Enhancing Safety and Outcomes in Brazilian Butt Lift: Mobile Ultrasound With Artificial Intelligence

The Brazilian butt lift (BBL) is increasingly guided by ultrasound to avoid deep or intramuscular fat placement, which has been associated with fatal pulmonary fat embolism. Real-time visualization of the superficial and deep gluteal fasciae improves safety, but consistent plane identification can remain challenging. Artificial intelligence (AI) may augment ultrasound by assisting with tissue-layer recognition, cannula tracking, and standardized interpretation.

A narrative review of gluteal anatomy, historical safety guidelines, and contemporary evidence on ultrasound-guided BBL was performed. We additionally outlined an AI-assisted ultrasound workflow and described a detailed surgical technique using mobile, handheld ultrasound with integrated AI-based optimization features. A preliminary retrospective clinical experience using this method was evaluated to assess feasibility and early safety signals.

Ultrasound reliably enables identification of the gluteal fascial layers and supports subcutaneous-only fat placement. AI-assisted visualization further enhances anatomical consistency, facilitates plane confirmation during injection, and may reduce operator-dependent variability. In our early clinical experience, the workflow was feasible, with no major complications observed and satisfactory short-term outcomes.

Ultrasound guidance has significantly improved the safety profile of BBL by allowing continuous confirmation of subcutaneous fat placement. The integration of AI offers a promising adjunct that may enhance precision, standardize technique, and expand accessibility for surgeons with varying levels of experience. Preliminary findings support the practicality of AI-assisted ultrasound; however, larger datasets are needed to validate its impact on outcomes and long-term safety.