Under The Knife: The Dangers Of Brazilian Butt Lift Surgery

The following is an edited extract from Get Rich Or Lie Trying: Ambition And Deceit In The New Influencer Economy by Symeon Brown. 

Micro-influencer Cherrise Massey may not be a celebrity, but she is working on it. In a Manchester hotel suite notoriously booked by adult entertainers for porn shoots, the 23-year-old asks me if I’d like to see her breast. ‘Sure,’ I say. Weeks earlier, towards the tail end of Britain’s first COVID lockdown, the young mother of two boarded a flight to Istanbul to have a breast and butt enhancement operation that she hoped would take her closer to her desired look, but as we speak post-op, her breast has a gaping wound where a nipple should be. ‘Tomorrow I could wake up and half of the boob can be black and fall off,’ she says matter-of-factly. ‘It’s scary, it doesn’t smell good. It’s rotten flesh.’ 

Cherrise is of medium height, with light brown skin and a long black weave. Her face and teeth look as if they have been edited by an Instagram filter, and in reality, they have. 

‘Last year Instagram had a few filters that chisel your nose, jaw and fill the lips. I went to the girl who does my filler and I said I want it so my face is like the filter so I don’t have to use the filter. Now when I use the filter it does not change my face.’ She is beaming with pride. Since she was 18, she has gone under the knife as regularly as on her summer holidays. She has had full-body lipo, implants, veneers and the infamous Brazilian butt lift (BBL), which transfers fat from unflattering areas such as the waist or stomach and pumps them into the behind to inflate it like a balloon. The procedure, which was made famous by Kim Kardashian, has the highest death rate of any cosmetic surgery.

In the influencer economy, how you look is a currency, albeit one increasingly set by algorithms and editing apps. The rising and real rewards of accruing followers drawn by desirable photographs are pushing more young adults – especially women – under the knife to achieve the aesthetic that will help them trend. ‘I want the curves, the hourglass figure, the Kardashian figure. I want the big bum, I want the boobs,’ Cherrise says. ‘If I had that desired look and that desired body, it’s clothing brands, it’s gym brands that want to collab with you, it’s a financial pathway. I said it to my parents [and] they said “Why are you getting all this surgery?” and I said “I’m investing in my future” and they couldn’t understand.’ 

Those who do understand now see young women like Cherrise as an easy meal for the taking. There is a fast-growing industry of pop-up companies in under-regulated countries like Turkey selling cosmetic procedures over Instagram. They appear overnight and hire freelance surgeons to carry out procedures on patients from more affluent economies. At best, the surgeries they offer girls from western Europe are more affordable than procedures in their home countries, but at worst, the companies can leave patients in danger by hiring dubious doctors whilst being unable to provide aftercare if things go wrong. The risks are heavily filtered. Despite advertising guidelines for cosmetic surgeries being strict in the UK, the main regulator cannot take action against companies operating abroad, as they are out of their jurisdiction.

The company Cherrise found operating in Istanbul was endorsed by numerous glamorous Instagram models, including several she knew. Avrupamed is one of the many enterprises that target aspiring influencers as both customers and potential salespeople. The company has a busy pipeline of predominantly young women from Britain, Sweden, France and Germany who move in and out at speed and are often unaware who their surgeon is going to be. Its booming Instagram page is littered with the before-and-after pictures of young bodies laid out on operating tables like carcasses in a butcher’s shop window. At the last count, it had gained over 60,000 followers. Cherrise told me the company offered her aggressive discounts because of her small but significant social media following of young women just like her.

The day of Cherrise’s consultation in Istanbul was the same day she was operated on. This turnaround would be unthinkable in the US or the UK for a planned surgery. Her procedure was also botched. Breast implants were used as bum implants and were subsequently rejected by her body, and that was not all. The surgery lasted nine hours and her blood levels dropped to dangerously low levels. Afterwards, she bled heavily but she was discharged after only four days. When she returned to the UK, her health deteriorated so rapidly that she was hospitalised, and she was told the actions of the clinic in Istanbul had led to her developing necrosis. Her breast was rotting due to a severe infection from an untreated blood clot. 

When I made contact with the company to hear their side of the story, the spokesman was haughty and aggressive. They accused Cherrise of being desperate for attention. A notable lack of concern shone through their reply, which was strewn with spelling errors. Cherrise ‘just wants money’, they said, as if I had not seen with my own eyes the pus pouring from her breast. I spoke to another woman in her forties who corroborated the company’s disdain for the women paying them. She herself was diagnosed with broken ribs after a suspected emergency CPR during her surgery in Istanbul. Her NHS doctor concluded that she had most likely died and been resuscitated on the operating table. If so, it was an event Avrupamed failed to tell her  about afterwards. 

One of the more bizarre aspects of the boom in surgery culture is the cult of young women setting up anonymous pages that display their obsession with famous cosmetic surgeons and transforming their bodies. On these pages, teenage girls and adult women religiously follow the Instagram models they want to look like, repost pictures of these models, and forward them to surgeons asking if they can remodel them in the image of their body inspirations. The women call themselves the ‘dolls’ of the surgeries and surgeons they lionise. Clinichub’s most prominent surgeon, Furkan Certel, has a following of over 35,000. Some of the names these women go by include @clinichub.babe, @clinhub_dollx and @Furkansdoll. Such accounts do not identify their real names, but one of them we have already met: Jade.

