Inside UK’s harmful world of non-surgical BBLs

The tragedy of a mother-of-five who died after having a BBL procedure in the UK has raised fresh questions over the alarming lack of regulation in the fast-growing industry.

While Brits may be used to hearing about horror botched surgeries abroad, medical experts have today laid bare how practitioners shockingly require no training or qualifications to perform non-surgical BBLs in the UK.

The popularity of non-surgical BBLs, which involves injecting filler into the buttocks, has increased significantly with the rise of influencers, but doctors have raised serious concerns over the ‘disgraceful’ lack of regulation.

Reacting to the death of 34-year-old mother Alice Webb, one leading UK plastic surgeon told MailOnline today: ‘In the UK it is, shockingly, not necessarily illegal to inject filler when you are not medically qualified.

‘This is another tragedy which with better regulation could have been prevented.’

Ms Webb died on Monday just hours after having the butt lift procedure, which is believed to have been performed in the West Country. 

Gloucestershire Police confirmed it is investigating the death and has arrested two people on suspicion of manslaughter.

What is a liquid Brazilian butt lift?

BBLs are used to make buttocks bigger, more rounded or lifted. Unlike a traditional BBL which sees fat transferred from other areas of the body, a liquid BBL involves hyaluronic acid fillers.

Dermal filler — the same material used to fill lips — is injected in large quantities into the buttock.

They are often advertised on social media as a ‘risk-free’, ‘cheaper’ alternative to the surgical counterpart.

But Dr Nora Nugent, vice president of the British Association of Aesthetic Plastic Surgeons, today repeated major concerns over the regulation of non-surgical BBLs in the UK.

The plastic surgeon told MailOnline: ‘I’m not directly involved, but I understand it was filler and this was done by an unqualified person in an unregulated environment.’

Laura Earps, a solicitor at Brabners Personal, added: ‘Non-surgical BBLs are often advertised and promoted as ‘risk-free and cheaper’ alternatives to surgical BBLs, however it is clear that this could not be further from the truth.’

How are non-surgical BBLs regulated in the UK? 

In a nutshell, they are not. Campaigners have been calling for better regulation as it is not mandatory to have training before injecting a patient with filler. 

Dr Nugent said that there are ‘loopholes’ in the UK which allow non-medical practitioners to perform these surgeries, something she described as a ‘total disgrace’.

She added: ‘This is totally outside of a regulated environment.’

‘It is an issue in UK. I have to say, there are a couple of cases floating around that have gone wrong recently.

‘This is a non-surgical procedure, filler in the UK is not regulated. You do not have to be a medical practitioner to inject filler, it’s shocking.

‘It is a medical procedure, but it is not seen as such in a regulatory sense. It can have seriously dangerous consequences.’

She added: ‘This was not a doctor, not a surgeon at all – and it fell outside of the medical environment.

‘For example, as a plastic surgeon I am required to have medical indemnity and to follow professional standards.

‘But someone who doesn’t have any qualification can inject a substance, an invasive procedure, in some poor woman’s buttocks and here we have the consequences.

‘We know there are risks with every procedure. But we are trained, we are doing it in regulated environment.

‘As a plastic surgeon, I have insurance, training, specialist registration. But someone can come along with any of that and perform an invasive procedure with awful consequences.’

Dr Nugent said that there is no mandatory training for non surgical BBLs. She explained that while it is recommended and most non-medical practitioners have done a short raining course, some have not even done this before they start performing.

How are UK councils clamping down on BBLs? 

With more awareness being raised about the dangers of these procedures, a number of councils across the UK are cracking down on companies offering non-surgical treatments. 

Last year, Wolverhampton City Council barred a company from carrying out non-surgical, or liquid, BBLs after identifying risks associated with their processes. 

These included blood clots, sepsis, and the potential for the death of body tissues.

Five local authorities in Essex and Glasgow followed suit and have banned certain companies from carrying out liquid BBLs in their area.

Just three days ago, Redbridge Council put out a warning about the dangers of BBLs and condemned companies operating in Brentwood, Essex. 

A spokesperson for Redbridge Council’s Environmental Health Team said: ‘Individuals who have undergone these procedures have experienced excruciating pain, discomfort and infections, some of which have required medical interventions and hospitalisation.

‘We strongly recommend that anyone considering a non-surgical aesthetic procedure do their research. If the cost of the treatment is lower than the market average, proceed with caution, as the practitioner may not be using the advertised products.’

Why do people want a BBL or liquid BBL?

Unhappiness over a ‘flat’ buttocks that lack shape, despite a healthy lifestyle, is a common reason listed by those who choose to undergo BBL surgery.

Experts have also blamed the allure of celebrity culture and choreographed social media images for fuelling the BBL trend.

Last year, London-based aesthetic surgeon Dr Veerle Rotsaert told MailOnline she discourages patients from getting any BBL and instead recommends they go to the gym and do squats.

She said: ‘In my practice if people want more volume in the buttocks area, I first of all educate them on normal anatomy.

‘I recommend going to the gym to do squats.’

Dr Rotsaert also urged Brits to shy away from BBLs, stating that the ‘Kardashian body type is a trend’.

‘And we all know trends go out of fashion at some stage,’ she added.

Love Island star Olivia Attwood also warned people off BBL surgery in her documentary ‘The Price of Perfection’.

She told viewers: ‘If I was to consider any treatment to give my bum a boost, I would do some serious research first. When it comes to the use of bum fillers, it seems to be a bit of a minefield.

During the show, Save Face Director Ashton Collins told her: ‘It is incredibly risky. Our issue with it is when these vast amount of hyaluronic acid fillers are being injected into buttocks, that increases risk of complication significantly. 

‘In the last 18 months, we had over 120 come forward with issues from this treatment – sepsis, severe infection, embolism, these are life threatening treatments. 

