Florida’s new BBL rules aim to improve patient safety

In an effort to help maintain patient safety in the land of Brazilian butt lifts, Florida has adopted new regulations regarding Brazilian butt lifts. The new bill, HB 1561, introduces certain protections to maintain medical and safety standards in the state’s surgical centers.

Florida has a troubling history with failed BBLs. From 2010 to 2022, pulmonary embolism resulted in 25 BBL-related deaths in South Florida. Disturbingly, 14 of these deaths occurred after 2018, despite the Foundation for Aesthetic Surgery Education and Research issuing guidelines recommending avoiding fat injection into muscle. This technique helps prevent fat embolism. Additionally, in 2019, the Florida Board of Medicine implemented a “subcutaneous injection only” rule to increase patient safety. Last year, regulations limited the number of BBL surgeons who could perform procedures per day. To increase patient safety, they must now use ultrasound technology during the procedure. This new regulation aims to further protect patients by holding surgeons and trainees financially accountable.

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New rules on fat transfers

Under the new legislation, doctors who perform liposuction with more than 1,000 cc of supernatant fat – either temporarily or permanently – are now required to register with the Florida Department of Health. This is a change from previous requirements, which only required registration for treatments involving permanent fat tissue removal.

This means that doctors must now register their practices even if liposuction involves the temporary removal of more than 1,000 cc of fat. This also applies if the fat may be re-injected into another part of the body, for example in the BBL.

Greater financial penalties for doctors

The law also imposes $5,000 per procedure fees on surgeons exceeding the 1,000 cc threshold in unregistered surgical offices. This is a significant change from the previous penalty structure, which limited fines to $5,000 per day for non-compliant practices. By introducing a fine for each procedure, the legislation increases the financial consequences for medical practices that do not meet registration requirements.

Brazilian Butt Lift Liability Insurance

The legislation also requires BBL surgeons to carry liability insurance of at least $250,000 per claim and $750,000 annually. They must also have an irrevocable letter of credit for the same amounts. This requirement is intended to provide patients with financial resources in the event of a medical error.

Greater accountability for surgical centers

The act also extends financial responsibility requirements to surgical offices where buttock fat tissue transplantation procedures are performed. This eliminates the possibility of centers operating without adequate coverage.

Vero Beach, Florida plastic surgeon Alan Durkin says the new rules will help eliminate some of the bad apples. “It’s a good idea to restore patient safety with gluteal fat transfer. While this may place a burden on many good plastic surgeons who already follow best safety practices, the reality is that the lack of consistency for physicians who have ignored patient safety for too long has been too deadly,” he says. “This unacceptable minority of surgeons, most of whom are not even formally trained in plastic surgery, must be controlled at some level. This is the beginning of this control.”

“Florida’s new regulations help protect legal U.S. Medical Board-certified plastic surgeons performing plastic surgery and their patients,” adds Delray Beach, Florida plastic surgeon Drew Schnitt, managing director of Inspire Aesthetics. “Our offices have always had registered surgical facilities, have been covered by liability insurance for both the doctors and the facility, and we use ultrasound guidance for buttock fat grafting. We do everything to the highest standards of care and believe that every plastic surgery center should be held to the same standards.