In this July 2026 podcast episode, host JJ Virgin interviews board‑certified plastic surgeon Dr. Rady Rahban about Brazilian butt lifts (BBLs). Dr. Rahban explains the BBL procedure, emphasizing the massive volume of fat required and the aggressive, often 360° liposuction needed to harvest it. He warns that the most common cause of BBL‑related deaths is fat embolism, which occurs when surgeons over‑inject fat—sometimes 800 cc per buttock—forcing the material into muscle and the bloodstream. The conversation also touches on the cultural drivers of large‑butt aesthetics (e.g., Kim Kardashian), the limitations of autologous fat for lean patients, and the emergence of a new product, Allaclay, a cadaver‑derived, DNA‑stripped fat scaffold. Dr. Rahban describes how Allaclay is processed, screened, and delivered in pre‑filled syringes, allowing volume augmentation in patients with insufficient donor fat. He discusses graft survival principles, noting that 50‑75 % of transferred fat typically persists, and stresses conservative, patient‑centered injection techniques to avoid over‑filling and complications.
Chapters
There are plenty of board-certified plastic surgeons that are terrible and should have their license taken away, and there are some non-board-certified non-plastic surgeons that are reasonably decent. But when you look at things, you look at things for trends and probability, and the probability is that if something goes really sideways, it's often— more often, usually— someone who's poorly trained and unscrupulous, which is parallel universe of plastic surgeons who are non-board certified. But unfortunately, you know, just like there's bad pilots and bad cops and bad priests, they're going to be bad plastic surgeons even though they're sort of board certified.
That's why you must do your homework.
Yes.
So BBLs.
Yes.
What are they? And they seem like they're the big risky one.
Yeah.
Are they?
So BBL is Brazilian butt lift, which as the name denotes, originated predominantly out of Brazil because of their aesthetic preferences, which is fuller, rounder, bigger butts. And essentially the idea is a Brazilian butt lift means that we are adding volume fat to your butt, which as it fills it, makes it lifted. Right. So as we put volume in your butt, it— because it swells up, it gets bigger, it quote unquote lifts it. Okay, got it. So the basic principle is we're going to liposuction your body, and it's usually everywhere. That's what they refer to as Lipo 360. I hate all these terms, but we'll use them because that's what you're going to hear. We're going to take all the fat that we took out of your body, put it in canisters, prep it, wash it, clean it, put it in syringes, and put it back in your butt. Okay, sounds pretty good. But so number one is, what could possibly be wrong with taking fat from all over my body? This is like the best surgery I've ever heard in my life. It's a win-win. Negative. In order for you to make any type of appreciable change in your butt— meaning I spent a shit ton of money, I went under anesthesia, yada yada yada, I look at my butt, wow, that's better— you need a lot of volume because a butt, even if you're a tiny person, is a big-ass space. When I want to fill your lips, I need 5 cc's at the most. When I want to fill your butt, I need hundreds of cc's. Even if you're like, no, no, I don't want to be Kim Kardashian— no, no, no, I'm not talking just a tiny change requires a lot of volume. Just like if I throw a penny into an ocean, it disappears. So number one, you need a lot of fat. Okay, I'm following. What's the problem? I got a ton of fat. No, you don't. And so what they do is, whereas if you came in and said, hey, Dr. Iman, could you lipo my arms and my belly and my back? First of all, I almost never do lipo, which is unheard of, because 99% of lipo leaves you loose skin, irregular, dense divots, looks like shit.
I've seen the worst from lipo.
Looks like shit. So I do it incredibly sparing. But if you came into me and you said, hey, Dr. Ivana, I think I have a little bit of stubborn fat here, I work out a lot, JJ, I would be lipoing you with the— your love handle in mind. Meaning I am looking at your love handle and going, that looks good, we're done. But when I'm lipoing you for fat for your butt, I don't give a shit what the donor sites look like. I need as much fat as I can get. So the liposuction done To do BBLs is the most aggressive liposuction you can have, meaning every area we lipo— we, them— they go to the— to 10. They lipo your arms, they take every amount of fat out, your upper back, your lower back, your abdomen, your inner thighs. Okay. And initially everyone's like, wow, this looks great. And then of course, 2 years later, now is the fallout. Loose skin, a bunch of dents, irregularities, etc. So we've now stolen from Paul who's poor, and we gave it to Peter. Now, what's the butt with the butt part? Okay, we inject the fat in there, and if you inject a little bit of fat, you're fine because you're injecting a small amount of fat and the butt can handle it. But where all the deaths occurred— because BBLs are the most deadliest procedure we've ever had in plastic surgery— is they were putting in hundreds, 800, 900 cc's of fat into each buttock And what was that?
What is that in pounds?
I don't know what it is in pounds, but in volume, it's like an entire canister in each butt. So an 800cc implant is the size of, let's say, cantaloupe. Wow. It's a lot of volume. Remember, these people have already their own butts, and usually the people going for the biggest butts already have a big butt, right?
