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By Thami Kwazi

Lifestyle Print Editor


Here’s everything you need to know about the Brazilian butt lift

The Brazilian butt lift is not a new procedure but it’s the in thing at the moment.


The Brazilian butt lift was pioneered in 1960 by plastic surgeon Ivo Pitanguy. At the time he had established a training centre in Brazil.

His methods were later shared among surgeons from other countries.

Move to the modern day, when a Brazilian butt lift (BBL) is one of the most sought-after procedures due to the likes of celebrities Kim Kardashian, rapper Cardi B and other famous women who have hourglass figures and rotund buttocks. 

On African shores, even though the shape of women is slightly more curvaceous than on other continents, the procedure is a current trend.

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Influencers and celebrities have posted that they are going to Turkey for full-body makeovers.

This can be quite costly, as we have highly qualified local plastic surgeons who can perform the procedure. A BBL can cost R200 000 but is seen as a complete lifestyle makeover and many a patient has gained confidence after curating their shape. 

Dr Letlhogonolo Brian Andrew Monaisa is a plastic and reconstructive surgeon who runs Marang Aesthetics at Netcare Pine Haven in Krugersdorp and is head of plastics at Chris Hani Baragwanath Hospital.

He performs BBL procedures regularly.

Monaisa is always looking for new methods to improve the experience for his patients and often posts on social media what additions and technological improvements are being made in the plastic surgery space. 

An award winner in his field, he previously was a runner-up on Bert Myburgh research day at the University of the Witwatersrand medical school for research conducted in cosmetic breast surgery. 

He also won Best Clinical Paper by a Registrar at the Association of Plastic, Reconstructive and Aesthetic Surgeons of Southern Africa congress for his work in limb reconstruction in 2015.

With his extensive training and constant upgrades to his surgeries, he’s the ideal surgeon to discuss BBL. 

He speaks to The Citizen about the procedure, telling us why it’s becoming so popular in South Africa, and what it involves. 

Brazilian butt lift explained

What is a BBL?

It is a procedure to transfer fat from the tummy, thighs and other areas into the buttocks. The goal is to increase the size and enhance the shape of the buttock area.

The maximum amount of fat that can be removed in one sitting is four litres, which gives about two litres of usable fat.

Why has this surgery become so popular?

I believe the desire to have a nice body has always existed – even if you look at Victorian fashion, you can see those women were trying to imitate the large beautiful African bum.

I think it’s local popularity is due to the expectation that South African women have nice bums.

We are known for this throughout the world, and I imagine that the desire to have a nice bum is especially high if you’re South African.

That said, I don’t believe it’s only about pressure, but also desire on the part of our women. 

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What does the process involve? Does the patient have to gain weight?

We generally don’t advise the patient to gain weight for the BBL.

The reason is that we can always use the client’s fat to enhance the shape.

Also, a BBL is as much about reducing the fat in the waist area as about increasing the size of the bum. The goal is to create a harmonious S-shaped curve and not just larger buttocks.

BBL procedure
Picture: iStock

Patients who aren’t happy with the results of the butt enhancement often decide to have a second round after gaining weight. 

Do you add substances or use the patient’s body fat?

We prefer to use the client’s body fat as this gives a more permanent result than using fillers or collagen stimulators. The result is also more natural. 

Is this surgery life-threatening? It’s said the fatality rate is high?

BBL has always been an extremely safe procedure since its invention in Brazil in the ‘60s.

The problem came when the Americans decided to try and modify it for their clients.

The Americans started injecting fat into the muscles, to try and increase the size of the buttocks even more, and also increase fat survival.

This unfortunately led to them sometimes accidentally injecting fat directly into the large veins in the muscles, causing fatal pulmonary fat embolism. Mortality at one time soared as high as one in 3 500.

Injecting fat into the muscle has been banned, and now the BBL is as safe as it was previously.

We have never seen a single death related to BBL in my practice. 

How long is the healing process? 

The healing process is usually about three weeks. It is essential to stay off the fat for the first three weeks, as pressure can kill it.

After three weeks the fat has usually survived, but we only confirm the final result at three months.

This gives enough time for the skin to shrink, and also for the lipoed area to soften, showing the final result. 

Who isn’t eligible for the procedure?

People who have poor wound healing, auto-immune disease, diabetics, and smokers aren’t eligible. 

Does it come with scarring and where?

The scars are usually about five millimetres or half a centimetre, two around the groin area and one around the belly button on the front, and two small scars either in the armpit or the bra line area, are usually the only scars.

For more information visit www.marangaesthetics.com.

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