Getting a Brazilian Butt Lift (BBL) vs not getting one
Last reviewed 2026-05-10
Evidence quality 3.38/5
Eight-dimension review score against the
quality rubric
. Each dimension scored 1–5.
D1 Source verification
4/5
D2 Source authority & independence
4/5
D3 Regret-rate accuracy
1/5
D4 Source comparability
2/5
D5 Gilovich pattern
3/5
D6 Prose quality
5/5
D7 Caveat completeness
5/5
D8 Sample quality
3/5
Average3.38/5
Proxy data — no direct regret survey exists for this decision. Rates are derived from satisfaction scores and access-barrier data rather than questions that directly asked about regret. See caveats below.
Action regret
Getting a BBL
14%
~14% (inverse satisfaction proxy -- no direct regret survey exists)
BBL patients, retrospective cohort; regret inferred from dissatisfaction
retrospective, 2018–2022 follow-up
Inaction regret
Not getting a BBL
8.0%
~8% (proxy estimate -- no direct inaction-regret survey exists)
Adults considering but not pursuing gluteal augmentation; body dissatisfaction proxy
retrospective, no fixed timeframe
% who regret this choice
Getting a BBLNot getting a BBL
14%8.0%
balanced — Roughly balanced — both choices carry similar regret.
Related decisions
Semantically similar decisions — same territory, different trade-offs.
The Brazilian Butt Lift occupies an unusual position in elective cosmetic
surgery: it carries the highest reported mortality rate of any aesthetic
procedure while simultaneously producing high patient satisfaction among
survivors. A 2024 retrospective cohort of 3,000 BBL patients (Güzey &
Ergan Şahin, Aesthetic Plastic Surgery) reported 86% satisfaction, implying
roughly 14% not satisfied. Crucially, no peer-reviewed study has applied a
validated decision-regret instrument specifically to BBL patients, so the
14% action-regret estimate is a satisfaction inverse — a proxy with an
inherent upward bias on the regret direction, since dissatisfaction and
regret are related but distinct constructs.
The mortality data provides essential context for why regret data is
structurally incomplete. Before the ASERF Multi-Society Task Force published
guidelines in 2018, the estimated BBL mortality rate was approximately
1:3,000 procedures — the highest ever recorded for elective cosmetic
surgery, driven by fat embolism when injected material entered the gluteal
venous plexus. Following adoption of subcutaneous-only injection techniques,
the 2019 follow-up survey reported a rate of approximately 1:14,952. The
implication is that any satisfaction or regret figure drawn from survivor
cohorts is subject to survivorship bias: patients who died or suffered
severe complications cannot report their preferences. Studies conducted
almost entirely at accredited facilities by board-certified surgeons further
select against the highest-risk surgical settings, where outcomes and
potential regret would almost certainly differ.
On the inaction side, no survey exists that directly measures regret among
people who considered but did not get a BBL. The 8% proxy is constructed
from general body-dissatisfaction data (37% per Ipsos) and qualitative
observation that BBL demand is heavily influenced by social media trends —
a mechanism that plausibly generates latent inaction regret in some
consumers who feel peer or aesthetic pressure. Both the 8% inaction estimate
and the 14% action estimate should be treated as order-of-magnitude
placeholders. The delta (0.06) and the “balanced” Gilovich pattern label
reflect this uncertainty: it is possible that, once properly measured, the
pattern would shift in either direction. This entry is a placeholder for a
genuinely data-sparse decision; the primary purpose is to surface the
mortality risk context and the absence of rigorous regret literature for one
of the most socially prominent elective procedures of the 2010s and 2020s.
Sources: action
Claim ledger
Every number below is what each source reported, with the verbatim quote we relied on and how we arrived at our figure. Click any link to verify directly.
[1]Aesthetic Plastic Surgery (Springer) — Brazilian Butt Lift: An Experience Over 3000 Patients
Peer-reviewed
86% of patients satisfied with outcomes; ~14% not satisfied
Excerpt
“"[Paraphrase from abstract -- full text paywalled] Of 3000 patients who underwent BBL between 2018 and 2022, 86% expressed satisfaction with their outcomes. The study concluded that BBL is a safe and satisfactory surgery when performed by experienced surgeons who adhere to fundamental principles, with 70% of transferred fat surviving in the buttocks."
”
Source data from
2024-04-01
Accessed
2026-05-10
Calculation
Güzey and Ergan Şahin (2024) retrospective cohort of 3000 BBL patients. 86% satisfaction rate used as the inverse proxy for regret: 100% - 86% = 14%. This is NOT a direct regret-framed question; it measures general satisfaction. Dissatisfied patients are not necessarily regretful (they may intend revision surgery), and satisfied patients may still report some regret. The 14% is used as an upper-bound proxy for action regret, likely overstating true decision regret. No peer-reviewed study has applied a validated Decision Regret Scale specifically to BBL patients.
