Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Brazilian Butt Lift

Episode Date: October 15, 2024

Some cosmetic surgeries include adding silicon or plastic to enhance the figure. But what if the extra fat came from your own body? Dr. Sydnee and Justin talk about the fraught and history of the Brazilian Butt Lift, or BBL, which is a story of eugenics, bad medicine, and unrealistic beauty standards. Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. Alright, this one is about some books. One, two, one, two, three, four.

Two, three, we came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert.

We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert.

We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. Hello everybody and welcome to Sawbones, a marital tour of misguided medicine. I'm your co-host, Justin McElroy. And I'm Sydney McElroy. And I am so excited to get started, Sydney. I'm going to take my glasses off and enlarge my document, because even though I'm sitting ... How far would you say I'm sitting from it?

From here to here. Let's see, I tried two feet. Two feet, it is blurry. Hold on. What's going on with you, kid? What's going on, Sidster? Well, I mean, generally speaking, I have 2400 vision.

Yes, but why are your glasses not getting the job done? This seems like what they were made for. No, it's because I was making you a harvest stew, and I had to chop Shallots as part of my harvest stew and I I don't know. I feel like I'm more sensitive man I hate saying oh, never mind. I just the onions got me. I don't like saying I'm more sensitive to onion I'm more sensitive. No, I just they just really got me. No, I just really got me and it's like clinging to the inside I don't know. There there really got me. And it's like clinging to the inside. I don't know, there are fellow glasses wearer out there

who know exactly what I'm talking about right now. Where you're wearing glasses while you're chopping an onion and it feels like it clings to the inside of the lenses. And so you have to take them off and clean them or else they're just like permanently onioned. That's the adjective. Sid, tell me when I finished up that job for you, I didn't seem to have any problems with it.

I don't think it's a sensitivity issue. Why didn't I have any problems? You wore goggles. You wore pool goggles. Pool goggles. Now, did I go all the way to the pool to get those pool goggles, Sidney? No, we keep some goggles in the kitchen.

We do for what purpose? For chopping onions. Okay, so what happened? I was just vibing. I was like, I'm going out of town for one night and Justin is going to be here alone with the children for one night. And so I was making him what he calls my Harvest Stew,

which is a, it's just everything that's fresh from my garden with some beans and then I put it, I make it saucy. It doesn't matter. The point is I was making that while I was watching the children building a Halloween themed, haunted gingerbread house kind of thing. It's all lives. And we were listening to the Buffy musical episode

soundtrack and they really liked it and it was just like, I was just feeling really good and I just didn't get the goggles, so it doesn't matter. Okay, yes, the harvest stew, and I'm sorry but you're recovering, you're doing okay. Yeah, no, the harvests do. And I'm sorry, but you're recovering. You're doing okay. Yeah, no, I'm okay now. I'm okay now.

That's the only thing I've ever found that works, folks. We've tried the gum, we've tried everything, but the only thing we've ever found that works is just some swim goggles. You keep them by the sink. Use them to chop your onions. And I cry a lot. And sometimes you just want that. Tears naturally clean out your eye.

Anyway, we mentioned on a previous, a recent episode, I think it was our medical questions episode, we talked about fat necrosis. And we mentioned BBLs, Brazilian butt lifts, in passing. I mentioned it. Do you remember this? Yes, not as it's sometimes used on the internet, big beautiful ladies.

That was- That's not what I mean. I know, I was just, the parlance of BBW or BBL was a popular internet parlance and I wanted to clarify the terminology. I am talking about the surgical procedure known as a Brazilian butt lift, BBL. So when I say BBL in this episode, that's what I mean.

All right. We got an email from Madison, thank you Madison, surgical procedure known as a Brazilian butt lift, BBL. So when I say BBL in this episode, that's what I mean. We got an email from Madison, thank you Madison, suggesting that we talk about the history of the BBL. I assume it is because we mentioned it in the episode. I don't know. It may have just been one of those moments where the universe coincidence, Pluto has left Capricorn.

