"Tell me what you don't like about yourself." The plastic surgeons of the '00s FX series Nip/Tuck began all of their consultations by posing this telltale question to their patients, all of whom harbor their fair share of insecurities (which they hope to dispel via plastic surgery — or at least try to). However, despite the show being a work of fiction, it draws inspiration from, and at times even parallels real-world cosmetic procedure cases and trends, whether that be chasing a bump-free nose, chiseled cheekbones, or a rounder and plumper derrière.

Brazilian butt lifts, otherwise known as BBLs, have seen a whopping uptick of 90.3% from 2015 to 2019, likely due to social media and celebrities (secretly) getting the surgery done, according to the American Society of Plastic Surgeons. The cosmetic procedure — which involves using liposuction to harvest fat from other areas of the body to be transferred to the buttocks, hips, or thighs — may seem appealing, but it might not be for everyone, especially those with a low BMI. The fat, after all, has to come from somewhere. So when there simply isn't enough, that's where the baby or petite BBL comes into play.

What Is a Baby BBL?

"A baby or petite BBL is simply a BBL for a patient who has a petite frame and lower starting BMI," explains Beverly Hills-based plastic surgeon Dr. William Rahal. "Many doctors will not do a BBL on patients with low BMIs or who are low in body fat," he says. "I do offer petite BBLs, and see quite a bit of them in my practice." With that in mind, it goes without saying that a baby BBL won't give you astronomical results, but the procedure can fill in hip dips and give the butt a rounder, plumper shape.

In terms of the procedure itself, the surgeon will be going through the same motions as a traditional Brazilian butt lift. What will differ, however, is the amount of fat that is harvested and perhaps the type of anesthesia used.

Once you arrive at the hospital and are prepped for surgery, the doctor will mark the areas where they will make tiny incisions to extract fat from around the body, as well as where it will be transferred. Then you will either be placed under general anesthesia or administered local anesthesia. Typically, it's the latter if working with a lower volume of fat.

Next, the doctor will begin the liposuction, collect the fat, and ensure it has been purified and prepped to be reinserted into the body. "Unless the patient has under 10% body fat, we're still able to obtain the fat we need from 360 lipo — abdomen, bra-roll, upper back, mid back, waist, hip-roll, and pre-sacral triangle — to utilize for adding volume and shape to the buttocks," explains Dr. Rahal.

"Most baby BBL patients have a BMI of between 20 to 23, generally. For reference, that would be a woman with a height of 5'4" and a weight of between 120 and 135 pounds," Dr. Rahal says. In patients where there's "not enough natural fat," a product called Renuva is used as a substitute, he adds.

"Renuva is what is called an extracellular matrix (ECM), the stringy collagen that is found between the fat cells. But although it volumizes, Renuva is not a filler — it's in a class all of its own," explains the surgeon. "When Renuva is injected, two things happen: first, your own fat cells go into the space and fill it in and that, in turn, causes stem cells to turn into fat cells. If you're just doing Renuva injections, there is essentially no recovery time, because you're not doing a surgery with general anesthesia or liposuction."

According to Dr. Rahal, most of his patients get a mixture of Renuva and fat grafting, which, of course, will require surgery. Once complete, the surgeon will close the incisions and dress the patient in a compression garment to minimize any risk of bleeding.

Post-Op Recovery

Believe it or not, patients can expect to be fully recovered fairly quickly after the procedure. "You want to plan for at least one week off work, two if possible," Dr. Rahal shares. "Pain usually lasts three to five days. After two weeks, you can begin to do light physical activity. Most patients are fully recovered and can do heavier physical activity and exercise by four weeks."Following your doctor's aftercare instructions is a vital step in the recovery process. This can include wearing a compression garment for a number of weeks, attending all follow-up appointments, and making sure to keep the area as clean as possible as the incisions heal.

Some of the over-the-top BBLs you may have seen on the internet are not actually the results you'll get from doing just one procedure. "The exaggerated silhouettes we see in the media are a result of several rounds of BBL surgery," Dr. Rahal clarifies. "[Patients] go back for two or three rounds because there is a limit to how much fat you can inject safely into the subcutaneous space in one sitting. Most patients only have BBL surgery once, one round. From that, they can get great results that look natural. No one is going to know you have had a treatment unless you tell them."

Risks and Side Effects

The good news? Side effects like infection and scarring are low-risk if you go to a trained surgeon. Emphasis on the trained surgeon. While we're not trying to be alarmist or anything, there is a one in 3,000 chance of death from a BBL surgery — the baby version or otherwise. And while that may not seem like a significant number, according to The Aesthetic Society, it's much larger than most cosmetic procedures.

If a doctor is not properly trained to do lipo or fat grafting, it could result in disfigurement (both where the fat was taken and inserted), along with a risk of infection that could require additional surgeries, and if the fat is transferred to the wrong area of the butt, patients could suffer a fat embolism of the heart or lungs, which can be deadly.

"Patients should take into consideration that there is a significant baseline cost, like anesthesia and operating room time, to do the procedure, and that baseline will vary between $3,000 to $5,000 depending on location and other factors," says Dr. Rahal. "If the cost of the surgery seems much lower than average, there is usually a reason for it — and it may not be favorable to a patient," he adds. Generally speaking, anything that sounds too good to be true typically is — and if there's one thing you don't want to bargain shop for, it's your health.

The Bottom Line

"If a patient wants more volume and shape to their buttocks, if they want to have more of an hourglass silhouette, then a BBL is for them," comments Dr. Rahal. However, it's important to consider the decision carefully, as it is a surgical procedure which means it comes with risks.

If you decide that a baby BBL, or the traditional butt lift, is right for you, and you've done your research to find an experienced and credible surgeon, take your time and ask as many questions as you want in order to feel comfortable and safe before getting started.