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An Oregon-based plastic surgeon has revealed the cosmetic procedure he would never undergo himself — and it’s one of Hollywood’s most popular surgeries.

Dr. Sean McNally, lead surgeon at Doctor PDX and Réviance in Portland, specializes in both cosmetic and reconstructive procedures, including facelifts, tummy tucks, breast surgeries, and hand procedures.

However, there are two procedures he categorically avoids. The first: butt implants.

“They carry a very high long-term complication rate, no matter how they’re done,” Dr. McNally told the Daily Mail. “That’s why we switched to Brazilian Butt Lifts (BBLs),” he added.

The second, more dangerous procedure: injecting fat into the gluteal muscles during a BBL — a technique popular among Hollywood stars, including Cardi B and Nicki Minaj.

Global data shows that BBL procedures surged nearly 63% between 2020 and 2024, with over 644,000 performed in 2025 alone. Typically, fat is harvested from other areas of the body and injected into the thighs and buttocks.

But injecting fat into the muscle has proven deadly.

“Initially, this was done to create more space for fat transfer, but it turns out it increases the risk of fat embolism, making BBL the most dangerous cosmetic surgery,” Dr. McNally explained. Today, surgeons use ultrasound guidance to ensure fat is injected into the correct layer.

The American Society of Plastic Surgeons warns that intramuscular fat injections can also cause fat necrosis — “death of fat tissue” — which appears as lumps and can lead to serious infections.

Dr. Fuat Yüksel from the UK-based Longevita clinic adds that many patients come in with unrealistic expectations. “There’s a limit to how much fat can safely be transferred, and a significant portion will naturally be reabsorbed during healing,” he said.

BBL is also one of the surgeries people most often regret. Last year, Grammy-winning singer SZA told British Vogue: “I’m so mad I did that. I gained weight while being inactive during recovery, trying to preserve the fat. It was just so stupid.”

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