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EXCLUSIVE Inside Miami's BBL trade, where 15,000 women a year risk their lives for bargain prices with sketchy surgeons
They descend on clinics all over Miami, this daily wave of women seeking to reshape their lives by reshaping their curves.
The arrivals pass by those who've had the operation and are leaving – heavily padded and walking gingerly – in a constant churn in the city that has become the world epicenter of the Brazilian Butt Lift.
But for some, they are dicing with death.
The recently announced passing of young Louisiana police officer Wildelis Rosa in Miami from a BBL has sharpened the focus on the procedure where the quest for looks really can kill those trusting the wrong people.
Now, can unmask the inside story on the horrors that still await some unsuspecting women who fly to the Magic City for a BBL – despite the industry's good guys' largely successful efforts to make it safer.
In an astonishing catalogue of shady practices in the production line of some rogue clinics, we can reveal:
Potential patients often have no initial physical exam but are 'diagnosed' for treatment in a virtual consultation by receptionists after being asked to provide photos of their butt.
Surgeons fly into Miami from other American cities for an exhausting week of money-spinning operations, creating deadly risks by performing far more than is safe each day.
If a clinic has had a series of complaints against it, the owners simply shut it down and start again with a new name at the same address.
'Recovery homes', where patients recuperate, can be seedy Airbnb's without a medic in sight, small warehouses filled with air mattresses or even a horse barn.
Disreputable surgeons' con patients by claiming accreditation to a medical board they have simply invented.
More than 15,000 women a year from around the world descend on Miami for a BBL. Many are attracted by a stay in the Florida sunshine and being at the hands of a renowned surgeon.
It's a common sight to see women gingerly walking out of medical offices heavily padded with surgical drains emerging beneath their shorts to manage their built-up fluids
Women often leave BBL clinics in wheelchairs, struggling to walk. But despite the painful recovery and rising death toll, many are approved for surgery without a physical exam - just a virtual consult with a receptionist who reviews butt photos
However, others are lured by shockingly cut-price surgery offered by some clinics as they vie for business on the internet – as little as $2,000 compared with up to $18,000 for a top end operation.
The surgery involves taking fat from the hips, lower back and abdomen through liposuction then injecting small amounts into the glutes giving the buttocks a curvier appearance.
Most deaths typically occur when the doctor accidentally injects the fat into a vein which then lethally moves to either the heart or lungs.
New Orleans PD cop and Army reservist Rosa died that way, according to her autopsy report obtained by The 26-year-old had just returned from deployment in Kuwait when she had her $7,500 surgery at Prestige Plastic Surgery in the Coral Gables area of Miami.
Over two days, we observed the comings and goings at several clinics spread across the city, including four who have experienced BBL deaths.
At one of the busiest, Seduction, in the Little Havana district of Miami, cars and minivans came and went picking up BBL patients throughout the day. It advertises the op for 'between' $6,000 and $12,000.
It is also where Tennessee mom-of-five Erica Russell died during a BBL in 2021. According to a wrongful death lawsuit, her surgeon Dr. John Sampson performed six BBLs starting at 6.32am before Russell's at 8.32pm.
Sampson and the clinic deny negligence in a legal response to the lawsuit filed in Miami Dade County Court. Sampson also denies not having 'appropriate control' of the surgical instrument he was using for the op.
The case is set for jury trial in January, 2026.
Ten women died from BBL blunders at various clinics in Miami that year. So far in 2025 it has been two – Rosa and Las Vegas mom-of-one Ahmonique Miller, 28, who died from a lethal mix of drugs administered in an unlicensed recovery home.
Pioneering plastic surgeon Dr. Pat Pazmino has been at the forefront of reducing those deaths from fat clogging an organ.
He developed a cheap ultrasound system for surgeons allowing them to see inside the body and greatly decrease the chance of hitting an artery with a fat injection. Its use was signed into Florida state law in 2023.