It is time. I'm entering my villain era as a cardinal sign as an Aries. If you know, you know. You're entering your villain era. Bad news for me, I guess. No, all it really means is I'm setting boundaries and I'm going to start self-actualizing and being concerned with what I need and want as well.

Not instead of, just also. I'm not putting myself on the top of the list. I'm just adding myself to the list. Just so. Let me know how I can help in this endeavor. As always, I stand ready. Well, right now you can listen to the history of the BBL. Hey, listen, that's a low bar to clear

and I will do it handily. So to be fair, I have never been in an OR where I have witnessed a Brazilian butt lift. I have not participated in any really cosmetic procedures in my medical training. And of course I'm a family doctor, so I wouldn't now, but even, I was in the OR for a lot of surgeries that I would never do and had a lot of experiences

that wouldn't be part of my career. But never. This was not one of them. And I think it's important when we talk about cosmetic procedures and medicine and aesthetics that we remember a couple things. I feel like it's important to preface with this. The procedures that are being done by plastic surgeons and then other estheticians, people who are involved in sort of that intersection

between where like a medical need and an aesthetic desire, need, want, I don't know. I think this is philosophical at this point. Can I ask you a quick question before you, is plastic surgery still a term that's in use or is that like, majority of? Yeah, we still say plastics. Yeah, no, we definitely say plastics.

I'm doing a residency, a fellowship, whatever. I'm studying plastics, yeah. But our definition of what we might seek changes place to place, time to time in history, right? So the sorts of things people sought out for cosmetic purposes, 100 years ago are different than now, and will, I assume, be different 100 years from now.

So I think it's really important to mention that because all the things that go into influencing someone to seek out a cosmetic procedure, some of those are positive, perhaps, things, and then some of them might be negative things. And so when we talk about the history of cosmetic procedures, you have to start talking about things like racism and eugenics and those sorts of topics.

And I feel like it's important to preface with that because when you hear that we're gonna talk about a butt lift procedure, it sounds, I think a lot of people wanna joke about it. And I'm not saying that there's not room for humor with the BBL, but I'm saying it's nuanced. You're saying this to me, you know you're looking at me while you're saying people. Yes, this is why I'm saying this.

You can't some people, your co-host, like it's just you and me here. Well, I guess this is also a warning to listeners. Like I'm not just talking about like, isn't this goofy what we do to butts? It's, it is more complex than that, and it intersects with a lot of things that are truly terrifying and horrific about humanity.

As well. You're saying you're basically just kind of giving me a heads up at the beginning that if I at any point during this episode find butts funny, I am racist. Is this what you're saying? No, that is not what I'm saying. I think we can all find butts funny. Okay.

We all, don't we? Don't we all? Isn't that universal? Doesn't that unite us that on some level, we all kind of think butts are funny? I still think it's legal. Whatever we like about butts or don't like about butts, I think we all agree they're kind of funny.

Like butts are funny. Like at the top of our legs, there's this extra tissue. And it's put there so we can fall on it, which is great and sit on it and not be in pain. Anyway, and if you, I am not gonna debate any ethics of plastic surgery. I think that there are a lot of strong feelings people have

about should you pursue a surgery that is purely for a cosmetic benefit? I think that that is a very personal decision and we all have our own opinions and we can keep them to ourselves. And I will not be talking about whether or not you should get a BBL. Just what is it?

Opinions are like buttholes. Okay. The thing that makes this surgery, a BBL, different and special from a lot of other cosmetic procedures, especially when it comes to previous butt-focused procedures, is a lot of them might be implant-based, and this one is exactly the lack of that.

When you talk to other doctors, do you find yourself saying butt most of all the butt words? Okay, because I'm going through my head. Yeah, we just say but, I mean, I don't say. I say but, right, like, because you can't use the swear. That's not a professional thing. And I mean, I know that. You can't say hinder, for sure.

We don't say behind. Rear. Bottom, rear. The bottom, honey, if you said bottom, I would call security. And you just squirted out. Gluteus just feels, it feels like you're intentionally, I would call security. You had to scorn it out. Gluteus just feels, it feels like you're intentionally trying not to say butt at that point.