I've seen some of these and they look ridiculous.
Well, you're in Florida, so it's funny. Small butts, women who are fit want small butts. Large butts, people who already have a lot want a lot. At any rate, when they were putting a lot in, they were putting it in, they ran out of space. So they started penetrating into the muscle, and then that's when you got what's called a fat emboli. Most people know about a pulmonary embolus, blood clot shoots outta your leg, goes through your heart and straight into your lung, kills an area in your lungs, you drop dead, okay? Well, now instead of blood traveling and doing that, fat is traveling. And then they did autopsies on these people. They found a bunch of fat in their lungs and their heart. Wow. So BBLs, that's why they're so deadly, because the deaths that were associated with the emboli and also all the damage from removing the fat. But they're still popular.
Are they popular?
They're popular in a subset of the world, meaning there are individuals in whom that is their aesthetic.
And Kim Kardashian, is that butt real?
No, of course it's not real because you don't, you don't need to be a, you don't need to be a rocket scientist. You just follow her. You follow her photos. She's been in the, she's been in the press since she was 20 or 19 with Paris Hilton. So her butt grows. I'm sure it's a combination of things. You can add fat, which I'm sure she had a BBL done. You can then add, um, back in the day it was called Sculptra. Sculptra was this sort of in-between filler. It wasn't the HA like Juvederm, but it was something in between. And it was very expensive. But if you had money, you could use it. And then you could always add a small implant. So those things are all the combination of things, which then takes me to the newest, greatest thing, which I actually think might be another one of these revolutionary things. Have you heard of Alloclay?
No.
Okay, this is perfect.
Is this for butts?
This is for wherever. So listen.
Wow.
Unfortunately, the leaner, fitter, older you get, the more fat you lose, correct?
Yeah.
And in your body—
I mean, I couldn't, I couldn't do lipo to put it in anything because I got nothing for them to get. We tried to even get it for stem cells, correct? Bruise, correct.
So the areas on your body in which you don't want fat, you're loving it. Ripped delts, ripped biceps, flat abdomen.
Awesome.
Breasts need fat. Faces need fat, butts need fat. Not everyone's butt, but a lot of people even don't have the anatomy that even if they do 4,000 donkey kicks or whatever, they're not going to develop the glute mass. So for the thin patients, which is a tremendous part of my practice because I live in LA and I have a lot of fit moms that are yoga, Pilates, da da da da, they had no— I don't do BBLs, but they have no recourse. Well, here comes a new product. So there is now something called Allaclay. It's cadaver fat. It's a donor. When you need a heart transplant, where do you get it from? A donor. And a lung transplant? A donor. Well, now that donor also— they take the abdominal wall. And this company, Tiger, has a proprietary method which works where they remove all the cellular DNA.
Mm-hmm.
All these patients have been screened for every genetic and bacteria and whatever disease, and then they create syringes full of this fat scaffolding, and it comes pre-filled, pre-ready to go. And I now, and I've done many of these cases, I'm able to very eloquently add volume in an otherwise fit, lean person from a syringe that I order. It's been a game changer in that I have such a fit, lean world, and before you couldn't take fat from anywhere.
Well, okay.
Wow. See, I knew it would blow your mind. Look at that. You're like, your wheels are turning.
I remember early on when people were doing fat to face and you had to overfill it a bit. Because some of it would die. Is this the same situation?
So once you take fat out of the body, yours, from a cadaver, from wherever, it's dead. The fat that just came out of you 35 seconds ago is now dead. It's disconnected from you. And then you put it back. And the whole principle behind fat transfer is once it goes in your body, it needs to be put into soil. Just like a seed comes alive because of imbibition, the stuff kind of seeps into it until it gets roots. So fat goes into your butt or your face or your breast, and then the surrounding fat starts to kind of like touch it and hold it and then give it blood supply. The reason people ran in trouble is that a certain percentage of the fat dies, and that fat dies because number one, it's sitting next to dead fat. So you can't just go overfilling it because most of the fat sitting next to a neighbor who's dead— your dead neighbor is not helping you.
And two, zombies.
Yeah. Two, your body starts to absorb it. Like, your metabolic rate is higher than, say, somebody else's metabolic rate. So it is true that in general anytime you transfer a fat, whether it's yours or this cadaver version, a percentage of it will go away.
And do we know how much?
Right now, the— it's been around for a few years in data. It's been around market-wise probably a year. The philosophy is about the same amount, a little, you know, let's say 50 to 75% of it remains. Like any product, there's a learning curve. It's a new product. Whatever it was, Botox was a new product. Juvederm was a new product. I don't overdo anything ever. It doesn't— I never overcorrect anything because I'd much rather you come back and say, oh my God, I'm so happy with that, I wish it was a little more, than what do I do with this now, how do I get it out? That's the case with breast implants, everything for that matter. I just thought it's a very interesting thing because as a fit, lean person, you're not— you're, you're not immune to wanting some volume. And this is the new world revolution, you know, amazing, holy shit kind of
