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BBL: fat embolism the serious one What it is if fat is injected into or below the gluteal muscle, it can enter torn gluteal veins and travel to the lungs/heart (pulmonary fat embolism) a potentially fatal complication The historical risk BBL mortality was reported at roughly 1 in 3,000 (some surveys 1 in ~2,350), the highest of any aesthetic procedure How safe technique lowers it the ASPS/ASAPS/ISAPS Practice Advisory sets the standard: inject fat ONLY into the subcutaneous plane (never into muscle), use a blunt cannula, and use ultrasound guidance in no confirmed BBL death did fat remain purely subcutaneous, and safe technique has produced far lower rates (~1 in 15,00020,000) Highest-risk window the first 24 hours