Backing Away From BBLs

It's no secret that the Y2K fashion and beauty aesthetic is back in a serious way, thanks in large part to celebrities like Bella Hadid and Gen Z's full-blown obsession on TikTok. But along with the nostalgic shift toward super low-rise everything, butterfly clips, and thin eyebrows has come the more sinister notion that certain body types and even specific body parts can also come in and out of fashion. Yes, we're talking about (big) butts.

On Twitter, talk of "the end of the BBL era" (aka Brazilian Butt Lift) has been swirling for months after photos began circulating of Kim and Khloé Kardashian with their backsides looking noticeably smaller, causing theories to swirl that they may have "reversed" their BBLs — procedures they've never actually said they had in the first place. On TikTok, there's been wild speculation about Kim's "butt reduction" and her "new" body (the one she somewhat problematically revealed in that Marilyn Monroe Met Gala dress). "Kardashian reverse BBL" is a breakout term on Google, meaning search demand has grown by more than 5,000% over the past 12 months. (That's all people searching for clues that a slimmer look is "cool" again, basically.)

As many have rightfully pointed out, this new anti-BBL wave feels like not-so-thinly veiled racism. After all, the Kardashians — who have long been called out for exploiting Black culture and aesthetics — helped the BBL to become one of the most popular and fastest growing cosmetic surgeries over the past decade. (Along with plenty of other celebrities and influencers, too.) Now, there's an aesthetic shift away from what's most often a naturally occurring body shape among Black and brown women, which feels no less offensive than the shift toward it was. As one Twitter user put it, the whole discourse feels a bit like, "We're done exploiting and capitalizing black women's bodies, byyeee!"

"At its core beauty should be timeless ... but the reality is there are ebbs and flows in the zeitgeist and what is popular, and media imagery, celebrities, influencers, all of that can influence what people want," says Lara Devgan, M.D., a top board-certified plastic surgeon in New York City. "I think that there has been a return to the concept of subtlety." And that spells bye-bye for BBLs, which are anything but subtle.

For the uninitiated, the Brazilian Butt Lift procedure, technically known as autologous gluteal fat grafting, involves taking fat via liposuction, usually from the abdomen, waist, and back, and transferring it to the hips and butt, explains Edward Chamata, M.D., a BBL surgeon in Houston, Texas. The result: A fuller, "lifted," more 'hourglass' shape without the need for any foreign injections or implants, he explains.

The BBL's meteoric rise to fame pretty much coincided with the advent of the peach emoji as both a sexting mechanism and the Twitter trend signifying "impeach" you-know-who. It coincided, too, with Kim Kardashian's Kanye West era and crescendoed, probably, around the time Cardi B. and Megan Thee Stallion's "WAP" video presented a disembodied, gold-plated rear as hallway art (August 2020).

According to a 2020 survey by the International Society of Aesthetic Plastic Surgery, the number of BBLs performed globally since 2015 has risen 78% — the largest growth out of any surgical procedure. In 2020 alone, there were 40,320 butt augmentations (including implants and fat grafting) totaling more than $140 million in revenue, according to a report from The Aesthetic Society. The BBL boom continued even after a 2017 report by the Aesthetic Surgery Education and Research Foundation found the BBL to have the highest mortality rate for any cosmetic surgery. Although new guidelines were developed in 2018 to make the procedure safer, Dr. Devgan, who stopped performing BBLs in her practice because of the "unacceptable level of risk," calls it "the most dangerous procedure that can be performed in the world of plastic surgery."

Although one would expect a label of "the most deadly" to be a strong deterrent, it seems the new wave of suspected celebrity "reversals" are what's finally causing the pendulum to swing away from butt augmentation. Plastic surgeons are naturally reluctant to declare we've reached the end of the BBL era, and Dr. Devgan notes every geographic area and plastic surgery practice is different. For example, the surgeons we spoke to say that in Miami, Florida, the BBL capital, butt lifts seem to have staying power, but more broadly, an aesthetic vibe shift is upon us.

"I do not think that people are going to be seeking the exaggerated hip-to-waist ratio and oversized buttock that they did in the past," Dr. Devgan says, noting that she's seen an uptick in interest for more "natural," non-invasive procedures, like Sculptra (poly-L-lactic acid), which stimulates collagen to give the butt a perkier shape without surgery.

