BBL in Turkey: What UK Coroners Found in the Deaths of British Women, and What to Ask Before You Book

A Brazilian butt lift takes fat from one part of the body, usually the stomach, and injects it into the buttocks. If some of that fat enters a vein, it can travel to the lungs and kill. That is the risk behind every BBL in Turkey, and behind every Turkey BBL package advertised online. Coroners in England have recorded the deaths of three British women after the operation there, and a fourth inquest is on hold while proceedings in Turkey run their course. This page sets out what the coroners found, how a fat embolism happens, and seven questions that answer their findings before you pay a deposit.

Why is a BBL in Turkey the procedure coroners keep writing about?

Because the same findings keep turning up. When an inquest shows that other deaths could follow unless someone acts, a coroner in England can write a Prevention of Future Deaths report to the person or body that could act. Two of the cases below produced one: Leah Cambridge's in 2019 and Melissa Kerr's in 2023. A third, Demi Agoglia's inquest in December 2024, ended with a conclusion of misadventure contributed to by neglect, and the coroner said he would write to the Health Secretary.

The operation itself is a long-standing worry among UK plastic surgeons. In 2018 the British Association of Aesthetic Plastic Surgeons advised its members to stop performing it in the UK, and in the Cambridge inquest an expert surgeon gave evidence that BBL risks were considerably greater than those of any other cosmetic procedure. In October 2022 the association changed course: its guidance now says no to the BBL as it was done, and yes to a superficial version with real-time ultrasound. We come back to that below.

Three things should be said before the cases. First, the operation carries this risk in any country, and the coroners did not say otherwise. Second, these are four documented cases. They are not a rate. We have found no reliable measure of how many women have a BBL in Turkey and come home well, so nothing here tells you the odds for any particular surgeon. Third, nothing on this page is a verdict on any hospital or clinic, and none is named.

Leah Cambridge: why did she sign three dozen pages she had no time to read?

Leah Cambridge was 29. She travelled to Izmir for a BBL under general anaesthetic. The coroner's report records that surgery began on Monday 27 August 2018, about 90 minutes after she was admitted to hospital at 08:17. During the procedure a complication arose, and she was pronounced dead at about 13:00 the same day. A post-mortem examination in England found that fat had entered veins in her body, leading to a fat embolism. The inquest concluded on 22 November 2019 with a narrative conclusion, and the Senior Coroner for West Yorkshire (East) signed his report on 29 November 2019.

The paperwork is what stands out. The inquest found that she had been asked to sign her name some three dozen times on pages in Turkish and English, without being given time to read and take in what they said. The coroner's concern was stated plainly: that informed consent is not obtained. The report says the information has to reach a person before any commitment is made or any money spent, and in a form they have time to absorb. Instead she had a substantial amount of material, some of it in Turkish, on the morning of surgery, shortly before being taken to theatre.

The report also records that the inquest heard that a UK agent named in it, Elite Aftercare, continued to arrange travel to Turkey for other clients to have BBLs. The coroner voiced concern at the lack of control of the procedure by UK regulators, and sent the report to the Health Secretary and the General Medical Council among others.

What would a check have shown? Asking for every consent document in English, days before travel, would have told her what she was about to sign. It cannot tell us what she would have decided.

Melissa Kerr: no surgeon before the day, a WhatsApp chat, cash

Melissa Kerr was 31. Her coroner's report says she was admitted to a private hospital in Istanbul on 19 November 2019 for liposuction and a BBL, and became unwell during surgery; she was declared dead. The medical cause of death was recorded as pulmonary thromboembolism and fat embolism. The inquest concluded on 12 September 2023 and the Senior Coroner for Norfolk wrote her report the next day.

The coroner's findings are specific:

• Ms Kerr was not seen by a surgeon or any clinician before the date of the procedures.
• She had a limited assessment beforehand, with limited psychological and physical assessment.
• She was given limited information about the risks and the mortality rate.
• There was limited documentary evidence about the procedures that were performed.
• Expert evidence was that two choices of technique raised the risk of fat embolus: the access incision for the cannula, and the decision to inject fat into the superficial muscle.

The coroner also said she was concerned that patients travelling to Turkey for this surgery were not being made aware of the high mortality rate, that controls on such surgery abroad were limited or absent, and that methods regarded as unsafe in the UK were in use. She noted that the UK Government has no control over what happens abroad. The report went to the Health Secretary and the Department of Health and Social Care.

Press coverage of the inquest added detail about how the booking happened. It was reported that Ms Kerr arranged to pay £3,200 in cash in a WhatsApp conversation with a hospital worker, and that she asked four times to see photographs of previous patients; the inquest heard no evidence that she received them. The surgeon who gave expert evidence put the death risk of a BBL as likely to be in excess of one in 4,000. That is one expert's estimate given at one inquest. Other estimates have been published and they do not agree with one another, so treat it as an order of magnitude and not as a statistic for any clinic.

