Through the years, the notion of the “ideal” female shape is always changing and often inspired by famous people at the time. In the era of Kim Kardashian, Nicki Minaj, and Beyonce, the hourglass figure is in vogue leading to a whole host of ways to enlarge ones bottom from special underwear shapers to butt workouts.

However, workouts and clever styling can only go so far in terms of highlighting the curves of one's figure and more and more women are turning to buttock enhancing procedures to get the look they want. This is why Brazilian butt lift surgery has become one of the most popular surgeries today.

What is a Brazilian butt lift?

A Brazilian butt lift (BBL) is a fat grafting procedure that improves the fullness and shape of the buttocks using your own fat. Liposuction is performed in areas that have excess fat, normally the tummy, sides and hips,to both improve the proportions and contour of the lower body and harvest fat to be added to the bottom.

The collected fat is then purified and prepared for grafting before your cosmetic surgeon strategically injects the fat into specific areas of your buttocks to create a fuller, more defined shape.

The effects of BBL surgery when done correctly in order to achieve the desired hourglass shape

This method has overtaken traditional options like butt implants in popularity for its more natural-looking results. However, Brazilian butt lift surgery is not without its complications or controversy, leading many patients to ask, “How safe is BBL?”

Last year a survey of 692 surgeons from across the world found 32 patients had died from a condition called a fat embolism , where the injected fat travels to other parts of the body that it shouldn't.

There were also 103 non-fatal cases, but there are probably many more that remain unreported, Prof Frame, a consultant at Springfield Hospital, Chelmsford, wrote for The Conversation.

Why is the mortality rate so high?

Fat embolism was recently identified as the leading cause of death in BBL surgery. The estimated death rate from fat embolism may be as high as 1 in 3,000 for BBL's. A study of deaths from BBL surgery conducted in 2015 concluded that they probably occur as a result of gluteal blood vessels becoming damaged during the procedure, allowing fat to enter the bloodstream. The authors recommended that “buttocks lipoinjection should be performed very carefully, avoiding injections into deep muscle planes”.

However, it should be noted that fat is also injected into muscle for some breast enhancement surgery, with no reported deaths. This suggests that there are other factors involved in the high mortality rate among BBL patients.

Most of these deaths appear to have been caused by inappropriately qualified practitioners working in non-approved facilities.

Other post-surgery problems, such as gangrene and sepsis, can also be fatal.

Is it worth the risk?

The potential risk of death from a fat embolism has to be weighed against the benefits, especially in cases where there are physical and functional benefits to having the surgery. In the case of the Brazilian butt lift, perhaps the risks outweigh the benefits.

Nevertheless, in this image-obsessed society in which we live, the procedure remains popular, despite the risks. It is vital that surgeons make the risks of the procedure very clear to anyone considering it. Patient safety should always be the top priority.