Miami woman, 32, dies from Brazilian butt lift after surgeon reportedly injected fat into glute muscle

A 32-year-old who visited a Miami surgeon for a Brazilian butt lift died after the doctor allegedly injected fat into her muscle, a potentially fatal surgical error.

The woman - only identified as WA - is the subject of a Florida Department of Health complaint filed against Dr Ernesto Torres, a surgeon practicing at Miami Lakes Plastic Surgery. 

The complaint claims the doctor injected fat into the patient's gluteal muscle - a violation of Florida law - which led to her death in May 2023. 

A Brazilian butt lift (BBL) is an increasingly popular cosmetic procedure that sees surgeons liposuction - remove - fat from the waist and back area and inject it into the buttocks to create a larger and fuller behind. 

However, during or after fat is injected into the butt, small particles can enter the blood vessels and travel to the lungs. If these particles reach the organs, they can obstruct blood flow, impair oxygen levels and patients can develop respiratory failure leading to death.

The unnamed woman is the subject of a Florida Department of Health complaint filed against Dr Ernesto Torres, a surgeon practicing at Miami Lakes Plastic Surgery

While this is the first complaint lodged against Dr Torres, there is a pending complaint from 2022 accusing Miami Lakes Plastic Surgery of several violations, including removing too much fat during a liposuction procedure.  

WA was under the care of Dr Torres for liposuction of the back and waist with fat grafting to the buttocks for a BBL - which typically costs between $8,000 and $10,000. 

The Florida complaint alleges during the procedure on May 26, 2023, Dr Torres injected fat into the gluteal muscle and the patient's heart began beating rapidly and her blood pressure plummeted. Clinic staff called 911 and began CPR on the patient. 

However, WA suffered cardiac arrest and died. 

An autopsy on May 28 'identified the cause of death as bilateral pulmonary fat emboli,' small round particles that block blood vessels. Bilateral indicates the emboli were in both of the woman's lungs.   

The autopsy report said there was fat within the gluteal muscles and surrounding the sciatic nerves - the largest nerves in the body that run from the lower back through the buttocks and down each leg to the foot. 

This, the report continued, 'ultimately resulted in bilateral pulmonary fat emboli.'

Florida Administrative Code states when performing a BBL, fat may only be injected subcutaneously - just under the skin - and 'must never cross the gluteal fascia,' a dense layer of tissue that surrounds and supports the butt's muscles.

The law also states intramuscular fat injections [directly into the muscle] or submuscular fat injections [underneath the muscle] 'are prohibited' and the complaint states Dr Torres 'violated' this law 'in his treatment of patient WA.'

If fat particles are injected into gluteal muscles they can enter the blood stream and travel to the lungs where they form pulmonary fat emboli. 

This can lead to decreased blood flow to parts of the lungs and impair oxygen in the lungs, which reduces the amount of oxygen that is circulated in the body.

The Florida complaint said the 32-year-old woman was undergoing a Brazilian butt lift at Miami Lakes Plastic Surgery

While this is the first complaint lodged against Dr Torres, there is a pending complaint from 2022 accusing Miami Lakes Plastic Surgery of several violations, including removing too much fat during a liposuction procedure

With insufficient oxygen circulating, patients can have trouble breathing and eventually go into respiratory distress if the lungs become so oxygen deprived they are unable to provide life-sustaining levels to the body.

Pulmonary fat emboli may also cause heart failure, organ failure and severe inflammation in the lungs.

It is vital the condition be caught early and treated quickly, but it may not be recognized because signs and symptoms can be subtle. They can include a skin rash and bruises, headaches, confusion and either slow or rapid breathing. 

Treatment consists of steroids, blood thinning medications, supplemental oxygen, ventilation or several procedures that can directly address the emboli in the body. 

The condition usually occurs following a break of a major bone and affects between 0.5 and 10 percent of cases depending on the cause. 

While the administrative complaint against Dr Torres begins the disciplinary process, it could take years before any decision made. 

The complaint recommends several punishments, including the permanent revocation or suspension of Dr Torres' medical license, restricting his practice and imposing a fine. 

The rise in BBLs is thought to be driven by social media, celebrities and the 'Kardashian effect.'

A record 28,600 women in the US had a cosmetic procedure to enhance their backsides in 2022, figures show, up 54 percent in five years.

While a fat embolism is the most worrisome risk of a BBL, other complications include tissue death and fluid retention — where fluids build up in certain areas and need further surgery to be removed.

And officials are warning of deadly complications after a rise in people traveling to other countries to get the procedure done at a fraction of the cost. 

Earlier this year, the CDC said 93 Americans have died after having BBLs done in the Dominican Republic since 2008.