An obsession that’s showing no signs of fading, Black women’s assets are permanently pinned to mood boards everywhere. Released in the spring of 1992, Sir Mix-A-Lot’s high-octane anthem for big booties, “Baby Got Back,” was a moment for thick Black girls. The song’s intro also revealed a not-so-secret truth about how many White women felt about those curves. “Oh. My God. Becky, look at her butt / It is so big,” says a Valley-accented voice in the song’s first 20 seconds. The speaker goes on to gawk at an unknown Black woman, finally wrapping up by saying what the actual issue is: “She’s just so, Black!”
In the 30 years since the song’s release, Black women’s bodies have continued to be a source of scrutiny and inspiration. In a highly problematic—and since-deleted—digital article, “We’re Officially in the Era of the Big Booty” by Patricia Garcia about big butts being a “thing,” the Vogue writer praised Jennifer Lopez’s backside and pointed out that in years past, derrieres were considered a hindrance. “A large butt was not something one aspired to, rather something one tried to tame in countless exercise classes,” the writer stated. Butts were to be hidden, as if curviness was a choice, because it wasn’t hip to the Beckys of the world yet.
Now, all it takes are a few scrolls on your Instagram feed to see a doctored, non-Black, voluptuous rump. Posterior cosmetic surgery, known as Brazilian butt lifts, or BBLs, are not solely a White phenomenon, although the majority of butt lift patients many plastic surgeons see are White. Brazilian butt lifts evolved from a derriere-lift surgery pioneered in the mid-1960s. In recent decades, the procedure has only risen in popularity. Black celebrities, including K. Michelle and Cardi B have candidly discussed getting butt injections, though K. Michelle has since stopped the practice for health reasons. While there are other stars who have obviously had work done on their bums, those who openly admit it are few. The impact is the same though: Everyday people are piecing together the clues and scurrying to the doctors’ tables themselves. The fantasy lies within the mystery, and even though conversations about the surgery are as commonplace as ones about breakfast, illusions remain.
“One of my colleagues says he invented the term Brazilian butt lift,” Michael K. Obeng, M.D., a Beverly Hills–based board-certified plastic surgeon says of his friend Anthony Griffin. However, the phrase Brazilian butt lift is -actually a misnomer, as the sometimes fatal procedure does not actually lift the butt. “Fat is transferred to the buttocks,” explains Terry Dubrow, M.D., renowned plastic surgeon and cohost of the popular E! Television reality series Botched. “You do liposuction on one part of the body, you take the fat cells out of it and you clean it, then you inject it directly into the buttock tissue,” says Dubrow.
As in-demand as the procedure is—it is currently the “fastest-growing cosmetic surgery” in the world, according to The Guardian—it’s also incredibly dangerous. It was once common for the fat to be injected into the muscle itself, but after surgeons realized that there was a heightened chance of the fat getting into the veins and traveling to the heart and lungs, that practice was mostly abandoned. Yet fatalities remain high.
A study, Assessing Cosmetic Surgery Safety: The Evolving Data, published in May of 2020 in the Plastic and Reconstructive Surgery Global Open that assessed the safety of cosmetic surgeries, found that one in 15,000 to 20,000 BBL procedures end in death. Dubrow says he no longer does the surgery at all, and instead focuses on cosmetic reconstruction. He mentions a task force, The Inter-Society Gluteal Fat Grafting Task Force, which fought to have BBLs banned altogether, but the effort was unsuccessful.
Recovery from a BBL is “wildly-uncomfortable,” says Lea Richardson*, who knows from experience. “It’s a pain that you’ve never felt before. It’s very bizarre; you can actively feel your body trying to heal because what happened was just so unnatural.” Indeed, the most difficult part of the procedure is the aftercare, during which patients aren’t allowed to sit for up to six weeks, giving the fat cells a chance to survive, which directly correlates to how the results will appear. “You have to deal with not being able to sit for weeks and yet the surgery is only a few hours,” says Richardson.
Richardson explains that scarring greatly contributes to the agony. “There’s fluid trapped in your body,” she says, noting that the lymphatic massage required to get the fluid out of the holes in the buttocks is gruesome. And Obeng lists a slew of post-surgery complications that can arise, including infection, scar tissue, seroma (an accumulation of fluid), asymmetry, necrosis (extreme cell death), blood clots and fat embolisms (blood vessels blocked by fat).
One grim Instagram account, Doll Memorial, @dollmemorial posts memorials of those who have died as a result of getting cosmetic surgery, some of which were fat transfers. There are more than 100 posts and images, with some of the procedures having taken place outside the U.S. Having surgery abroad is common for those looking to cut costs, as fat transfers can go for upward of $5,000 and does not include aftercare, some people have opted to undergo surgery abroad. Some people, seeking to spend less, also ignore the advice of certified plastic surgeons about associated risks, opting for less safe facilities.
“I had a patient, a flight attendant who came in for a BBL consultation,” shares Obeng. “She said I was too expensive and decided to go to the Dominican Republic for the procedure. And she died.” Obeng says he still gets emotional when he recalls this harrowing story.
With all of the harm that the procedure can cause, why is the BBL still so sought after? Dubrow chalks it up to the escalating interest in the Kardashian family. Though none of the women have admitted to any kind of augmentation on their buttocks, Kim and Khloe Kardashian and sister Kylie Jenner are thought to have undergone surgery. Dubrow suggests that the sisters’ prevalence in the media has played a role in the way that other women see themselves. While the family is regularly accused of cultural appropriation, specifically for style choices like cornrows and kanekalon made to resemble Black hair, they have also been called out for imitating some Black women’s natural forms.
In the unending cycle of inspiration versus appropriation, and the rounded rump so many people are literally dying to achieve, it might be time to consider other cosmetic options. These come with varying degrees of invasiveness, but may pose less risk to your life.
*Name changed to protect privacy.
What is it?: Silicone implants are placed in the tissue of the buttocks through surgery.
Qualifications for surgery: This works best for thin patients who are, say, 5 feet 9 inches tall and weigh less than 130 pounds. “That person will probably do better with implants than a BBL,” says Obeng.
Cost: Approximately $5,000
What is it?: Using a technology patented by Aaron Rollins, M.D., unwanted fat is removed while the patient is awake, without needles, a scalpel or stitches. An entry point into the skin is made. The fat is then numbed, heated and permanently removed and placed into the buttocks. Most patients are able to return to work the next day.
Qualifications for surgery: The procedure can be performed on most people, Rollins says.
Cost: Varies based on how many areas of the body are targeted.
What is it?: A powdery substance is suspended in water and is then injected into the body as a filler. According to Arash Akhavan, M.D., your body reacts by building collagen bundles around the powder, adding volume.
Qualifications for surgery: This process is suited for those who don’t have much body fat to harvest.
Cost: One round of Sculptra can start at $5,000 to $8,000. Three rounds is typical.
What is it?: This is the only FDA-approved device for a nonsurgical lift. Paddles are placed on each cheek, causing swift, dense muscle contractions. Doing this four times a week for four weeks results in a 25 percent increase in gluteal muscle mass.
Qualifications for surgery: Akhavan says this works best for those who have muscular buttocks.
Cost: The price tag can run $4,000 for four treatments.
This article originally appeared in the Januarya/February 2022 issue of ESSENCE magazine, available on newsstands now.