But he still paints a picture of terrifying lawlessness and negligence in the industry among some practices who flout the legislation and callously bend the rules, sometimes lethally, for profit.
From his office in the trendy Brickell area of Miami the Harvard-educated doctor warned: 'It's like a game of Whack-a-Mole. You solve one problem and another pops up.
'There's no silver bullet to this. People are still being drawn to operations that are dangerously cheap, that cut corners and risk lives.'
In a series of astonishing revelations, the doctor who works with other surgeons collating information to banish the rogues from his industry continued: 'Patients tell us that when they reach out to the very cheap clinics on social media, the clinic will tell them go ahead and send your pictures.
'And then the receptionist or the patient coordinator, who is not trained in medicine, will go ahead and tell the patient what they think they need and sign them up for surgery and collect the payment.
'And this person could be in St. Louis and the clinic will be in Miami. And no one's physically examined.
Dr. Pazmino (pictured) also said that other doctors that conduct the procedures aren't even present for their patients post operation because they're flown out to Miami by the clinic, leaving the care of the patient up in the air
'It's terrible because that receptionist, they're assessing the patient. They're coming up with some kind of judgment. They're coming up with a diagnosis and they're eventually formulating a treatment plan.
'So, clinics that are doing that are illegally using non-medical personnel to illegally practice medicine.'
Of the scalpel-for-hire surgeons, he revealed: 'What's very common is that these clinics will often attract doctors from other cities that will fly into Miami for a week, do surgery, and then leave.
'No appropriate plastic surgeon would ever practice that way. I would be thinking the whole time, what's going to happen to the patient once I leave? Who's going take care of that patient?
'And many of these clinics say they will do a BBL in one hour. I teach this procedure, and it takes me at least two hours. Ninety percent of it is liposuction, which is very physically demanding. It requires a lot of strength.
'Using fitness trackers, we've estimated performing one BBL is the equivalent of a 45-minute spin class. Some of these clinics are getting 70 or even 80-year-old surgeons doing large numbers of BBLs each day. Can a 70-year-old do the equivalent of multiple spin classes a day and not make a mistake?
'Some patients report that they were wheeled into the operation room at 9pm and the doctor had started working at 6am.'
Pazmino, who is regularly updated with testimony reports to the Florida Board of Medicine and attends its meetings, disclosed horrifying details on some 'recovery homes' that pop up in Miami.
Most BBL patients struggle to walk and battle through the pain of the first few hours, when they need the utmost care and attention. However, establishments provide a cheap BBL 'package' which at times are lethally and depressingly dangerous in their own right.
'These clinics will get an Airbnb for a month and fill it. They'll try to get in as many patients as they can. We've also heard about warehouses being rented out in that way too. They'll put down air mattresses, because they are portable and very cheap.
'But the worst so far is a budget clinic package where aftercare was included. Patients were attracted to that because it sounds like an incredible deal.
'But after surgery they were brought to what they were told was an aftercare center, yet in reality was a barn for horses with mattresses on the floor. That's where they were told to lie and recover.
'It was not sterile, it was filthy and there was no nursing staff. This is going on all the time.'
Pazmino warned prospective patients considering a BBL to research not only the name of the clinic they are considering but, crucially, the address.
'When a clinic has many complications and maybe a death their name becomes toxic on the internet. So what they do is just change the name and keep going until a number of patients are hurt again,' he said. 'The same people, the same practices.'
He also urged patients to minutely check a surgeon's credentials and warned of make-up artists.
Rosa, who was also an Army reservist, had told the clinic multiple times in those four days leading up to her death when she came in for a lymphatic massage that the oxycodone she was given hadn't helped with the pain and that she was losing sensation in her toes
'You should look for the correct board certification, the American Board of Plastic Surgery,' he said. 'Because there are surgeons who come up with their own boards.
'So they say, I'm certified with the American Board of Abdominal Surgery. And the patient thinks, that's great. What they don't realize is it's completely made up, dishonest and dangerous. This is important, because someone can be a surgeon, but not have the expertise in this area. This is an ongoing problem.'