What would a check have shown? A written answer to "who will operate on me, and when will I meet them?" would have exposed the gap the coroner found. A request for a contract and invoice from the hospital would have shown that the booking existed only as a chat and a cash promise.

Demi Agoglia: what does "no proper informed consent" look like in practice?

Demi Agoglia was 26, a mother of three from Greater Manchester. She died on 8 January 2024 at a hospital in Istanbul, three days after a BBL in Turkey. Her inquest was held at Bolton Coroner's Court on 11 December 2024. The coroner, John Pollard, concluded that she died by misadventure contributed to by neglect. The medical cause of death was reported to be a microscopic fat embolism.

What he said about the care around the operation is reported as follows. There was no proper informed consent. There was no proper pre-operative care and advice, and no proper post-operative care, which he described as ranging from woeful to non-existent. The staff sent to the villa where she was recovering were not qualified nurses, and she was taken to hospital by taxi, not ambulance. He described the practice in the harshest terms, as medicine that would not be tolerated in the UK. The Turkish authorities refused to co-operate with the inquest, and the hospital and the surgeons did not answer requests for statements. He said he would write to the Health Secretary.

The pattern is the same as in the two earlier reports, with one addition: the recovery arrangements. Where a patient recovers, who is with her and how she reaches a hospital if something goes wrong are part of the operation, whatever the package calls them.

Hayley Dowell: why is an inquest still waiting on Turkish proceedings?

Hayley Dowell was 38. She died on 3 October 2023, reportedly after a package of a BBL, a tummy tuck and liposuction at a private clinic in Istanbul. Her inquest, reported in November 2025, has been adjourned. The coroner acted after a Turkish lawyer warned that anything done in the English inquest could prejudice Turkish criminal and civil cases, and a new date will be set once more is known about those proceedings. Her widower is reported to have started civil proceedings, and the Turkish health ministry is reported to be investigating. The same report cited Foreign Office data of at least six British deaths in Turkey in 2023 after travelling for medical procedures; that count covers procedures of every kind, not only BBLs.

We do not know what happened in the operating theatre, and neither does anyone else yet. What the case shows is a practical point about recourse: when something goes wrong abroad, answers can be slow and may depend on courts in another country. This inquest was still waiting more than two years after the death. That is a reason to settle your questions before the operation, when they cost nothing. For combined packages, see our guide to the tummy tuck in Turkey.

What can a complication look like from the patient's side?

One woman who spoke to the press in February 2024 described a third BBL in Istanbul that she paid for in January that year. She had two earlier BBLs there, in April 2019 and August 2020; she said she was pleased with the first and unhappy with the second. She had also worked with the same network of doctors as an ambassador, receiving free procedures in return for promoting it on social media. After the third operation she said she blacked out, was in severe pain, and needed blood transfusions after her haemoglobin fell. She said her follow-up with the surgeon was rushed, that her cannulas were not removed, and that her complaints to the clinic were at first ignored. The clinic's owner was reported to have apologised after her video went viral.

This is one person's account, relayed by a news outlet, and the clinic's own response was not reported. It does not show that anyone was at fault. It does show two things worth knowing: the person who recommends a clinic online may have been paid in free surgery, and a complaint to a clinic's WhatsApp number depends on that number answering.

What is a fat embolism, and why does BBL technique matter?

An embolism is a blockage carried in the blood. In a fat embolism the blockage is fat. If the cannula that injects fat into the buttock enters a vein, or if fat is placed in muscle where large veins run, some can be drawn into the circulation and travel to the lungs. In Leah Cambridge's case the post-mortem found fat in her veins; in Melissa Kerr's, the cause of death included fat embolism; Demi Agoglia's was reported as a microscopic fat embolism.

UK plastic surgeons have said the same thing about where the fat went. A 2018 statement from their association said that all the deaths investigated were due to fat emboli and that fat was found in the buttock muscle. Their 2022 guidance says the recorded BBL deaths all involved a breach of the fascia, the layer over the muscle, with fat injected into the muscle. It therefore accepts only superficial gluteal lipofilling, in which the fat stays in the layer above the muscle, and says the cannula should be watched in real time on ultrasound to confirm that it does. That matches what the Norfolk coroner heard about the incision and the depth of injection.

Three cautions. Ultrasound does not remove the risk: the association's addendum, issued in October 2024 and updated in December 2025, still lists fat embolus, sepsis and severe bleeding among the risks of buttock surgery. A clinic that says "we use ultrasound" has told you one fact, not the whole picture. And the guidance is a UK professional standard, so you are entitled to ask whether the surgeon who will operate on you works to it. Finally, the surgery is not only a technique question: in all three inquests the coroners also found failures in information, consent and aftercare.

What should you do if you are already booked, or already home?