In May 2019, another young woman I followed for over a year, 20-year-old Jade - a north Londoner who grew up with an awareness of how she looked became one of Clinichub’s clients. ‘I had 360 lip and a BBL. So I only had my waist, my stomach, my back liposuctioned and mainly reinjected into my hips.’ The Brazilian butt lift is an extensive procedure with a significant rate of fatality or post-op disfigurement. Physical recovery time is up to six months and the mental strain can last even longer. Jade had opted for a tamer version, dubbed the light BBL. The procedure sculpted hips into her straight figure and boosted her buttocks, but was more subtle than the extreme forms that make a body look wildly disproportionate by adding a bum to a figure with tiny thighs. 

Jade captured the recovery process on her Instagram page and told followers to subscribe to the new YouTube channel she had set up. The images she posted showed a changed body still in its early days. It regularly swelled, and because the surgery sculpted newly transferred fat, she could not yet do simple tasks, as she had to constantly wear a post-op compression bodysuit. She missed being able to sit on her ass and avoided playing with her children. Her body felt stiff, but nevertheless she was initially happy. ‘I’ve got the typical Instabody,’ she posted with a smiley emoji face. While in Turkey, she had thanked Clinichub for giving her life a new trajectory. ‘I came here looking like a fridge and I’m leaving looking like Kylie Jenner.’ 

However, there was pain to Jade’s pleasure. The procedure left her itchy, constipated and on an emotional rollercoaster. ‘Sometimes because of the swelling I feel like “what have I done to myself?” which can heighten my anxiety to the point where I don’t even want to go to the supermarket … Yesterday I had my toddler run into my hip where he’s left a small dent. I don’t know if only I can see it or maybe I’m just paranoid.’

Jade shared some of the more minor mental toils in the community of dolls. It was common for the girls to caption the date they had booked their surgery for in the hope of finding a buddy who would be heading out to Turkey at the same time with the same surgeon. Afterwards, they shared pictures of the results and the process seemed both cathartic and sisterly. On the surface, the dolls’ community appeared to be a safe place where women could find out the truth about drastic procedures from their peers. However, in practice there was an unspoken code of omission and dishonesty. 

Unknown to their impressionable audience, Clinichub had been botching surgeries, and the dolls who were sitting offline with unsatisfactory results were saying the opposite online. Uncertainty is part of medicine, but risk is amplified when an often unattainable ideal is being pursued via such drastic means. In the community of dolls, young women were refusing to be honest with their followers and were arguably misleading their friends. 

The internet was supposed to democratise the spread of information and make companies more open by elevating the independent voice of consumers, but the world of surgery is just one example of how easily that can be corrupted by warped incentive models. Several months after first interviewing Jade, I got back in touch with her. I had been following her life online and a lot had changed. Now aged 21, she had split with her partner and had paid off the cost of her surgery through selling twerk videos on OnlyFans. She was also booking modelling jobs thanks to her new figure and was even considering additional bum implants. But she no longer wanted to talk because she was unsure how she felt about surgery, or at least that was what she told me. The truth is that Jade was still an impressionable young woman still creating herself. 

Teenagers and young adults everywhere on the planet are growing up under the unbearable pressure of being both hyper-visible to strangers and distanced from real-life friends. This became even more acute during the COVID pandemic. The young women in the doll community live in a world where the judgement of their peers is more intense than at any moment in contemporary history. On social media there is no escape from the gaze of others, even while alone. According to the famous words of the existential philosopher Sartre, hell is other people. In the social media age, that hell is closer, more prolific and more powerful than ever. 

The whole system has a tragic absurdity. The dolls I spoke to have taken risks with their own bodies for the dubious reward of advertising cheaply manufactured knock-offs sewn together by exploited labourers. If Kim Kardashian made the BBL aesthetic mainstream, then fast fashion made it an aspirational career move that actually paid, and cosmetic surgery companies created an incentive model that presented invasive procedures as risk-free and necessary for aspiring influencers. It is unsurprising that the number of procedures has now soared.

When Clinichub directly messaged the influencer Nella Rose offering her a BBL to improve her shape and better present the clothes she was promoting, Nella was distraught. She took an image of the message and posted it online to shame them. The company was booed on the blogs and meme pages central to black British youth culture, even by people who had surgery appointments booked with them. Clinichub publicly apologised and gave a corporate response dripping in dishonesty. ‘Clinichub pays great attention to BODY AWARENESS and BODY POSITIVITY. We believe all human bodies are perfect and we always stand for this philosophy.’ If they believed this, they would not even be in business, let alone pitching up in the inboxes of young women, and they are not the only ones. Women now find themselves the targets of an entire new ecosystem of apps and platforms promising them financial freedom by selling themselves in both new and old ways.