The dangerous rise of BBL surgery... fuelled by TikTok

·11-min read
Photo credit: Florence Ogram - Getty Images
Photo credit: Florence Ogram - Getty Images

Paygie wanted revenge. Sitting in her apartment alone, nursing a broken heart after her partner of three years had left her for another woman. Paygie, who was 25 at the time, felt the harsh sting of rejection. She wanted to get even. But she didn't want to slash her ex's tyres or go after his best friend. No, instead, she wanted him to know what he was missing out on. She wanted him to want her back. To regret ever leaving her and to transform herself into a double-tap fantasy he could no longer have.

The content creator, from Texas USA, had seen her partner scroll through Instagram and like pictures of influencers with curves. She saw them living a life that she desperately wanted. “I just thought this is what I need to do,” Paygie said. Within months of their break-up, she had gotten a Brazilian Butt Lift (known as a BBL.) But the dream she’d envisioned for her future didn't match reality...

The rise of the BBL

BBLs have become one of the biggest surgery trends in recent years – between 2015 to 2019 BBLs increased by 90%. The procedure involves fat being transferred from one part of the body to the butt. The fat is processed, prepped, then re-injected into the bottom, approximately three–five incisions are required, which are then closed by sutures – meaning it's not for the faint-hearted. And they're costly, in the UK, a BBL can cost anything between £2,000 and £7,000.

It's official: the hourglass-enhancing surgery has firmly taken the reins from the noughties boob job boom. In the past “your butt looks fat” was an insult. Now? It’s high praise. But how did this happen? And why are women so desperate to get an unattainable figure that they’re even willing to risk death?

While Kim Kardashian isn’t the sole reason – although her behind is synonymous with her fame – it’s impossible to discuss society’s booty obsession without bringing her into the conversation. In the early seasons of Keeping Up With The Kardashians, Kim’s derriere was so widely discussed that she even went to a doctor to dispel rumours that she’d had work done. While the doctor cleared her of any cosmetic procedures, such as silicone, a procedure called fat grafting couldn’t be ruled out, as it wouldn’t be picked up on an x-ray. Over the years, people have continued to question the validity of Kim’s x-ray.

Outside of reality TV, the hourglass shape has become a staple on social media, with huge swathes of influencers and Instagram models seemingly following the status quo. On TikTok, the hashtag #BBL has more than 3.7 billion views. Videos are filled with countless BBL before and afters. But while TikTok makes it seem like a BBL is a quick fix to getting a small waist and a full butt, there are so many things that can’t be shown in a short video clip. The transformations plaguing the platform drown out the very real issues that people face. And once the “trend” is over, where does it leave the women who chased this fleeting beauty ideal all the way to the operating table?

Especially when you can't escape it in fashion, either. Take one scroll through some of the major fashion retailers websites and you'll see the same designs cropping up again and again. Cut-outs, plunging necklines, thigh-high slits. All styles designed and geared towards a certain type of body... now, clothes are made for small waists and thicc thighs.

Case in point? When curvaceous model Demi Rose’s Pretty Little Thing collaboration dropped in August this year, it set Twitter ablaze as many voiced their concerns about the clothes being unsuitable for the average human. "Mass producing fast fashion catered to a very specific body type achievable almost exclusively through a surgical procedure with the highest mortality rate of all elective surgeries >>> this is actually very good and safe for society!!!" tweeted @thebiggestyee. Demi's own behind has also been speculated about, too.

And as so many of us aren't built this way, the devastation that follows buying something that doesn’t fit the way it does in the pictures is a dark rabbit hole to doubting your own beauty.

Paygie, who is now 28, feels the beauty standard within the Black community especially put an astonishing amount of pressure on her. “I felt pressure as a Black woman to look a certain way. I felt like I needed to have a butt. It played a part in my decision,” she explains. “I didn’t understand that it is just genetics, not every Black woman has a butt.”

Photo credit: Florence Ogram - Getty Images
Photo credit: Florence Ogram - Getty Images

A few months after her surgery, Paygie wasn't happy with the results. She explains that one thing the doctors didn't tell her is that patients will lose roughly 40% of the fat they transfer because it won’t survive. Paygie’s body simply couldn’t sustain the fat. “I regret the fact that I spent around $4,800 (£3,607) to get this surgery,” she confesses. And to make her butt "pop" after the surgery, she had to wear surgical padding (fajas.) Paygie said she was really "dissatisfied," as her butt actually "deflated."

Likes or death

A BBL is considered one of the riskiest cosmetic procedure with a mortality rate of 1 in 3,000 patients [medical report from 2017, The American Society for Aesthetic Plastic Surgery, Inc.]. Compared to boob jobs or nose jobs where the greatest worry is administering the anaesthesia, a BBL is especially dangerous because there are a lot of blood vessels in the bum. Meaning, when fat is transferred into the buttocks, doctors can find it hard to inject it in the correct place. If it ends up in the wrong place, fat can enter the bloodstream and cause serious illness – or in the worst cases, death.

“I no longer perform this operation,” says holistic plastic surgeon Dr Anthony Youn. “Once the high mortality rate was reported, I made the conscious decision to stop performing BBL surgery. I didn't want any chance a young woman would die on my operating table.”