[2]Aesthetic Surgery Journal / ASERF — Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force
Peer-reviewed
BBL mortality rate 1:3,000 (2017 pre-guideline era); reduced to 1:14,952 after subcutaneous-only technique adoption (2019)
Excerpt
“"The probability of having either a fatal or non-fatal pulmonary fat embolism was determined to be 1:1,473. The task force calculated the BBL death rate to fall between 1 in 6,214 and 1 in 2,351 cosmetic surgery patients."
”
Source data from
2018-03-01
Accessed
2026-05-10
Calculation
ASERF task force anonymous survey of 4,843 plastic surgeons worldwide. Establishes baseline mortality context (not the regret rate). Post- guideline data (2019 ASERF follow-up published in Aesthetic Surgery Journal) showed the rate fell to approximately 1:14,952 after adoption of subcutaneous-only injection technique. Mortality is cited here as context for why complications drive regret, not as the regret rate itself. Cited to establish why action regret may be underreported: patients who died cannot report regret, and survivors with complications may not be captured in satisfaction surveys.
Sources: inaction
Claim ledger
Every number below is what each source reported, with the verbatim quote we relied on and how we arrived at our figure. Click any link to verify directly.
[1]Ipsos — Most Americans Experience Feeling Dissatisfied with How Their Body Looks from Time to Time↗ 2 other entries
Primary study
37% of Americans feel dissatisfied with their body whenever they look in the mirror; 56% experience dissatisfaction from time to time
Excerpt
“"Most Americans experience feeling dissatisfied with how their body looks from time to time, including nearly two in five who feel this way whenever they look in the mirror."
”
Source data from
2018-01-10
Accessed
2026-05-10
Calculation
Ipsos survey of 1,005 US adults. General body-dissatisfaction rate (37%) is used as an extremely broad upper bound. No survey exists that directly asks people who considered but did not get a BBL whether they regret that inaction. BBLs are a niche procedure; the share of the general population considering one and experiencing lasting inaction regret is likely a fraction of general body dissatisfaction. The 8% is a constructed proxy -- higher than the breast augmentation inaction proxy (5%) to reflect that BBLs are increasingly trend-driven (social media exposure) and that the decision may be more socially salient among younger women in certain communities. This is speculative, not a measured figure.
[2]International Society of Aesthetic Plastic Surgeons (ISAPS) — ISAPS Global Survey 2024: Full Report
Reference source
Gluteal fat grafting ranks among the top 10 most performed cosmetic procedures globally; procedure volume grew substantially 2019–2023
Excerpt
“"[Paraphrase from abstract -- full text paywalled] The ISAPS Global Survey 2024 reports gluteal fat grafting as one of the top 10 cosmetic surgical procedures worldwide by volume, with Brazilian Butt Lift procedures representing a significant share of body contouring surgeries performed globally."
”
Source data from
2024-12-01
Accessed
2026-05-10
Calculation
ISAPS annual global survey of member plastic surgeons. Procedure volume data confirms that demand for gluteal augmentation is real and substantial, indicating a plausible pool of people who considered but did not proceed. However, volume data does not translate to inaction- regret data. Cited to establish demand context, not as a regret measure.
Caveats
Both the action and inaction figures for this entry are proxy constructs, not measured regret rates. No peer-reviewed study has applied a validated decision-regret instrument specifically to BBL patients. The action-side 14% is the inverse of 86% satisfaction in a 3000-patient Turkish cohort (Güzey & Ergan Şahin, 2024) -- satisfaction and regret measure related but distinct constructs, and this conversion overstates true decision regret under the most generous interpretation. The inaction-side 8% has no direct evidential basis at all; it is a speculative proxy from general body- dissatisfaction data. The delta (0.06) and the gilovich_pattern label ("balanced") should be treated as editorial estimates, not empirical findings. A secondary complication is survivorship bias: BBL has the highest reported mortality rate of any elective cosmetic procedure (1:3,000 in the pre-2018 era; approximately 1:14,952 post-guideline). Patients who suffered fatal or severe complications cannot report their regret, systematically depressing the measured action-regret rate in survivor cohorts. Additionally, BBL outcomes vary dramatically by surgical setting and surgeon experience: procedures performed outside accredited facilities by non-board-certified surgeons carry substantially higher complication and mortality rates than the academic center figures reported in peer-reviewed studies. The satisfaction literature almost exclusively captures outcomes from regulated surgical settings. Social-media-driven demand -- particularly among younger women exposed to "BBL body" aesthetics -- introduces selection effects that further complicate any attempt to generalize regret rates across the BBL patient population.