Despite safeguards passing into Florida law, 'unfortunately patients are still dying from BBLs in Miami, with organ injuries, infections, poor after care. So these are things we have to focus on now.'
Echoing Pazmino's aftercare concerns, investigation reveals a heartbreaking countdown to death for latest BBL victim Rosa at her down-at-heel looking Airbnb while she was being attended by a friend.
It happened in March, but her family only revealed the tragedy late June.
The Miami-Dade Medical Examiner's report shows Zavaris Leon-Moctevuma battled in vain to save Rosa with CPR when she was 'unresponsive' at 7am following four days of agony.
Leon-Moctevuma was the sole caretaker. There was no medical staff at the single-story house on a small side street of modest homes half a mile from Prestige Plastic Surgery in Coral Gables.
Rosa arrived in the city on March 18 without telling her family and the surgery took place next day. She was kept in the post-op room for one hour then discharged to the Airbnb, says the report.
The next day, the cop took oxycodone before her follow up appointment, where she complained it wasn't nulling the excruciating pain. She was given a lymphatic massage, which removes excess fluid, and sent back to the Airbnb.
Leon-Moctevuma helped her take a shower, where her blood pressure fell and she started to have trouble breathing, adds the report. The following day Rosa continued to battle for breath and 'complained that her glutes were hard'.
Twenty-four hours later Rosa was still battling for breath. She had another lymphatic massage at the clinic and returned to the Airbnb 'where she complained of not feeling well and having no sensation in her toes'.
Leon-Moctevuma attempted to help her by getting her snacks to help her sugar levels, tried to build iron levels by cooking her liver and showered her.
At 7am on Sunday, March 23 the friend went to check on Rosa and found her unconscious in bed. She rang 911 and battled in vain to save her friend with the kiss of life before emergency services arrived.
The report said Rosa, a native of Buffalo, New York, lived alone and it appeared she was 'not happy' at times and had made a therapist appointment. Her official cause of death is recorded as pulmonary embolism due to deep venous thromboses associated with cosmetic surgery.
A fatal cocktail of drugs at a 'recovery' house killed other 2025 BBL victim Ahmonique Miller, 28, according to her Miami Dade Medical Examiner's report, obtained by
She had her op at Avana Plastic Surgery, located inside a large nondescript building with other businesses in the north of the city, on March 7.
And the medical report highlights the flexible nature of some quarters of Miami's BBL world. Miller arrived with her sister Kiera Barnes on March 6. Both planned to have the op that day.
But Miller wanted extra work done. Her surgeon refused, saying he 'wasn't comfortable with that many surgeries in one day'. However, she found another surgeon with the same company 'who agreed to perform the surgery for an additional $1,500'.
After the op she was taken to the unlicensed Keyla's Recovery House, a few blocks from bustling Calle Oche in Little Havana and run by Keyla Oliver. Her sister had already had her surgery.
'There are several accounts of what occurred after she arrived at the facility,' says the report. 'Per the decedent's sister, the owner… gave the decedent an unknown amount of the sister's muscle relaxers and two Percocet tablets from an unlabeled bottle... because her medication was not ready.'
Later that day 'the owner' said she tried to wake Miller, but she didn't respond. The cause of death is recorded as acute combined drug toxicity (Oxycodone and Bromazolam).
Percocet contains oxycodone and Bromazolam is a mind-altering designer drug that has never been marketed for medical use.
When knocked on the door of the home to speak with owner Oliver, there was no response, despite two cars being on the driveway.
But her attorney Bob Pardo told 'We do not comment on pending investigations.
'That said, Ms. Oliver has expressed her deepest condolences and prayers for the family and loved ones of the deceased.'
Prestige Plastic Surgery said no one would be available for immediate comment on Tuesday but have not responded since.
Avana Plastic Surgery did not respond to a request for a statement – nor did the Florida Department of Health, which regulates the ops, despite repeated attempts to obtain one.
