In 2015, MSNBC published “Nipped, Tucked and Wide Awake?”—an article warning about the dangers of cosmetic surgeries performed under local anesthesia. At the time, the trend was marketed as modern and affordable. But the reality? Patients often faced compromise, discomfort, and unnecessary risk.

More than a decade later, those warnings have proven accurate. A recent New York Post report echoed the same concerns—this time spotlighting the rise of “awake BBLs” (Brazilian Butt Lifts). The article included patient horror stories of complications, poor results, and regret.

Across both eras, the message is clear: when cosmetic marketing prioritizes low cost and comfort over safety and surgical integrity, patients can suffer.

What the MSNBC Article Taught Us (2015)

The 2015 piece investigated clinics promoting “wide-awake” contouring procedures, often performed in non-hospital office settings. Red flags included:

• Patients kept awake for long, invasive procedures
• Heavy reliance on large doses of local anesthetics
• No anesthesiologist present to monitor safety
• Limited or no emergency protocols in case of complications

In the years since, those risks have become reality. Cases of lidocaine toxicity, uneven surgical results, uncontrolled bleeding, and poorly prepared facilities have been reported.

The NY Post “Awake BBL” Warning

Fast forward to today, and the risks are even clearer. A recent NY Post article highlighted “awake BBL horror stories” including:

• Surgeons cutting corners on credentials and training

• Patients experiencing pain, anxiety, and unsafe conditions mid-surgery

• Serious complications like bleeding, fat necrosis, and deformities

Even board-certified experts interviewed for the article said they would never perform an awake BBL due to the lack of safety controls.

Bringing together both articles, here are the biggest concerns with awake plastic surgery:

• Unqualified operators – Often performed by non–board certified practitioners.
• Non-accredited facilities – Many lack the infrastructure of accredited surgical centers.
• Lidocaine toxicity risk – High doses increase the chance of overdose.
• Limited surgical access – Surgeons must hold back to avoid pain, leading to under-correction or uneven results.
• Longer procedural times – Awake surgeries can take longer and cause more bruising/swelling.
• Patient movement – Without deeper anesthesia, movement can cause bleeding or compromise safety.
• No backup – Without an anesthesiologist or emergency protocols, complications can escalate quickly.

At 9201 Park Plastic Surgery, PLLC, Dr. John Burns and his team hold safety as the highest priority.

• All procedures are performed in an on-site, AAAASF-accredited surgery center

• Anesthesia is delivered by board-certified anesthesiologists from Dallas Anesthesia Associates
 
• All staff are ACLS certified with training specific to plastic surgery

• Every patient receives personalized, concierge-level care from consultation to recovery

With more than 25 years of surgical experience and recognition from Newsweek, D Magazine, and Texas SuperDoctors®, Dr. Burns offers patients not only advanced techniques but also the peace of mind of true safety standards.