‘We had one woman who had to have her buttocks  surgically removed because she had such a severe infection. She’s devastated, it’s impacted how she lives her life now. They think it is a risk-free cheaper alternative  and it’s not.

‘When a treatment risks outweighs the benefits, they shouldn’t be carried out.’

Olivia then asked her: ‘As it stands in the UK now, anyone can inject someone with filler and it’s not against the law?’

Ms Collins replied: ‘It is totally unregulated. We’ve investigated people working in retail a week ago, done an online course, bought their products over the internet and start injecting people. 

‘We want bum and boob fillers completely banned, they are just so unsafe.

Olivia finished by saying: ‘I wouldn’t say no to a little more volume in the back, I know from asking that I’m not a suitable candidate for a BBL, so my only options were an implant which I wouldn’t do, and filler.

‘To me the filler was looking like the attractive standout option, in and out, quick and easy. 

‘After talking to Ashton today, no way. There’s a reason why doctors and surgeons aren’t doing  dermal filler to the bum, it’s because they have too much to lose and the risk is too high. That should tell you everything you need to know. ‘

Are there other examples of botched BBLs in the UK? 

Although many will travel to countries such as Turkey, there are still procedures that happen in the UK. 

In March, a mother-of-one also called for a ban on liquid BBLs after a botched procedure left her buttocks with leaking black holes and in pain ‘worse than childbirth’. 

Monique Sofroniou, 30, from London, booked an appointment at what she believed was a reputable salon to enlarge her bottom after undergoing a ‘Brazilian Butt Lift’ in 2021.

The aesthetician spent £3,000 on the non-surgical procedure to have one litre of filler injected into each bum cheek.

She was injected with silicone in a hotel room and has since been left with permanent scarring.

She says she woke up the night after the procedure with a temperature, her sides red raw, and she was being violently sick. Doctors sent her to hospital where they told her she had a severe infection.

What are the dangers of having a non-surgical BBL? 

Last month, Save Face revealed it had seen an ‘alarming increase’ in the number of liquid BBL related patient complaints.

The ‘severity of complications caused by these procedures is alarming’, the body added.

Unlike with facial fillers where complications can be managed by skilled injectors, these procedures often require hospital settings, intravenous drugs, and surgical intervention to rectify.

Dr Thuva Amuthan, Expert Aesthetics Trainer, has also long been campaigning for improved regulation.

Highlighting some of the major risks, she told MailOnline: ‘According to peer-reviewed studies, BBL surgeries have the highest mortality rate of any cosmetic procedure, with estimates of 1 in 3,000 to 1 in 6,000 cases globally resulting in death.

‘Other risks include infection, tissue necrosis (where tissue dies), asymmetry, scarring, and long-term complications that may require corrective surgery. 

‘These dangers make it crucial for it only to be performed by regulated, experienced healthcare professionals—specifically doctors trained in anatomy, surgical techniques, and emergency procedures—to perform BBLs.

She added: ‘Practitioners that are not adequately medical trained, pose a greater risk to patient safety. 

‘Without formal medical training, they often lack a deep understanding of human anatomy, particularly when it comes to complex procedures like fat transfer. 

‘This makes it far more likely that non-medics will inject fat or fillers into the wrong anatomical planes, causing complications like fat embolism or vascular occlusion.

‘More concerning is their inability to recognise early warning signs of complications. Trained medical professionals can identify symptoms such as pain, swelling, or sudden shortness of breath, which may indicate life-threatening issues like infection, vascular blockage, or embolism. 

‘Non-medics, by contrast, may miss these critical signs or fail to act swiftly enough, delaying the necessary emergency interventions that could save a patient’s life. 

‘In a worst-case scenario, they may lack the skills and equipment to manage these complications effectively, leading to irreversible harm or fatality.’

Dr Amuthan said that while cosmetic surgery in the UK is governed by the General Medical Council (GMC) and clinics must meet standards set by the Care Quality Commission (CQC), there are currently no regulations specific to BBL surgery itself.

She added: ‘This leaves gaps in ensuring that patients receive the safest possible treatment. Non-surgical procedures, such as dermal fillers, are even less regulated, meaning non-medically trained individuals can legally perform these treatments.’

Dr Amuthan said this can result in complications such as infections, blockage of blood vessels and facial disfigurement if fillers are ‘incorrectly administered’. 

Why do people travel abroad for a BBL?

For decades, Brits have been warned against seeking cheaper surgery in places like Turkey, Eastern Europe, or South East Asia.

Turkey is not inherently more dangerous than other surgical tourism hotspots.

But cheap flights between it and the UK — as well as the rise of the trend combining cosmetic surgery with a holiday — have made it one of the leading destinations for Brits looking to go under the knife. 

Dr Nugent told MailOnline: ‘There are many reasons why people travel abroad for cosmetic surgery including BBL — but one of the most common reasons is price. 

‘Overseas surgery can be cheaper than surgery in the UK. Differences in the cost of living, business expenses, cost of ensuring compliance of premises and processes with UK regulations and medical insurance are some of the reasons why it can be more expensive in the UK. 

‘The BAAPS urge people to look at quality and service provided as well as cost though as it is vital to know what is included and not included and to have full information on the procedure and your surgeon and hospital too.’

In Turkey, the BBL and even what are dubbed ‘extreme BBLs’ are promoted. 

In fact, some clinics even underplay the risks linked with the surgery. A MailOnline investigation last year found one clinic claiming that a BBL is ‘completely safe when carried out by a qualified BBL surgeon in Istanbul’. 

Another offered a more extreme BBL — the ‘BBL with Vaser Liposuction’. 

With this procedure, the clinic claims they are able to extract more fat from the body at once and says this results in a slimmer abdomen which makes the hips more noticeable.