'My liquid BBL went well but I regret it now I know the risks'

Cairo Nakhate-Chirwa had a non-surgical Brazilian butt-lift (BBL) in June.

She's happy with the results - but says that she now regrets it after finding out the procedure was unregulated and potentially risky.

This comes after arrests were made following the death of Alice Webb, who is thought to have undergone the procedure.

A non-surgical BBL most often involves filler being injected into the buttock to make it bigger, more rounded or lifted, and is not regulated in the UK.

Experts have called the lack of rules in the UK the “wild west” while NHS England has warned against the procedure entirely.

The Department of Health and Social Care says it is currently exploring regulatory options of the non-surgical cosmetics sector and says it will provide an update in due course.

Cairo used Instagram to find someone to give her a liquid BBL - another name for a non-surgical BBL - in late June.

She found one page that was advertising the procedure for £1,200.

Twenty-four hours later, she arrived at a London flat for her appointment.

She did not check whether the person performing the procedure was a qualified medical professional.

“When they’re advertising themselves, you just assume they are [qualified]," Cairo said.

But non-surgical cosmetic procedures are not regulated in the UK - this includes liquid BBLs.

The BBC contacted the person who performed Cairo's BBL for comment, but they did not respond.

Cairo said the only drawback, aside from the “pain” of the procedure, was some leaking from the site of the injections two weeks later.

She said she looked into the risks for the first time after hearing about Alice Webb’s death – and that while her experience “wasn’t all negative”, she regretted it and wished she had done more research.

"I’m happy with how I look.

"It made sense, it was cheaper. But now I’m questioning.”

Non-surgical BBLs can be done using local anaesthetic and generally take place in a clinic room - rather than a sterile operating theatre.

There are even reports of procedures taking place in hotel rooms.

Recent research by organisation Save Face, suggests many people don’t know what is injected into their bodies.

The filler used could be hyaluronic acid & PLLA (Poly-L-lactic acid), for example.

NHS England strongly advises against having a non-surgical BBL “because it is unregulated”.

Surgical BBLs meanwhile often involve transferring fat from one part of the body into the buttock.

This most often happens under general anaesthetic in an operating theatre, and can involve extensive liposuction, with large volumes of fat being transferred.

In 2018, because of concerns around high death rates linked to surgical BBLs, the British Association of Aesthetic Plastic Surgeons asked for a four-year pause on its members carrying out the procedure.

In 2022 it published new guidelines, encouraging surgeons to use a different technique - called superficial gluteal lipofilling (SGL).

While it uses fat collected from the body, this is only injected below the skin whereas BBLs insert fat deep into the muscles.

It also recommends surgeons should only carry out SGLs while simultaneously using ultrasound scans so they can see where the cannulas are going.

This procedure carries its own risks.

Mr Marc Pacifico of the British Association of Aesthetic Plastic Surgeons said the lack of regulation meant the UK was “known as the wild west”.

In the UK, the filler injected during non-surgical procedures is not classed as a medicine, and so it does not need to be prescribed. Instead, it’s classed as a device.

“That’s one of the biggest loopholes we have in the country,” Mr Pacifico believes.

“And that’s why anyone and everyone could have access to get hold of them."

This makes the UK “the most outlying country” in Europe, he said.

Dr Sophie Shotter, who runs her own private clinics and is a trustee of the British College of Aesthetic Medicine, said “a lot of people don’t have a clue” about the risks before signing up for a liquid BBL.

She says she does not offer non-surgical BBLs because of the potential risks – and although Cairo was OK, this isn’t the case for everyone.

A serious concern is that the injection can cause a blockage in a blood vessel that can in turn lead to a blood clot travelling to the lungs – what is known as a pulmonary embolism.

This can be lethal.

Infections, scarring, significant deformities and reactions to local anaesthetic, including toxicity, are also risks.

There is no data on the death rate of liquid BBLs, but the British Association of Aesthetic Plastic Surgeons said the procedure was associated with a higher complication rate than other non-surgical procedures.

Dr Shotter said regulatory action had been slow "because the people in power don't take it seriously".

"I think it's because of a little bit of inherent misogyny," she said, since the procedures are more popular with women.

She said she wanted to see regulation of who can administer fillers and where this is allowed to take place.

"It feels like it’s spiralling and spiralling.

"Alice's case is absolutely tragic – but many of us feel like we’ve been expecting it for a while."

NHS England advises against having a non-surgical BBL altogether.

"There is no guarantee that the right safety measures are being taken,” the NHS’s National Medical Director Prof Sir Stephen Powis said.

Referring to all cosmetic procedures, a Department of Health and Social Care spokesperson said: "The safety of patients is paramount, and we would urge anyone considering a cosmetic procedure to consider the possible health impacts and find a reputable, insured, and qualified practitioner."

Cairo, who performs as rapper Lavida Loca, said she wanted a BBL because of pressure to look a certain way: “In the hip hop world... women are meant to be curvy.”

“I fell into the pressure. I tried to do it naturally and it wasn’t working, and I didn’t have enough fat on my body for a surgical BBL.”

According to Prof Elizabeth Daniels, director of the Centre for Appearance Research at the University of West England, people who have cosmetic procedures often feel dissatisfied with their body image.

But she stressed that relationships and societal factors, like laws and mental health resources, also come into play.

“It’s important not to pathologise people or make assumptions about their motivations and instead think about – this is a big social issue and how can we make the situation better?”