Constantino Mendieta: Surgeons for Safety agrees with Board’s ultimate goal of promoting, improving patient safety


In June, the Florida Board of Medicine approved an emergency rule to significantly limit the practice of gluteal fat grafting, more commonly known as a “Brazilian butt lift,” in Florida.

In the emergency rule, there are two highly problematic and ineffective restrictions, including an arbitrary limit of only three procedures being performed in a day and a new requirement that ultrasound equipment be used during the procedure.

As board-certified plastic surgeons, we know firsthand what is needed to ensure patient safety, and we also look to science-based research and facts when it comes to the practice of medicine. That is why we at Surgeons for Safety believe that the gluteal fat grafting procedure can be performed safely.

We commend the Board for displaying an unambiguous commitment to patient safety by acting decisively and putting in place an emergency rule to immediately attempt to address safety concerns.

The procedure is not inherently dangerous when performed correctly by well-trained and seasoned surgeons; however, we agree there are surgeons that have not been following the standard of care and thus have not been practicing a safe procedure.

In our opinion, as surgeons who have been performing these surgeries for years with a focus on safety and quality outcomes, the emergency rule restrictions will do nothing to address the underlying problems we know exist in our industry. These include, but are not limited to, surgeons running too many operating rooms at once, falsifying or hiding medical records, and a disregard for what amounts to ineffective enforcement.

In fact, the policies contained in the emergency rule will likely make the situation worse for patients, as high-quality, law-abiding surgeons will comply with the new restrictions, resulting in a reduction in supply of safe procedures. This will drive the patient demand to the bad actors.

We want to emphasize and be clear here: The arbitrary procedure limits and ultrasound requirement currently contained in the emergency rule will not reduce demand for these procedures, nor will it increase patient safety. In fact, as currently drafted, we believe they may actually have the effect of promoting increased danger to the patient.

It is important to note that Surgeons for Safety does support the Board’s ultimate goal of promoting and improving patient safety, but we believe that the substance of the emergency rule should be replaced by a more sophisticated and results-oriented policy in the form of a permanent rule.

The changes that can and should be implemented to the standard of care, which would promote a safer procedure industrywide, include:

1) Establishing in rule a doctor-to-patient ratio to prevent the issue of surgeons running multiple operations concurrently;

2) Codifying a requirement, so that it is unambiguous that injections must be performed by the surgeon performing the procedure and may not be delegated; and

3) Creating a task force for the specific purpose of making recommendations to the Board and/or the Legislature to address further issues such as unregulated recovery houses.

We feel the proposed solutions in the emergency rule, while well-intentioned, will result in more safety concerns for patients, and we are hopeful that the Board will consider our recommendations for an alternative solution. We all want to promote and improve patient safety, and we believe that was the Board’s intention from the start. We look forward to working with them as we collaborate to ensure that these guiding principles remain at the core of the practice of medicine.


Dr. Constantino Mendieta, M.D., FACS, is a Board-Certified Plastic Surgeon in Miami-Dade and is recognized as one of America’s Best Plastic Surgeons 2022 by Newsweek. He is part of the Surgeons for Safety effort, which is comprised of board-certified plastic surgeons whose mission is to focus on educating and advocating for safety measures as it relates to medical procedures in Florida and promoting common-sense measures for the plastic surgery industry based on proven scientific and medical data.

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