Curves to die for? How a dangerous trend began

Under the skin of a fatal attraction to buttock enhancement surgery

British women were always more interested in their bust than their bottom until Latino curves, as seen on Jennifer Lopez and the supermodel Gisele Bundchen, burst on to the scene in the 1990s.

The US singer of Puerto Rican descent and the Brazilian model were the trigger that led American and European women to shift their attention from their front to their behind, following the example of the Latin countries, according to Luiz Toledo, a plastic surgeon. "Women started turning up in clinics with pictures of Gisele Bundchen saying they wanted to look like her. She started the trend," he said.

Beyoncé Knowles cemented the image of generous buttocks in the public mind, with ever curvier bottoms gracing the covers of magazines.

This week the trend claimed its first British victim when Claudia Aderotimi, a 20-year-old Londoner, flew to Philadelphia for a cut-rate bottom enhancement in a hotel near the airport.

On Sunday she had a silicone injection into her buttocks as a top-up to a procedure carried out last November. The treatment was arranged over the internet and carried out by a practitioner believed to be unqualified. Ms Aderotimi paid a reported $2,000 (£1,200).

On Monday she developed chest pains and was taken to hospital where she died on Tuesday from a suspected pulmonary embolism – a blood clot in the lung possibly caused by the silicone entering her bloodstream.

Dr Toledo, a Brazilian who runs a clinic in Dubai specialising in facial and body contouring, said demand for buttock enhancement was growing. British women are his second biggest patient group after those from the Emirates. His favoured method – the "Brazilian buttock technique" – involved "lipotransfer", in which fat is removed from the stomach and hips by liposuction and pumped back into the buttocks. A member of the International Association of Aesthetic Plastic Surgeons, he has lectured on the technique in Britain. "Everyone who comes for liposuction says 'oh maybe you can use the fat to put a little on my buttocks.' They have read about it in magazines. We use this method except when the woman is too lean and we don't have the fat to aspirate.

"In that case there are two options: insert a silicone implant into the muscle of the buttock or inject an absorbable filler such as macrolane. But there are problems with both of these because the macrolane injections are too expensive and as it is reabsorbable it disappears and has to be redone after a couple of years. With the silicone implants you cannot have injections in the buttocks because they will puncture the implants."

Injections of liquid silicone, as reportedly performed on Ms Aderotimi, were widely used in the 1970s, initially without problems. But as larger amounts were injected and the procedure was taken up by non-medically qualified practitioners problems, including deaths, grew. The injections were banned in Brazil, where they had been most widely used in 1982 and later in the US and Europe.

Dr Toledo said the Brazilian fascination with the female behind dated from colonial times. "In the days of slavery, the Africans brought to Brazil came from a region where they had very small waists and big bottoms. The Portuguese colonisers were completely crazy about them and many had children with them – 30 per cent of Brazilians are mixed race."

Cut-rate procedures of the kind offered to Ms Aderotimi were offered in hotel rooms in Dubai, too, carried out by unqualified practitioners, he said.

"I have patients who have come to me to patch up their problems. I ask them 'why would you go to a hotel room?' They say: 'My friend had it and she was all right.'"

David Sharpe, professor of plastic surgery at Bradford University, said: "I had a few women approach me five or six years ago but I wouldn't do it. Dissecting out a pocket in the muscle of the buttocks near the sciatic nerve to take a silicone implant didn't seem like a good idea to me.

"Putting in an implant that you are going to sit on was also going to put it under some stress so it would be likely to wear out quicker. Lipotransfer is becoming more popular – it featured quite heavily at our last scientific meeting."