Yeah, it's like overly technical, like an alien that's afraid of butts. And you're not supposed to cuss at work, so you don't use the A word. Yeah. Yeah. So the implant, so to speak, in a BBL is your own fat. This is, a BBL is an autologous fat transfer, which means we're taking fat from one place in your body

and we're putting it into another place in your body. That's what makes this procedure special when it, that's why it is kind of risen above other butt-focused cosmetic procedures. It's less of an implant, more of a gym plant. And I'm assuming, by the way, that your name is Jim for the joke twerk. Right, and if you are Jim and you got a BBL,

it would be a Jim plan. If your name is not Jim, it would, that has nothing to do with this. So basically when you go in for BBL, they're gonna liposuction, so remove, liposuction I think we're mostly familiar with, removing fat tissue. And you can do that on its own

and then they just dispose of it. And then I guess if you're in Fight Club, you're gonna collect that and make soap out of it. So there's a use for that. But we're gonna lipo section. American movie classics. For all you youngins out there, that's a, people our age know, we know, we were all, listen.

They were legally required to see Fight Club, everybody was. And you as a man watching Fight Club had a moment where you're like, is this it? And then you grew up and were like, I'm gonna go to the fight club tomorrow. Listen. I was legally required to see fight club. Everybody was. And you, as a man watching fight club, had a moment where you're like, is this it? And then you grew up and realized like, oh, it's satire. No, we made food club, where it was exactly like fight club,

but we would just go to a buffet and see who could put away the most pizza hut or what have you. Well, and not exactly like food club because you just talked about it. So we're like fight club. Ooh, good point. So they're going to liposuction fat tissue

from another part of your body, usually the thighs or the stomach. And then they're going to inject it back into specific places in your buttocks. Buttocks, I think buttocks, that's an acceptable term if you don't wanna say butt. Hey, who are you trying to convince then? And they're trying to give you lift, probably volume.

Like generally the idea of the BBL is that you want a larger buttock, you want a rounder behind. Hey Sid, you trying to describe a big beautiful bottom on this program is really slowing things down. We all know, we don't have to get in the weeds in this. We all know what the goal of the BBL is. This is special and different

because you don't have to deal with implants, which I mean, and that's not to say that everyone who's ever had an implant, because there are lots of, like you can get breast implants, obviously, I think we're most familiar with those, breast augmentation, you can get calf implants, you can get, I mean, you can get implants lots of places.

So I don't think, obviously most people who get implants have no problems, but there are specific concerns with implants and this avoids those because it's your own tissue. Okay, can I say with my understanding of the human body, it feels weird to me that this works because in my head, if tissue got moved around like this, that it would not be a long lasting thing. You know what I mean? In my head, if tissue got like moved around like this,

that it would not be a long lasting thing. You know what I mean? It just feels like everything would kind of redistribute. It depends on where you're putting it. And this was part of perfecting, like they had tried different cosmetic procedures on the buttocks before, and you have to know what planes of tissue to insert things between in order for it to stay.

Now this is a concern, not just- It would have been rough to be one of the guinea pigs on that particular learning journey. Well, that's still happening. We'll get to that. That's still happening. I don't wanna get in the leads here. But let me say, what you're talking about is,

and if you watch TikTok, you know what I'm saying, there is a ton of discourse about this right now when it comes to filler in the face. And I don't mean your own filler. I mean, getting some sort of synthetic compound injected into different areas of your face in order to reshape your face. There's a ton of concern now

that that stuff doesn't dissolve like we thought it would or resorb. And it also doesn't just sit there, it can move, it can migrate and also it can absorb water and expand over time. So there's a lot we, I think we're still learning about, we know what this cosmetic procedure looks like if done appropriately in a year, in five years,

in 10 years, I think we're starting to hit the limits of what, you know what I mean? So I mean, there is discourse about that. What happens long-term? Now there have been a lot of implant-based cosmetic procedures that accentuate different areas of the body, if that's what you're trying to do, for a long time.

