The Brazilian Butt Lift occupies an unusual position in elective cosmetic surgery: it carries the highest reported mortality rate of any aesthetic procedure while simultaneously producing high patient satisfaction among survivors. A 2024 retrospective cohort of 3,000 BBL patients (Güzey & Ergan Şahin, Aesthetic Plastic Surgery) reported 86% satisfaction, implying roughly 14% not satisfied. Crucially, no peer-reviewed study has applied a validated decision-regret instrument specifically to BBL patients, so the 14% action-regret estimate is a satisfaction inverse — a proxy with an inherent upward bias on the regret direction, since dissatisfaction and regret are related but distinct constructs.
The mortality data provides essential context for why regret data is structurally incomplete. Before the ASERF Multi-Society Task Force published guidelines in 2018, the estimated BBL mortality rate was approximately 1:3,000 procedures — the highest ever recorded for elective cosmetic surgery, driven by fat embolism when injected material entered the gluteal venous plexus. Following adoption of subcutaneous-only injection techniques, the 2019 follow-up survey reported a rate of approximately 1:14,952. The implication is that any satisfaction or regret figure drawn from survivor cohorts is subject to survivorship bias: patients who died or suffered severe complications cannot report their preferences. Studies conducted almost entirely at accredited facilities by board-certified surgeons further select against the highest-risk surgical settings, where outcomes and potential regret would almost certainly differ.
On the inaction side, no survey exists that directly measures regret among people who considered but did not get a BBL. The same 2018 Ipsos survey reports that 8% of respondents “always feel dissatisfied with how they look,” regardless of setting — the most chronic, cross-situational tier of body dissatisfaction it measures, distinct from the 37% who feel this way specifically in front of a mirror. This entry uses that directly-reported 8% as the inaction-side proxy, on the reasoning that persistent, situation-independent dissatisfaction is a closer analogue to durable regret than transient, situational dissatisfaction — though it remains a general body-dissatisfaction measure, not a rate specific to foregoing this procedure. Both the 8% inaction estimate and the 14% action estimate should be treated as proxy constructs rather than directly measured regret rates. The delta (0.06) and the “balanced” Gilovich pattern label reflect this uncertainty: it is possible that, once properly measured with a validated regret instrument, the pattern would shift in either direction. This entry’s primary purpose is to surface the mortality risk context and the absence of rigorous regret literature for one of the most socially prominent elective procedures of the 2010s and 2020s.