If you are booked, you can still ask the questions below, in writing, and a clinic's refusal to answer is information. Read your deposit terms before you decide whether to go, so that you know what you would lose by delaying.

If you are home from a BBL and you feel unwell in a way that frightens you, get urgent medical help where you are. Do not wait for a reply to a message. Tell the doctor you have had a BBL and when. After that, ask the clinic for your operation record, consent forms, anaesthetic record and discharge notes, and keep every message, invoice and photograph with dates. If you have a problem and need a view on what happened, those papers are what any doctor, solicitor or complaint route will ask for first. For the other warning signs, our guide to red flags in medical tourism in Turkey covers the pattern.

Seven coroner findings turned into seven questions for your clinic

Each question below answers one finding from the cases above. Put them to the clinic in writing and keep the replies. A vague answer, an answer in a voice note or no answer at all is itself the finding.

1. Who is the surgeon, and will I meet them before the day?

The finding: Melissa Kerr was not seen by a surgeon or clinician before the date of the operation. Ask for the full name and registration details of the surgeon who will operate, and whether you will have a consultation with them before you travel or at least before you pay. "Our expert team" is not a name. Compare the name with the doctors recorded against the facility's register entry; a missing name is a question for the clinic, not a disqualification. Our guide on how to check a doctor in Turkey shows how.

2. What assessment will I have, and by whom?

The finding: the assessment was limited, physically and psychologically. Ask what examination, history and tests come before the operation, who performs them and when. A quote that arrives from a photograph describes a body that has not been examined. Ask what would make the surgeon decline to operate on you.

3. Have the risks and the mortality been explained in writing?

The finding: in all three cases information on risks, or on mortality, was limited or missing. Ask for the risks of a BBL in writing, including fat embolism and death, and for the surgeon's own account of how often it has happened in their practice. If the answer is a reassurance with no figures, that is not an explanation.

4. Will I have every consent document in English, days before I pay?

The finding: Leah Cambridge signed about three dozen pages in two languages with no time to read. Ask for all the forms in English now, and decide how long you need. A document that first appears on the morning of surgery is not consent in the sense the coroner meant.

5. What technique will be used, and will it be written in the operative plan?

The finding: the choice of access incision and injecting fat into muscle were identified as raising the risk. Ask where the fat will be placed, whether it will stay above the muscle, whether real-time ultrasound will be used and who will be watching it. Ask for the technique to be written into the plan. You are not trying to second-guess a surgeon; you are making sure the question was asked.

6. Where will I recover, who is with me and how do I get to a hospital?

The finding: in the Agoglia inquest, the staff at the villa were not qualified nurses and the patient was taken to hospital by taxi. Ask where you will sleep, who attends you, what their qualifications are, which hospital is used in an emergency, and how you would be transported. If the answer is a villa and a driver, you now know what the package is.

7. What documents prove who I am dealing with, and what I will take home?

The findings: limited documentary evidence of the procedures performed, a booking that existed only as a chat and a cash payment, and, in the Agoglia inquest, a hospital and authorities that did not co-operate. Ask for a written contract and an invoice from the facility that will operate, not from an individual's account and not in cash. Check the facility on the Ministry of Health register with our register search; an entry shows authorisation, not which operations the facility performs. Ask whether a UK agent is involved and what they are responsible for. Before you leave, you should be given an operation record, anaesthetic record and discharge notes. Our guide to how to verify a Turkish clinic's licence explains the document, and the general plastic surgery in Turkey page covers what to ask of any plastic surgery clinic.

Copyable checklist

1. Surgeon: full name and registration details in writing; a consultation with them before I pay; compared with the register entry
2. Assessment: what examination, history and tests come before surgery; who does them; what would make them decline
3. Risks: BBL risks including fat embolism and death in writing; the surgeon's own record explained, not a reassurance
4. Consent: every form in English, days before payment, with time to read and ask
5. Technique: where the fat goes, whether it stays above the muscle, ultrasound, who watches it; written into the plan
6. Recovery: where I stay, who attends and their qualifications, which hospital, how I am transported in an emergency
7. Paper trail: contract and invoice from the operating facility, no cash; facility found on the register; UK agent's role asked; operation, anaesthetic and discharge records on departure

How does a Clinimora investigation help with a BBL booking?

The register tells you whether a facility is authorised. It does not tell you what the clinic's own paperwork shows, whether the doctors recorded against it are the ones who will operate on you, or whether the promises in its quote hold together. A Clinic Investigation takes one named clinic and builds a dossier on those questions: the company, the official registration, the provider details, the doctors and the claims the clinic has made, with the findings and their limits stated.

It does not assess a surgeon's skill, and it does not predict how an operation will go. It makes the seven questions above easier to answer from documents rather than from a coordinator's messages. Clinics cannot pay Clinimora for anything. See how Clinimora works and the Research Pass.