We have been doing breast augmentation since the 1800s, which blows my mind. And that will be, as I read this, I thought I'm not gonna get into it because this is an entire episode of Sawbones all on its own. The stuff we tried to do to boobs in the beginning, well, it won't shock you if you are a-

Sawbones listener, yeah. If you're a Sawbones listener, it won't shock you. We started using silicone back in the 60s for breast implants. And so it was only natural that after that and some success was, and obviously there are other things we do now, but in addition to silicone as well,

but we started to wonder, couldn't we put implants other places? Now, why then, why would buttocks be the next frontier? Are you asking me? I mean, I could explain it to you, I guess. I mean, I guess it goes back to like art and stuff. Well, I mean, that's what I'm getting at.

Rubenesque, I know is a word people say when they're being classy and talking about boobs and butts. So perhaps Rubenesque would apply here. I think that's part of this story that is really interesting is why butts? Now, I mean, and I mean, you know, maybe this is, and this is me talking from my own cultural bias,

for me, breasts seemed more obvious. If you see someone with large breasts and you're talking from a purely biological perspective. If we are, if we are imagining that we are driven to be, you know, excited by and attracted to someone who can help us further the human species. So reproduction, if you, if you look at, you know, any sort of sexual interaction that could result in offspring as that being the primary driver of that interaction,

which I'm not saying it is, I don't believe that personally, but if you look at it that way, then someone with a, we talk about that golden ratio of waist to hips, someone with larger hips and someone with larger breasts would be an ideal partner for bearing children. And so I think from a biological perspective,

are we more attracted to, is it our mammalian-ness? Bigger breasts can feed more babies, a larger behind and larger hips can- Can poop more babies out from the larger butt. No, not like that. Technically speaking. So is it about biology, but I don't, I mean, obviously that simplifies it, right?

Because we are thinking sentient creatures and we are not purely driven by these instincts of, you know, reproduction. You also have to consider what movie is the person like. There's also a lot, well, there's also a lot of attraction that does not result in any, like the coupling would not result in any offspring.

I thought you said there's also a law of attraction. I was like, whoa, okay, Siddy, let's do it. But clearly they're still drawn to each other. So I think if you wanna talk about the BBL specifically, you have to get into the history of Brazil, especially prior to its invention, like what led to the sort of culture where someone would say, I need this surgery.

So slavery was abolished in Brazil in 1888, about 20-ish years after slavery was abolished in this country. And in a lot of colonized parts of the world, even though the lighter skinned Portuguese descendants in Brazil were outnumbered by the darker skinned African descendants, the people of Portuguese descent were in the positions of power and wealth and in control of society. And you see that in a lot of places that have been colonized, right?

The number of people shifts in the direction of the oppressed but the power and money is in the direction of the oppressors, right? And at the same time, as we're moving into the early 1900s, you see this interest in race as a scientific pursuit. Can we perfect the human race? By breeding us in certain ways. And this is eugenics.

So eugenics is an area of interest for scientists all over the world. And white people who had oppressed black people and brown people and other people of color all over the world for years through slavery were looking for other tools of oppression. And this is, I mean, this is all sort of coalescing at the same time.

And these alternate roots of oppression can look like segregation, economic policies. I mean, we could go on and on about that in the US, right? We have lots, hopefully we are learning the history of that. But some of it is in the guise of science and eugenicists believe that white traits were more desirable than black traits

and that the mixing of different races was dangerous to the quote unquote purity of the white race, right? We have done, by the way, several episodes about eugenics in previous solvents. There's a lot of history there to unpack. Can I tell you, if you are someone who is interested in the history of science or medical science specifically, it is something you need to accept right now.

As you research medical history, a lot of the people you may have known their names or admired them or been taught to idolize them for their contributions to medical science, a lot of them dabbled in or fully embraced eugenics. And it is really hard as you start unpacking that history to realize how many people were drawn to this completely made up and racist and misogynist and you know just horrible way of thinking that is unscientific ultimately. So there were a lot of people who were concerned about whiteness as a concept being erased

as different people from different races produce more offspring. And their idea was that we would be erasing these more civilized and culture traits that they associated with whiteness, right? And so that's, again, this is all based on racism. So how do you prevent that? Well, the initial thought was, and this is true, right? It was true in the US, you just ban it. Don't let people of different races marry.

