Dr. Miami Starts Association to Defend Brazilian Butt Lifts

Dr. Michael Salzhauer, AKA Dr. Miami, is best known for wacky antics like writing a children's book about plastic surgery, live-streaming operations on Snapchat, and recording a surprisingly successful dance song called "Flawless."

But now the Bal Harbour plastic surgeon is taking on a new role as an advocate for physician education and patient safety. The challenge: He's defending the Brazilian butt lift, a procedure that sucks fat out of one part of the body and injects into the buttocks. The so-called BBL was cited in 32 deaths worldwide in a recent survey and dubbed "the deadliest of plastic surgeries."

Salzhauer announced this month that he's starting an organization named the World Association of Gluteal Surgeons, or WAGS. The group of nearly 100 surgeons, complete with a purple logo of a woman with a buxom behind, will press for safe performance of the procedure. 

"I just feel like the word is not getting out quickly enough to enough surgeons and enough patients," Salzhauer tells New Times. "I felt there was a need for surgeons to act independently."

Thanks in part to "belfies" from the likes of Kim Kardashian and Nicki Minaj, butt-enhancing surgeries have exploded in popularity in recent years. But as Brazilian butt lifts have become more common, the risks have become more apparent.

According to the American Society of Plastic Surgeons, the mortality rate could be as high as one in 3,000 — far higher than any other cosmetic surgery. In Miami, a plastic surgery capital, there have been multiple high-profile cases of butt lifts gone horribly wrong.

One doctor, Osakatukei Omulepu, was ordered to stop performing the procedure after injuring four patients in three days.

In another case, a mother of five's blood pressure and oxygen level plummeted five minutes after her surgery ended at a Miami-area clinic overseen by a doctor named Ismael Labrador. She died hours later at the hospital. A recent USA Today investigation found a clinic and facility also overseen by Labrador had seen eight women die within six years, four after undergoing Brazilian butt lifts.

The deaths have been attributed to fat being injected into muscle, where it can enter the bloodstream and then pool in a patient's heart or lungs in a deadly blockage called an embolism. In response to the high fatality rate, the American Society of Plastic Surgeons and other professional groups in 2017 issued an urgent warning to Brazilian butt lift surgeons, directing them never to inject fat into muscle. Instead, the warning said, it should go into the subcutaneous tissue.

Salzhauer, who says as "crazy" as his persona may be, he's a "very, very cautious surgeon," is concerned the message isn't reaching enough surgeons and patients. He says his group will try to educate the public and physicians and ultimately may offer a training component.

Although the plastic surgeons society said it can be easy for a needle to accidentally enter muscle during subcutaneous injection, Salzhauer insists adequate training and experience can prevent that. Because the procedure has become so hugely popular, some doctors may be getting into it without being fully prepared.

"The demand is huge," Salzhauer says. "What we're trying to do with WAGS is increase the supply of surgeons that are trained and educated properly to do it to meet demand before more people die needlessly."