One of the more serious complications of BBL remains fat graft becoming infection if the fat material is inadvertently contaminated. The reason why this complication is serious is that the fat cells are infected as small packs of 0.5 to 1.0cc in volume. For example, if you have 1000cc of fat injected into your buttocks, you are having to deal with 1000 to 2000 separate sites of infection that need to be drained. About one year ago, I was called into the local hospital with a patient who had an infection of her buttocks following BBL. She was nearly comatose and on the verge of death. She required four separate surgical incision and drainages as well as 5 drainages performed by interventional radiology. Fortunately, she survived this nightmare complication but obviously her buttock contour was severely compromised. As such, many steps are taken to ensure the avoidance of contamination. The first precaution taken is to use a closed-loop system.
The closed-loop system eliminates the risk of external contamination of the fat cells. This avoidance of external exposure and contamination of fat cells is accomplished by keeping the fat cells away from external air exposure. This is accomplished by sucking the fat with a sterile cannula and tubing directly into a sterile collection canister. The fat is only washed with antibiotic solution prior to being reinjected through the same tubing back into the body. Another precaution is to reinject the fat cells back into the buttock within 30 minutes of being collected. When fat cells are removed from the body they begin to suffocate, just like a fish out of water, and become compromised and are thus prone to getting an infection. A final precaution to avoiding infection is the integrity of the canister being used. It goes without saying that you should not use a canister that has a lining compromise that would potentially create opportunities for contaminants to escape the autoclaving and sterilization process.
Unfortunately, Wells Johnson company sells a relatively expensive canister that costs over 1000$ but has a defective lining. This lining will become compromised within a few dozen sterilization cycles. This photo demonstrates the defect in the lining and what you will observe following the sterilization of the cannister. Although this breakdown of their canister may be safe, the detrimental consequences of risking a fat transfer infection, forbid its use. Even more concerning, is the companies outright denial that this problem exists. The worst component of the company is that they blame it on your processing of instruments during sterilization. This is even in the setting of a reputable center that has performed well over 10,000 cases. Finally, they are not even willing to replace this expensive cannister or even call back to discuss the problem. Shame on a company that is attempting to be the trend leader in fat transfer procedures. As a frequent speaker on high definition liposuction and Brazilian buttock lift at national meetings, I have made multiple attempts to get the company to correct this concern, and they have turned a shoulder. In summary, as an advocate of safe Brazilian buttock lift procedures, I feel that it is my duty to inform the medical community that I fear detrimental consequences of using a product that develops compromise in its lining for the purposes of collecting live tissue in preparation for transfer back into the body.
This is a 26-year-old female before and 6 months after her buttock enhancement procedure.