Don't let them have children. We'll just make it illegal. And then we can demonize people of different races marry, don't let them have children, we'll just make it illegal. And then we can demonize people of the race that we, the ruling class, do not feel is desirable. This wasn't very successful, there are a lot of reasons that we could get into. And I think the most stark reason is that the evolution of that, what you ultimately see

is what happened under Hitler and the Nazis. And a lot of people were put off of that, what you ultimately see is what happened under Hitler and the Nazis. And a lot of people were put off by that, even though they were thinking in that same line of these are the people who should reproduce and these shouldn't, this was a step too far. So instead, some scientists and politicians and thinkers began to advocate for the idea of race mixing as a way of diluting out the traits that we don't like

and perhaps creating a melting pot of a new national identity. And this is what you start to see in Brazil. The idea that we are going to sort of capture the ultimate picture of femininity and beauty by combining the best features of different, like this multiracial culture that we have here. And then you see the rise of the Brazilian beauty.

Light skinned, full figured, a tiny waist, but large breasts and a full round butt. And before we go to the billing department, we're about to go. Okay. Just for a second, I think that if you are, I mean, I'm 41 years old, I was raised in the United States.

Did you have this cultural perception when you were younger, if you're about my age and raised in this country, that Brazil is where the most beautiful people on earth live? Yes, and yes. Think about that for a second. 100%. And let's go to the billing department people on Earth live. Yes, and yes. Think about that for a second. 100%. And let's go to the billing department. Let's go.

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what we're talking about. Listen to Maxim to maximum film on maximum fun or wherever you listen to podcasts So Sydney So I found this this was a stark realization for me. Yes I it's one of those unexamined biases that when you take it out, you're like, whoa, I'm ignorant I don't know anything about this. It really shocked me that I had always, I remember thinking that and I remember thinking also, and again, this is something that I think it's important as we get, especially those of us who are white, to unpack these sorts of ingrained beliefs that aren't necessarily negative. Like, in what way would it seem negative for me to say Brazil produces the

most beautiful people on earth? Why is that an insult? Well, because in my head, I'm seeing one image of what someone from Brazil looks like. And obviously people from Brazil can look myriad different ways, just like people from the US. So making one the beauty and culture ideal then makes everyone who doesn't meet that beauty and culture ideal less than.

You're also making a, like an entire, you're reducing a nation to a silhouette basically. Exactly, and while I am talking about this happening in Brazil because we are talking about this specific surgery that is developed in Brazil as we're about to talk about and is called the Brazilian butt lift This happens in every place on earth, right? Not just every country if you look across the us you see different like

Perfect standards of beauty from region to region So this is not I am in no way suggesting that brazil is unique in this particular form of sort of I don't know, oppression. We all engage in this. The idea that there is a one way that is best to look. We all engage in this thinking. So we know that no matter what color your skin is, you may not necessarily have the figure that I just described, this sort of hourglass shape, right? And the plastic surgery industry in Brazil was ready and willing to meet that need. So if you were a Brazilian woman

who did not meet that perfect cultural sort of epitome of this is what we look like, this is what Brazil is giving to the world, the most beautiful woman that could exist. If you don't look like that, we can fix it. We can make you look like that. Which again, happens in every country. So Dr. Ivo Pittenguy is widely known

as the father of the BBL. So he started back in the 60s with just a butt lift. The idea was that over time, if because of changes in your body shape or figure, or just aging, your butt starts to sag, you could remove some skin and tissue and make it look firmer, right? Sure.

Okay, I mean, we do that, right? We do, it's tummy tuck, but for the butt, same idea. But no volume is added in that procedure. You're not making the butt bigger. It's not juicier. No, it's just firmer, just tighter. In the late 60s and 70s, the same sort of silicone implants that we were seeing in breasts

started to be placed elsewhere. And there were people who started to request, you know, maybe that would actually look kind of good in my butt because my butt's kind of flat. I just had this thought though, Sid, with the chest implants, they're just sort of hanging there, I get it. Mm-hmm. If you get a butt implant...

