From Massachusetts General Hospital; the University of Texas School of Medicine; 4Beauty Aesthetic Institute for Plastic Surgery; Cirumed Clinic; the University of San Martin; Weymouth Hospital; and Swansea University Medical School.
Plast Reconstr Surg. 2021 Dec 1;148(6):1270-1277. doi: 10.1097/PRS.0000000000008599.
Although abdominoplasty is a mainstay of the plastic surgeon, the safety of the Brazilian butt lift (BBL) has been questioned, effectively being prohibited in some countries. The central rationale for the safety concern over the BBL stems from a publication stating a mortality rate of one in 3000. The question remains: What is the real safety of these procedures?
Focusing on mortality, literature searches were performed for BBL and for abdominoplasty. The 2017 Aesthetic Surgery Education and Research Foundation survey data and publication were examined and analyzed. Additional data from the American Association for Accreditation of Ambulatory Surgical Facilities were obtained independently.
Abdominoplasty and BBL appear to have similar safety based on mortality; however, the nature of their mortalities is different. Although most abdominoplasty deaths are secondary to deep venous thrombosis/pulmonary embolism-inherent circulatory thrombotic abnormality-BBL mortality is associated with iatrogenic pulmonary fat embolism. BBL mortality rates from more recent surveys on BBL safety demonstrate a mortality of one in 15,000.
Although deep venous thrombosis/pulmonary embolism will always remain an abdominoplasty risk, intraoperative BBL pulmonary fat embolism has the potential to be reduced dramatically with a better understanding of dynamic anatomy, surgical instrumentation, and technique. The authors are now presented with a better lens with which to view a more accurate safety profile of BBL surgery, including its place among other commonly performed aesthetic procedures.
尽管腹部整形术是整形外科医生的主要手段，但巴西臀部提升术（BBL）的安全性一直受到质疑，在某些国家实际上已被禁止。对 BBL 安全性的关注的核心依据源于一份报告，该报告称其死亡率为每 3000 例中有 1 例。问题仍然存在：这些手术的真正安全性如何？
本文专注于死亡率，对 BBL 和腹部整形术进行了文献检索。检查和分析了 2017 年美容外科学教育和研究基金会的调查数据和出版物。还独立获得了美国门诊手术设施认证协会的其他数据。
基于死亡率，腹部整形术和 BBL 似乎具有相似的安全性；然而，它们的死亡率性质不同。尽管大多数腹部整形术的死亡是由于深静脉血栓形成/肺栓塞——固有循环血栓形成异常——但 BBL 的死亡率与医源性肺脂肪栓塞有关。最近对 BBL 安全性的调查显示，BBL 的死亡率为每 15000 例中有 1 例。
尽管深静脉血栓形成/肺栓塞始终是腹部整形术的风险，但通过更好地了解动态解剖结构、手术器械和技术，术中 BBL 肺脂肪栓塞的风险有可能大大降低。作者现在有了更好的视角，可以更准确地了解 BBL 手术的安全性概况，包括其在其他常见美容手术中的地位。
