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You CAN get an awake BBL, here’s what you need to know

You CAN get an awake BBL, here's what you need to know

Do you want to get a BBL procedure but don’t want to undergo general anesthesia? If your answer is yes, awake BBL can make it happen. Awake BBL allows you to get BBL without undergoing general anesthesia, which makes it a very appealing procedure for people who are looking for anesthesia-free alternatives to it. General anesthetics have possible risks, and make the recovery a bit more complicated, making the patients seek a procedure that doesn’t require going under general anesthesia. 

In this article, we are going to talk about awake BBL, explain what is it, whether it is painful or not, its benefits, risks, and more to make you see all aspects of having Brazilian Butt Lift while awake, helping you understand the whole process clearly. 

Table of Contents

What is Awake BBL?

Awake BBL is a surgical procedure performed to make enhancements in the buttocks while the patient is awake. The surgery is performed under local anesthesia, which means only the surgery sites are numbed, the patient is conscious and able to communicate with the surgeon during the procedure. The improvements are made with the patient’s body fat, and it enhances the overall body figure as well as the shape and volume of the butt. 

How the awake BBL procedure works

The procedure takes around 2-3 hours, depending on the amount of fat that is removed and transferred. During the operation, the surgeon administers local anesthesia into the sites where liposuction and fat transfer are going to be performed. Local anesthetics numb only the injected sites while the patient stays awake. You will be able to talk with the surgeon and surgical team during the operation.

After the injection of the anesthetics, the plastic surgeon makes small incisions around the liposuction sites and removes the excess body fat. When the required amount of fat is suctioned, the fat is purified to make it free from undesirable components. Once it is ready for transfer, tiny cuts are made around the buttocks, and the fat is transferred through the incisions.

Is the awake BBL surgery painful?

No, awake BBL is not painful since the local anesthetic medications are injected into the surgery sites. You don’t feel pain during the surgery, but you can feel a kind of pressure, a feeling of vibration while the surgeon operates on the body. The feeling may be disturbing for some people since not everyone feels the discomfort at the same level.

Is awake BBL procedure safe?

Yes, awake BBL is considered a safe surgery in terms of general anesthesia risks. General anesthesia has several potential complications that can have serious consequences such as heart problems, and getting BBL under local anesthesia eliminates these risks. Local anesthesia is considered safe compared to general anesthesia and has fewer risks.

However, some cosmetic surgeons believe that BBL should be performed under general anesthesia because it is a major surgery.

Does local anesthesia limit the operation?

Yes, using local anesthesia limits awake BBL in terms of liposuction and fat transfer. It is safer to remove and transfer small volumes of fat deposits if the surgery is being performed with local anesthesia because large volumes of fat transfer can put the patient in danger.

Large volumes of fat require large amounts of tumescent solution (a fluid that makes the lipo easier and safer), which requires close monitoring of the patient by an anesthesiologist (1). Plus, it extends the surgery length and longer surgeries need to be performed under general anesthesia to ensure the safety of the patient (2).

Process of getting an awake BBL

In the following paragraphs, we explained the overall awake BBL process step by step to make you see what kind of experience you will go through so that you can decide whether you are ready for it or not. Let’s start exploring with the very beginning, the consultation.


The initial BBL consultation will start with the surgeon looking at your medical history to see if you are eligible for awake BBL or not. After that, you will explain your expectations from the procedure and discuss them with the surgeon. The surgeon will explain the surgery in detail, and emphasize potential risks and challenges you may face.

After a detailed discussion, the consultation will be completed, you will come up with a decision and start to prepare for the surgery. 

Candidacy for awake BBL

Meeting the candidacy criteria for awake BBL depends on the body you want to achieve, the way you want to get it, and your health status. If your goals meet the operation’s goals, you can be a suitable candidate for awake BBL surgery.

An ideal candidate for awake Brazilian Butt Lift surgery would be a person who: 

  • Is healthy enough to undergo surgery
  • Don’t have serious medical problems
  • Has a problem that makes general anesthesia risky
  • Don’t have a bleeding disorder
  • Can stop smoking
  • Wants to improve the volume and the shape of the buttocks
  • Don’t want to undergo general anesthesia
  • Wants to be awake during the procedure
  • Want to enhance self-confidence


You will start the BBL preparation period by quitting smoking and alcohol since they can interfere with the healing period. A month before the operation you will be asked to take certain tests to ensure that you don’t have a condition that can make the surgery risky.

If you are healthy enough to undergo the operation, you can start eating healthy and taking some vitamins such as folic acid to have a strong immune system and to recover from the surgery as fast as possible with the least discomfort. 

Recovery period

Except for the general anesthesia effect on the body, the recovery period will be the same as regular BBL recovery. Your number one priority will be wearing your compression garments, avoiding sitting for a couple of months, getting lymphatic massages, and adjusting your diet to have an easier, faster, and more successful recovery.

To get detailed information about the recovery period you can jump into our BBL recovery article.


You will see the final BBL results when your body is healed from the procedure, which means after at least 6 months. Even though you see the change in your buttocks right after the surgery, they will be swollen due to the procedure. It is inevitable as it’s the natural reaction of the body. As the body heals the operated body parts, the swelling will start to disappear and the buttocks will get its final shape. 

Benefits of Awake BBL

We just learned what it is like to have a BBL awake, and if it limits the operation from any aspect. Now, it is time to see what makes it appealing for people who want to undergo BBL awake, and the benefits that being awake during Brazilian Butt Lift offers to the patients.

Affordable procedure

Awake BBL is affordable compared to regular BBL because of the type of anesthesia that is used in the procedure. It can be said that if traditional BBL costs 9,000$, awake BBL can cost around 5,500$. Why? Because local anesthesia for an operation can cost up to 500$, general anesthesia can cost up to 3,500$.