Yes? You're gonna feel it every time you sit down. Mm-hmm. That's wild! Yes. I've never thought about this. Mm-hmm. That's wild. You're gonna feel it every time you're sitting.

Is it gonna feel like you're sitting? How do they dial in the exact squishiness that I crave? Is it adjustable? Now that would be a product. That would be a product. Or you could just, like the Nike, like the old Jordans that you could pump. Like the Reebok pumps.

Yeah, Reebok pumps. Jordans that you could pump. Like the Reebok pumps. Yeah, the Reebok pumps. Were they Reebok? Yeah, the ones that you could pump. Oh, stadium seating, I'm gonna need a few extra pumps of pressure. I feel like this was an SNL sketch, actually, as you're saying. No, it is a billion dollar idea, Sharla. So, Dr. Pitengi came from a wealthy, supportive family,

the valued education. He studied medicine in Brazil. He had a very illustrious educational background. He studied at esteemed institutions in the US, in France, in the UK. He came back to Brazil in the 50s as a top plastic surgeon. And I will say initially,

because there's the whole range of plastic surgery. Plastic surgery, I think, gets pigeonholed into cosmetic procedures. And it does, certainly, there are many who do that. But there are also plastic surgeons who do a lot of reconstructive surgery. And so initially he was kind of known for doing like reconstructive procedures on people who had suffered

some sort of trauma or burn or injury or something, right? Yeah, incredible. And he made it- Incredible field. Truly incredible field. It really is. I mean, and what he really, so he was part of this, there was this moment in his life that really pushed him in this direction.

There was a large fire that occurred in a circus tent in a nearby Brazilian town. And he helped with the reconstruction. There were like 500 people in there. And there were a lot of people who perished, but there were also a lot of people who were just burned badly. And he helped with the reconstructive procedures

on many, many of these burn victims. And it led him to really believe that aesthetics matter. They matter to our quality of life, to our ability to live rich, full, happy lives. It is not just you wanna be pretty. It matters. Right. And it's not simply vanity.

It's embodying how you want to be in the world. Yes. And so he wanted to make this sort of surgery, this sort of reconstruction available to everybody, especially people who had undergone some sort of trauma. He wanted it to be, you know, not so unaffordable that you wouldn't be able to access this as well. And so he was a surgical expert and he was a philanthropist.

I mean, he did a lot of pro bono surgery. He did a lot of work trying to make these sorts of procedures accessible to the masses. And I- So he's Bono's guy too? Wow. No. So he did both.

He did reconstructive and then procedures that were more just elective. Not Humbano. I have no evidence that he did surgery on Bono. I'm not saying that. Stop insisting he's pro Bono, Sydney. And at the same time that people are doing the implants everywhere and then we're also seeing like liposuction

and body sculpting become part of like, let's just take fat out and reshape your body. At the same time that all this is becoming popularized, especially as we get into like the 1990s, it occurs to him that maybe we could take fat out of these other places instead of just getting rid of it, giving it to Brad Pitt, maybe we could, he was in Fight Club for those and he could own it.

Thank you for giving me this fat man, I really appreciate it. And. With these two good youths. And Edward Norton, honestly it was really just Edward Norton, right, because Brad Pitt didn't, anyway. Whoa, Sydney, calm down, okay? We just talked earlier about how nobody's seen

this flicky reference, you're not gonna go rosebud it for everybody, right? What do you mean nobody has seen Fight Club? I'm just saying if we broke down the reference earlier, we're assuming some people haven't seen it, so let's not spoil the film. So he started popularizing, hey, we're taking this fat out of other places.

Why don't we go ahead and inject it into these areas of the butt? We can make the butt bigger, rounder, this more desirable shape that people are seeking. And it's kind of a two for one, because you're also having- You can do both cheeks, obviously. Well, yeah, both cheeks.

But also you're having fat extracted from places that maybe you didn't want it. So maybe you don't like the size of your thighs, or you don't like the size of your stomach, you want some fat taken out of there, and then you can put it into your butt. And so- Do they do muscle? Like if, and then you can put it into your butt. And so if you- Do they do muscle?

