anyone who is considering a Brazilian Butt Lift (BBL) in Vancouver. In it’s most common form, the BBL is a two part procedure comprised of circumferential liposuction of the torso and fat transfer to the buttocks. Recently, several plastic surgery organizations have expressed their concern regarding the safety of the Brazilian Butt Lift procedure. A selected group of international experts was asked to review the matter and their findings and recommendations have recently been made available.  I would like to review these findings, the history and current state of BBLs in my practice and my thoughts on where we go from here.

My Experience

In my own practice, the BBL has been a safe and effective method of improving body shape and proportions. Over the past 12 months, BBLs have emerged as one of the most common procedures in my cosmetic practice. I’m not aware of any complications, in my own practice, that have been related to the fat grafting portion of the procedure.

Cause for Concern

During the last few years, the popularity of BBLs has grown rapidly, however, several fatalities, outside of Canada, have been cause for concern. Many of these cases have been reviewed. Here is what is known:

  • The mortality rate is approximately 1 in 3000 - the highest for any aesthetic procedure by a wide margin.
  • In all cases of BBL related deaths, the cause was a fat embolism - a complication where fat injected in to the buttock area enters a deep vein and travels to the heart and lungs.
  • In all cases of fat embolism, transferred fat was identified within and deep to the gluteal muscles, where these large veins are found.
  • There have been no identified cases of fat embolism when the fat is exclusively grafted in to the subcutaneous layer.

The recommendations that followed this review address technique and equipment in an effort to help surgeons avoid intra-muscular injections and fat embolism.

Impact On My Practice

I have reviewed my own practice so that I may offer the safest BBL possible. As before, I will continue to avoid intra-muscular injections of fat, however, inadvertent placement of fat in the muscle remains a possibility. Patients need to be aware of this issue and give it due consideration as they weigh the potential risks and benefits of surgery.

Given that intra-muscular injections are to be avoided, and given that the subcutaneous layer will only accommodate a finite amount of fat, there will be limitations to the amount of fat that can be grafted and therefore limitations to the degree of gluteal augmentation that can be achieved.

Part of my role is to clarify the balance of risks and benefits for each patient during the consultation so that it’s possible for patients to make an informed decision. I will continue to follow this issue closely in an effort to stay current with the best available evidence.

by Dr. Owen Reid

Cutting Edge Technology

 

Over the past few years the task of 'staying up to date' in my chosen field has gone from being a tedious chore to something convenient and enjoyable. A software program called ReadCube has changed everything.
In the beginning, when I was a medical student, I could search for journal articles on line but to read them I had to physically find the journal in the UBC Medical Library. This was a slow process and as a result, most of the reading and studying that I did was in textbooks.
Years later, when I started my Plastic Surgery residency in Calgary, I had on line access to Plastic & Reconstructive Surgery, the premiere journal in my field. While this was certainly an improvement it was only one journal and therefore provided access to only a fraction of the articles I needed.
Fast forward to the present and the situation is much improved. A couple of years ago, I discovered a program called ReadCube . . . "read, manage and discover new literature like never before". Their tag line is true! The convenience and power of this software was immediately apparent to me and worth the added monthly expense. As a Clinical Instructor with the UBC Faculty of Medicine, ReadCube allows me to search any journal within UBC's massive library of international titles. Articles that interest me can be immediately downloaded. In addition, ReadCube allows me to sort and file the articles as I see fit, which makes for easy reference later. The ability to sync my ReadCube library between all my devices means that I have access to my favourite papers no matter where I'm working. ReadCube even helps me to stay current by flagging newly published articles that are similar to my previous downloads. With these features, ReadCube has helped me to improve patient outcomes in my practice by making it easier than ever before to do the research that is sometimes required as I prepare for an upcoming case.
Thank you ReadCube . . . just in case you're reading my blog.

by Dr. Owen Reid

What to expect during your consultation

Here's a blog post that is perhaps applicable to everybody. Most blog topics are particular to a specific procedure or treatment and, therefore, only relevant to a small subset of patients. As an alternative, I will lay out a framework for the consultation process and a scaffold for the information that needs to be delivered during any consultation. My hope is that this will reduce the number of unknowns, improve the quality of the discussion and promote better, more informative consultations.
Almost all consultations follow a set structure that is designed to meet the needs of our patients. To begin with, we will ask you for some basic information so that a chart can be developed within our electronic medical record. Following that, you will be provided with some written material that is specific to your area of interest (e.g. breast augmentation). In a private consult room, our patient coordinator will review your treatment goals and provide you with some preliminary information.
The substance of the consultation really begins at this point. Dr. Reid will record the relevant aspects of your medical history. He will also provide some background information on the topic and his approach to treatment (e.g. how to select implant type, size, etc.). The discussion that follows, with Dr. Reid, helps to ensure a mutual understanding of your goals, expectations and concerns. A directed physical examination provides the remaining information required for Dr. Reid to prepare a personalized treatment recommendation.
There is a lot of information during this last phase of the consultation and it's most easily remembered if you break it down into the following categories.
  1. Your diagnosis and recommended treatment plan
  2. Alternatives to the recommended treatment
  3. Technical details about the procedure itself
  4. The expected outcome
  5. The recovery process
  6. The potential risks
  7. The fees and the booking process
For most cosmetic procedures, we prefer to arrange a second office visit approximately 4 weeks prior to the scheduled procedure. This 'pre-operative' visit provides another opportunity to clarify your goals, the treatment plan and your plan for recovery.  If there are questions that need answering prior to the pre-operative visit, we can always be reached by telephone or email.
We aim to create a consultation experience that is comfortable, thorough and informative. If you have any questions or comments about our consultations, or if you would like to arrange a consultation with Dr. Reid please contact our patient coordinator at jean@drreidplasticsurgery.ca

by Dr. Owen Reid