This shift was met with a new procedure category — the "skinny BBL" or "baby BBL" — and an influx in patients who want their original booties back, explains Thomas Su, M.D., a cosmetic surgeon in Tampa, Florida. Dr. Su adds that he has seen many women regret going supersized initially, or who want to scale back after gaining weight post-surgery during the pandemic.

"Really, in the last two years, we've seen a trend of people wanting less volume as part of a BBL. The emphasis has become on more of a 'more natural look,'" says Steven Williams, M.D., a board-certified plastic and reconstructive surgeon, and vice president of The American Society of Plastic Surgeons (ASPS). He adds that patients have been seeking reshaping to achieve less pronounced, squared off hips or "hip dips."

In theory, BBL "reversal" is as simple as liposuctioning out the fat that had been added in. In practice? "These surgeries can become quite complex and challenging, because any secondary or revision surgery is complicated by scar tissue formation from the initial surgery," Dr. Chatama explains. You can also run the risk of ending up with a behind that looks "deflated, sagging, or unnatural in shape," Dr. Su adds.

Even with the best surgeon in the world (and all the money: a reversal can run anywhere from $5,000 to $30,000, according to the plastic surgeons we spoke to) true reversal is impossible, says Dr. Devgan.

"It's not an accurate term. You cannot reverse a BBL. It's like un-frying an egg," Dr. Devgan says, explaining that no more than 50% of added volume can be sucked back out, so the end result "will still be much larger than preoperative." And then, there's the loose skin to contend with — the reality of overextending any tissue, for example, during pregnancy. To tighten the skin, some surgeons may suggest the addition of energy-based, minimally invasive radio-frequency devices, but for those who want to undo a really exaggerated BBL, this may involve additional surgery to remove the overstretched skin, which can add larger scars, Dr. Devgan explains.

"It's a big surgery to begin with and it's a big surgery to reverse it," says Amy Wechsler, M.D., a New York City-based board-certified dermatologist and psychiatrist, who's dubious of the risk-to-reward at play. "Trying to emulate celebrities is so tricky because we're not seeing any of the real stuff. Wouldn't it be nice if someone had a surgical procedure and revealed the details of what that was like? There's always pain. There's always swelling. There's potential scarring. There's time off work and from exercise and interrupted sleep — all of that stuff is not sexy and glamorous at all — it's real but it doesn't get likes on Instagram." (Side note: When Marc Jacobs went public with his face lift in 2021, it got a lot of likes on Instagram, perhaps proving that keeping it real doesn't always mean keeping it natural.)

Unsurprisingly, all of the plastic surgeons we spoke to attribute the initial BBL explosion to the impact of celebrities and influencers (sometimes secretly) going under the knife, as well as sharing Photoshopped and FaceTuned images on social media with exaggerated proportions that often aren't achievable, even with surgery. But if someone is really altering their body to keep up with social media trends that cycle every few years, going under the knife — as industry leading researchers will tell you — surely isn't going to deliver the answer.

"Cosmetic procedures are elective, not necessary, and the benefits of them are often more psychological than functional," says David Sarwer, Ph.D., Associate Dean for Research in the College of Public Health at Temple University, who has conducted research on the psychological aspects of cosmetic surgery for over 25 years. "Patients should have appropriate motivations for surgery — that they are doing it for themselves, not others — as well as realistic expectations of how the procedures will impact their lives."

Sure, the demise of this unhealthy, unachievable Instagram body standard may be a seemingly positive change. But in reality, it's part of a never-ending cycle of unrealistic body standards, making way for a new unhealthy trend like 'heroin chic' to go viral. Clearly, body parts and types shouldn't be treated as aesthetics like a skinny jean or brow — but we've got a long way to go to break the cycle.

"There should not be such a crazy emphasis on body trends," says Dr. Devgan. "It's not like fashion where pink is in, so you throw away your orange sweater. You can't just get a new body every three years."

For more stories like this, check out EveryBODY In, our celebration — and send-up — of summer bodies, available for digital download now.