Like if I start tearing- No, it's not muscle. I keep tearing the sleeves of my shirts, and I thought maybe they took some of the muscle out of my arms and can move it to my butt. And then you want a really thick butt muscle? Just more, just evenly distributed. Just a muscle-y butt.

My arms are so big. Just a muscle-y butt. Okay. A butt that can lift weights. Don't, just move on. Okay, the point is that if you look at before and after pictures of BBL- There better not be a point, I paid a lot for this butt.

You're gonna see, you're gonna see a difference. If you're getting butt implants, you will see someone with this size butt and then the after picture will look like a bigger butt, right, like obviously. Presumable. But if you get a BBL, you will see a difference in their entire figure, right? It's a butt reborn.

Well, it's not just the butt. If you look at the before and after, their entire shape looks different. And it's because you've removed fat from other places. And so this is what really got people excited is, I am looking at this procedure and maybe I'm a lay person, I know nothing about medicine, I know nothing about surgery, but what I can see is that that after is more desirable

to me than the after of just a butt implant, right? And so people sought that out. And I think it's interesting because Dr. Pitengue got to carry the Olympic torch for Brazil in 2016. Like he is a revered figure in Brazil. And a lot of what he did were revolutionized reconstructive plastic surgery techniques. I mean, he was really, he was a genius in his field.

And I think a lot of people are going to remember him as the father of the BBL, which is fine. Again, this is no shade on the BBL, but there are other things that he contributed to medicine that I would bet if you asked him, he would like to be remembered for all of these contributions and not simply the BBL. So as this procedure took off and especially as you move into the 2000s you see more and more people desiring this shape, right? They want the big butt and when we get to the year 2014 this is

now known especially in like plastic surgery circles as the year of the rear, which I didn't know that. And then you start to talk about the celebrities that we know for their butts, right? We know JLo about, I mean, well, we know a lot about JLo nowadays. Like, I feel like this is a whole new era for JLo. But like we talk about the size of her butt

and with Nicki Minaj and Cardi B and of course, Kim Kardashian who, and all the Kardashians, but Kim specifically who was so accused of having a fake butt basically that you did something to augment the size of your butt, that she had an x-ray done of her butt on her reality show to prove that she didn't have implants, which she did not, but if you got a BBL, it wouldn't show up because it's her own fat.

So who knows? I have no idea. I don't know if Kim Kardashian got a BBL or not, and honestly, I can't say that I care. The problem with all this is a couple things. One, we're setting beauty standards and a feminine ideal that really doesn't exist. For the most part, the kind of shapes that some people are achieving with a BBL are extremely rare in nature. And especially if we're associating this,

which a lot of it gets associated with the shape that black women are supposed to have. And obviously not every black woman has that shape either. And then a lot of black women are still suffering from discrimination because of their skin color and sexualization of that kind of prototypical black woman shape. And so they're not necessarily benefiting from this like idolization of that specific body form. Do you know what I mean?

Like you would think like, well, everybody wants your shape. So obviously life must be great for you. And we know that that is not the reality of existing as a black person in this country or most countries. And then the other problem with this is that a lot of people who are doing these surgeries don't know how to do surgery. Oh, well that is a problem, Sydney.

So in this country, we have a for-profit medical system. We also, this is interesting, I am a family doctor. I was never trained in liposuction. However, my medical license, if I were able to purchase a facility with an operating room and liposuction equipment, if I were able to do that on my own, my medical license allows me to do liposuction. It does not put any limitation on what I'm allowed to do. Now, certainly if I tried to do it at a local hospital, they wouldn't grant me privileges.