However, the risks associated with the surgery hasn’t steered patients away.

A 2020 survey by International Society of Aesthetic Plastic Surgery reported that since 2015 there has been a 77.16% increase in people getting BBL surgery, making it the fastest growing cosmetic procedure in recent years. The British Association of Aesthetic Plastic Surgeons even called for a ban on the BBL procedure because of its high mortality rate and they have also condemned cosmetic surgery tourism.

BBLs are also expensive in the UK, so the low cost keeps luring people to seek procedures abroad, where regulations are more lax. A popular cosmetic surgery destination is Turkey, where BBLs cost at most £2,699. The death of Leah Cambridge – a 29-year-old woman who passed away during her BBL surgery in Turkey – hasn't been enough to put people off, either.

It didn't stop Nicole, a 35-year-old investor, from London, flying out to Turkey on her own – but, then, Nicole isn’t afraid of dying. She's a veteran when it comes to plastic surgery; before her BBL, she underwent a tummy tuck, breast augmentation, liposuction, a nose job and is now planning a further 'mini' tummy tuck in the coming months.

Photo credit: Florence Ogram - Getty Images
Photo credit: Florence Ogram - Getty Images

And the specific risks of BBL surgery didn’t faze her. “I enjoy life so much. I'm excited for death because to me, death is like the next stage. Like it’s a new experience,” explains Nicole. “I don't think about the negativity. I just think about the positive outcome.” And that positive outcome was to be more attractive for her partner who constantly compared her to an ex (who was an Instagram model) and who had undergone the same procedure.

The turning point for Nicole was when she asked him how their sex life was, and he rated it 9/10. He said she’d be 10/10 if she had a better body – then offered to pay for her BBL. Nicole accepted. She flew to Turkey alone and came back home with a new lease on life. However, Nicole and her partner broke up soon after the procedure. "He dumped me," says Nicole. "We lacked things in common – apart from sex – and I knew it wasn’t healthy."

Massages are part of BBL aftercare as they help decrease recovery time and improve results, and although her ex covered the surgery cost, Nicole had to pay for a course of massages herself – which was costly as she had to have 20 sessions at 50 quid per time.

She likened her situation to TLC’s 'Unpretty' music video, in which Chilli, one-third of the 90s girl group, is pressured by her boyfriend to get a boob job. Chilli ultimately runs away from the operating table, but while she found freedom running away from the surgeon’s knife, Nicole found freedom running toward it. “I'm pleased with the results. I don't regret it, not one bit. It’s enhanced my self-esteem,” she says.

Nicole then laughs as she recalls the number of men that stop to get her number when she’s walking down the street in London. “Body privilege 100% does exist," she nods. She now likes dating guys who are “alpha males” and earn more than her, and feels that her new body gives her access to the kind of man she wants. “I now have 100% better options [when it comes to] men,” she says.

Unable to afford the surgery, Paygie paid for it by taking out a line of credit. She chose a bundle option of $4,200 (£3,154), for a BBL special by a renowned doctor in Miami. Bundles are packages offered to people considering BBLs and can include surgery, massages, accommodation and/or aftercare depending on the doctor. Various hidden fees brought her total bill to way more than $4,200. Paygie needed to buy a BBL pillow, so she could sit with comfort while she recovered, and also compression garments that facilitate the healing process. In the end, she paid an additional $600 (£450), and had to increase her credit to pay for it.

Four years have passed since Paygie got her BBL, and while she has her regrets, she’s beginning to be able to move past them and stand in her mistakes, saying she feels in a much better headspace now. “I’ve slowly become satisfied with the fact that it’s something I did in my past and it doesn’t define who I am now.”

“[I wish I’d had someone] in my corner to tell me that if I trust the process, I can like my body the way it is now,” Paygie adds. “At that time, I just wanted what was the quickest solution. The biggest regret I have is I didn’t take the time to do the research.”

The length to which many of us will go to reach that elusive standard of beauty has left us bankrupt and without any sense of reality. While the decision lies in the patients’ hands, it must be made armed with facts – and the knowledge that you may not get what you bargained for. “If you decide to get this done you may be stuck with whatever body they decide to give you that day,” are Paygie’s last words.

Our bodies aren’t trends

The ideal body is completely unattainable – not because you need money for surgery, or because of your genes, but because body trends are always changing. Like chasing a butterfly that will always escape you... While you may come close, you’ll find your hand empty and clutching the air.

In the late 90s being a size zero was favoured, and it had an impact on how women felt about their bodies resulting in eating disorders and body dysmorphia – its effects are still felt today by young women who grew up during this time. And just look back at Renee Zellweger in Bridget Jones’s Diary and the discourse surrounding her weight. She stepped on the scales, looked down to see 9st 7lbs, and balked at how “fat” she was. And when the average weight of British women is 11 stone, what message was Bridget sending?

And now, social media platforms like TikTok will continue to set the tone for what’s beautiful and what's not, reinforcing it more than any billboards, TV shows or magazines in the 90s or noughties ever could.

The BBL journey isn’t the same for everyone, but one thing that should apply to all is the importance of making an informed decision based on thorough research and an internal desire – not a need for external validation, or an unachievable ambition to look like your favourite influencer.

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