Local anesthesia is more affordable because the anesthetic cost less, it requires fewer medical personnel, and less equipment. Awake BBL doesn’t require an anesthesiologist to monitor the patient during the surgery and there is no need for the usage of equipment such as a breathing tube. These together with low-cost anesthetics creates a significant difference in terms of price and make awake BBL a budget-friendly procedure. 

Free of general anesthesia complications & side effects

Unlike local anesthetics, general anesthesia has more complication risks and side effects because it changes the body’s function. General anesthesia affects brain activity, heart rate, breathing, and metabolism, but local anesthesia doesn’t have a big effect on the body. It affects the nerves in the injected part and numbs the area, causing minor side effects.

Rare but possible general anesthesia complications include: 

  • Blood clots
  • Respiratory problems
  • Aspiration
  • Cardiac arrest

Rare but possible local anesthesia complications include:

  • Allergic reaction
  • Systemic toxicity 

It is very common to have side effects after general anesthesia, while side effects of local anesthetics are not that common. For that reason, having Brazilian Butt Lift while awake will also make a couple of days following the surgery easier.

Side effects of general anesthesia include:

  • Nausea
  • Vomiting
  • Constipation
  • Irritation of the throat
  • Confusion

Side effects of local anesthesia include:

  • Bruising
  • Itching
  • Pain at the injection site

Suitable for patients with certain conditions

Awake BBL is very convenient for patients who have a medical condition that can interfere with general anesthesia, such as pulmonary disorders. General anesthesia affects the lungs, which can be risky for a person with lung problems because the person already has problems with breathing.

However, since local anesthesia only affects the injected area and doesn’t make changes in the functioning of the lungs, it doesn’t create a dangerous situation for the patient.

Possible downsides of Awake BBL

As with everything, awake BBL also has possible risks. Patient safety must be the number one aspect that needs to be considered before undergoing a procedure. Before getting a BBL awake, you must think about all of the factors that may lead to undesired outcomes, so that you can make a reasonable decision.

Unqualified clinics are more likely to perform awake BBL

Some clinics which don’t offer quality service and meet the safety measures are able to perform awake BBL since the anesthetics are not expensive and it doesn’t require an anesthesiologist to be involved in the procedure.

Undergoing BBL under local anesthesia in a clinic that is not eligible to perform the surgery can put you at risk and can’t ensure a quality result. Make sure to choose a high-quality clinic, do some research, read reviews, look before and after photos, and decide the most reliable one. 

Dissatisfaction with the results

If you want a dramatic change in the buttocks, awake BBL is more likely to disappoint you. As we mentioned in the previous paragraphs, local anesthesia limits the amount of fat that can be operated on, and small amounts cannot create significant changes in the buttocks. Before undergoing the surgery make sure that awake BBL can give you your desired change by discussing this with your surgeon. 

Local anesthesia also has risks

Local anesthesia is not dangerous, however, it has a rare but possible risk that is called Local Anesthetic Systemic Toxicity (LAST) which causes serious problems with the brain, heart, and breathing such as lung failure and seizures. It can happen in a case where the local anesthetic is given more than the safe amount, or when the anesthetic is injected into the systemic circulation (3).

If the surgeon injects high amounts of local anesthesia to be able to operate on more volumes of fat, LAST may be a possible risk, that’s why it is important to have an anesthesiologist who knows the proper amount of anesthetic injection during the procedure. So, even if local anesthesia is considered safe, it must be administered meticulously following the safety standards.

It can also cause an allergic reaction

Another very rare side effect of local anesthesia is an allergic reaction. When the anesthetic enters the body, the immune system misidentifies the anesthetic and thinks that it is a thread, and reacts to it. This reaction can show itself in different ways such as edema. Allergic reactions happen right after the injection and require quick action.

  • (1) Sood, Jayashree et al. “Liposuction: Anaesthesia challenges.” Indian journal of anaesthesia vol. 55,3 (2011): 220-7. doi:10.4103/0019-5049.82652

  • (2) Smith G, D’Cruz JR, Rondeau B, et al. General Anesthesia for Surgeons. [Updated 2023 Jan 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

  • (3) Mahajan A, Derian A. Local Anesthetic Toxicity. [Updated 2022 Oct 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023

  • El-Boghdadly, Kariem et al. “Local anesthetic systemic toxicity: current perspectives.” Local and regional anesthesia vol. 11 35-44. 8 Aug. 2018, doi:10.2147/LRA.S154512

  • Granados-Tinajero, Sergio, et al. ‘Anesthesia Management for Large-Volume Liposuction’. Anesthesia Topics for Plastic and Reconstructive Surgery, IntechOpen, 3 Apr. 2019. Crossref, doi:10.5772/intechopen.83630.

  • Seify, Hisham. “Awake Plastic Surgery Procedures: The Use of a Sufentanil Sublingual Tablet to Improve Patient Experience.” Aesthetic surgery journal. Open forum vol. 4 ojab056. 27 Jan. 2022, doi:10.1093/asjof/ojab056

  • Short, Timothy G et al. “Anaesthetic depth and complications after major surgery: an international, randomised controlled trial.” Lancet (London, England) vol. 394,10212 (2019): 1907-1914. doi:10.1016/S0140-6736(19)32315-3 

  • Smith G, D’Cruz JR, Rondeau B, Goldman J. General Anesthesia for Surgeons. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2022. PMID: 29630251.

  • Stutishree Tripathy. “Complications of Local Anesthesia”. Indian Journal of Forensic Medicine & Toxicology, vol. 14, no. 4, Oct. 2020, pp. 9079-82, doi:10.37506/ijfmt.v14i4.13157.

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