Right, but you could have your own set up. If you can set up your own, you can do it. And so we do see people who are pediatricians or podiatrists or family doctors, people with general surgery background who don't know plastic surgery, lots of different types of physicians who are doing these techniques

because they are extremely lucrative and who do not have training in this area of medicine. And that is completely legal. Yikes! That's scary. They're cashing in on people's general ignorance of how the medical licensing system works and their desperation

for a good deal. So you'll find places where they're charging you, they're like, well, 4,000 bucks, you can have a BBL. That is not a $4,000 surgery in this country. That doesn't even cover operating room and anesthesia and all the other things that go into it. So somewhere corners are being cut and you should be scared. And the result of all this, this fervor to get this shape, and all of these predatory individuals

who are doing these surgeries on the cheap without really having the appropriate training and sterilization techniques and all that goes into it, at one point in 2019, the mortality rate from these surgeries was one in 3,000. That's an outpatient elective procedure. One in 3,000 people were dying. This isn't-

That's high. Yes, that is a high, it's a wildly high number. It's higher than breast augmentation, it's higher than appendectomies. If you start to dig into liposuction numbers, they're actually a little scarier than you'd wanna think about, but it's for the same reasons. It's because you have people who are doing surgeries who don't know what they're doing, and they're trying to little scarier than you'd want to think about, but it's for the same reasons. It's because you have people who are doing surgeries

who don't know what they're doing, and they're trying to do them quick and cheap and make as much money as they can. At one point, it was kind of called, and again, this wasn't a literal, this is not literal, this isn't true, but colloquially, it was the most deadly surgery you could have done.

Now it is not, but the point is, if you don't know what you're doing, you can accidentally take fat that you have removed from the stomach or thighs and inject it into some of the larger blood vessels in our buttocks, and that causes something called a fat embolism, which means a little ball of fat goes through a blood vessel and can lodge anywhere in your body

and can absolutely be fatal, often is, and so can kill you. In addition, obviously you can have infection, you can have the fat necrosis that we talked about before, you can have a poor cosmetic result. So, you know, best case scenario, it just doesn't look the way you want it to, worst case scenario, somebody who doesn't know

what they're doing could absolutely kill you during this procedure. And this is true even with somebody who has been trained in liposuction, they haven't necessarily been trained in then re-injecting that fat into the buttocks. These are two different procedures. So just because somebody knows how to do liposuction, doesn't mean they know how to do a BBL,

but there are people who are out there doing it. The recovery is really rough, which a lot of people don't know. It depends on exactly like how you came into it, but generally speaking, you have to wear some sort of corset afterwards to keep all the fat in place so that it sort of like binds to the fat

that's already there. And kind of what you're worried about, Justin, you said like fat moving around. For about three months, you have to sleep face down for six weeks. You have to sit on a special pillow all the time. You need- I already do the sleep down thing.

So that actually- So you got that part. Maybe I'm a good candidate. There are special massages that can help. A lot of people are in so much pain afterwards and peeing specifically is so difficult that they just end up peeing all over themselves. They're all the, I mean, they're terrible.

You can look all over TikTok, they're all over the internet, YouTube series of people who got BBLs and had absolutely horrible recovery periods because they didn't know what they were getting into and maybe they didn't have, you know, someone who knew what they were doing. If you're trying to get surgery done on the cheap,

it's a bad idea. Yeah, don't scrimp. And I understand, we live in a country that encourages you to do that. Our healthcare system in America tells you to go try to get the best deal. It's capitalism. And that's-

We're all incentivized to do that. Right, and that puts our lives at risk. Right. It's wrong, and it shouldn't happen. And our culture of body shaming and these unrealistic figures leads to us risking everything to try to attain physical ideals that really,

for the most part, I mean, yeah, certainly, there are people out there who are blessed, who are blessed beyond me, but most of us are not born to achieve those sorts of beauty standards. Hey, thank you so much for listening to our podcast. We hope you love yourself just the way that you are. We also hope that you enjoyed yourself

while you listened to this episode. We try to put one out once a week for you. It's kind of a deal. Thanks to the Axe Vaders for the use of their song, Medicines, as the intro and outro of our program. You can find more of their music on Bandcamp. And thanks to MaxFun Network for having us as part of their extended podcasting family. And thanks to youFun Network for having us as part of their extended podcasting family.

Thanks to you for listening. That's gonna do it for us for this week. Until next time, my name is Justin McElroy. I'm Sydney McElroy. As always, don't drill a hole in your head. All right! Maximum Fun, a workaround network of artist-owned shows, supported directly by you.