Janatiss, big brown eyes wide over her black surgical mask, spins Aaliyah around to point out her surgical incisions. There are small pocks of darkened skin on her back, stomach, and just below her tailbone. Dangling from her hip is a drainage bag to collect the anesthetic Lidocaine. Janatiss pulls her client to the center of the room. For BBL patients, compression garments called “fajas” are an important part of post-op care: They stimulate lymphatic drainage, knit new fat together with old, and minimize swelling. With gloved hands, Janatiss works a black faja over Aaliyah’s legs as generic Lifetime TV drones in the background.Even a week after her surgery, getting Aaliyah into the faja was a slow and painful process. Though some fajas are more like a waist trainer, Aaliyah’s is a full-body suit. “It feels like somebody is pressing on your burn,” Aaliyah says, eyes skyward and lips locked in a grimace, one pink-nailed hand spread to cover her naked chest. For many, BBLs are the surgical route to the iconic hourglass silhouette: a waist dwarfed by ample hips and the kind of round, firm ass best described as “juicy.” That kind of figure, natural or augmented, is flaunted in music videos and Instagram posts by some of today’s biggest stars: Megan Thee Stallion, Kim Kardashian, Cardi B. Online brands, like Fashion Nova (which counts both Meg and Cardi among its collaborators), have dedicated their marketing to those curves, and rappers have praised them (21 Savage bragged that all his bitches have BBLs on his Metro Boomin collab “Runnin’”). The BBL as a cheat code to sex appeal may be a 1960s invention, credited to Brazilian plastic surgeon Ivan Pitanguy, but its popularity is a somewhat recent phenomenon: Sir Mix-a-Lot’s lament from his 1992 hit “Baby Got Back” that popular culture dictated that “flat butts are the thing” is hardly recognizable 30 years later.“My clients—they can’t bend, they can’t lift. They can’t get in and out of bed and use the bathroom on their own. You’re swollen for six to 12 months.”
“I don’t even want to say it,” said a doll named Nellie (whose last name is being withheld for privacy reasons), one week after her first BBL. “But my boyfriend said, ‘You look the same [now after surgery], like you do in your Instagram pictures.’ I was like, ‘Babe, those are angles. I’m tired of angles. I want to look like the real thing in real life.’”To reach that glamorous final form, some spend years consuming surgery community material before they book their first appointment. They swap horror stories and memes and pair up when their appointments align, becoming “surgery sisters.” They also meticulously document their progress, whether they’re swollen and leaky immediately post-op or twirling in front of the mirror in lingerie.And they pursue BBLs in spite of their documented dangers: with one death per 3,000 procedures performed, it’s been dubbed the riskiest cosmetic procedure, in part due to opportunistic surgeons who rush through as many procedures as possible, as well as the difficult nature of the operation itself. It’s hard to accurately inject fat into the buttocks, and fat shot into muscle or a blood vessel can easily cause a deadly embolism.The BBL’s popularity, according to a survey by the International Society of Aesthetic Plastic Surgery, has exploded, increasing by 77.6 percent between 2015 and 2019.
Rose Menos is a post-op car service owner in New York City, where she ferries clients for her company Post-Op Rides NYC to appointments in a gleaming black Mercedes SUV, charging $100 to $150 per ride. The Mercedes is outfitted with a custom mattress strapped into the back seat to keep passengers, who must lie on their stomach to avoid putting pressure on their swollen posterior, as stable as possible. She keeps glass bottles of Aquapanna and ginger candies on hand for post-op nausea and dons a baby pink surgical mask whenever a client enters her car.“[Surgeons] used to provide aftercare and keep patients in the hospital after having the surgery performed. Now, they completely leave out post-op care and leave it up to their patients.”
Shortly after my visit, though, an allegation about the Recovery Retreat’s billing practices came to my attention. Kyera Watts, a 32-year-old woman from Atlanta, Georgia, said that she paid $1,600 for a stay at the Recovery Retreat in October 2021, but she canceled her reservation a week in advance after being told she could only stay five of the nine days she’d booked. Watts was promised a refund multiple times in text messages that VICE reviewed.More than four months later, after everyone associated with the Recovery Retreat stopped answering her calls and texts asking about the refund, Watts’s friends and family members turned to social media, posting comments like “SCAM!” and “Give her back her money!” under the business’s Instagram posts. Though Saran initially responded to Watts’s sister over Instagram DM, Watts has still not received a refund. Saran and Angel did not respond to multiple requests for comment about the situation from VICE following the initial interview and there were no allegations of medical malpractice. The Recovery Retreat’s Instagram account last posted in December 2021, a few weeks after my tour. In Florida, providers told VICE that surgery centers are only legally required to ensure patients leave their facilities with someone over the age of 18. Other than that, there are no explicit regulations around aftercare for outpatient procedures. But licensing requirements for assisted living facilities have also been used to shut down recovery houses, especially those with unsatisfied customers ready to file complaints. (The Florida Department of Health did not respond to multiple requests for comment about if and how it plans to regulate the recovery care industry.)“It’s similar to the difference between prescriptions/medications, and homeopathic and herbal treatments,” said Tito Vasquez, an assistant professor of plastic surgery at the Yale School of Medicine and practicing surgeon. “They’re not regulated because the safety profile and the effect is not as significant or severe enough to warrant it. I don’t think that’s ever going to change.” As long as the beauty ideal—and the glittering lifestyle its fulfillment promises—can be achieved through surgery, some women will find a way to ascend to dollhood. Sometimes, particularly when money is tight, that means navigating a shadowy world of opportunistic doctors and unlicensed post-op care workers, with little more reliable research than a collection of Instagram testimonials. But that isn’t stopping the dolls. On a Post-Op Rides NYC drive in the backseat of Menos’s Benz, Nellie was flat on her stomach, dressed in sweats with her curly hair pulled into a topknot and freshly aching from an hour-long massage session. “I actually feel like a woman now,” said Nellie, beaming through her seventh day of BBL recovery. “I have the curves. I have the shape. I can wear a dress and feel confident in it. I can wear jeans and know from the back that it looks nice. I don’t regret it—and I’ll do it again.”Correction: This story has been updated to clarify the roles of two workers. Katie Way is a staff writer at VICE. Follow her on Twitter.“I have the curves. I have the shape. I can wear a dress and feel confident in it. I can wear jeans and know from the back that it looks nice. I don’t regret it—and I’ll do it again.”