Hand Surgery to Staff
You are asleep under general anesthesia. Parts of your operation pass to a technician, an assistant, or a doctor with no U.S. license. The surgeon has moved to the next room.
The Standard We Kept
The official statement from Goals Aesthetics & Plastic Surgery on why we left Miami. We built Goals on three things: a surgeon you know by name, a patient who is awake, and a room ready for inspection any day. Miami rewarded the opposite, and we would not trade. Here is what we built instead, and how to check every word.
Why Goals left Miami · Published October 2026
Why this page exists
A Statement, Not a Sales Page
Goals operated in Miami. Then we left. This page says why, in our own words. We name no other clinic. What we describe is a climate. We saw it ourselves. Patients told us about it, again and again. So did people who had worked inside other clinics. Where Florida has since written rules about the same problems, we cite them. Where the science shows our way is safer, we cite that too.
BBL safety
The Arithmetic of a Bad Idea
1 in 3,448
Deaths per Brazilian butt lift in the 2017 surgeon survey that set off the alarm¹²
10
Verified deaths Florida’s Board counted in the 36 months before its 2022 emergency rule⁴
1 in 14,952
Deaths per BBL by 2019 among surgeons who followed the new rule: fat under the skin only¹³
The market
The Local Customs We Declined
Habits that had become normal in the market we competed in. Patients described them to us again and again. So did people who had worked inside other clinics.
Schedule Twenty a Day
Fifteen or twenty major operations on one surgeon’s list for a single day. That number is only possible when someone else is doing the cutting.
Manage the Inspection
A surprise inspection is expected. So the surgery days are emptied out. The inspector walks through quiet rooms and finds nothing.
Sell on Price Alone
The ads lead with the lowest package price. The surgeon’s name, the room’s accreditation, and who will actually operate never come up.
Drawn from our own years in that market and many repeated conversations with patients and former staff of other clinics. We name no practice. Florida’s rules below describe the same climate.
Side by side
Two Ways to Run a Surgical Practice
| The model we left | Goals | |
|---|---|---|
| Who operates | Staff may do parts of your operation while the surgeon moves between rooms. | The surgeon you met. First cut to last stitch, and at your follow-up. |
| Anesthesia | General. You are unconscious for hours. | Local. You are awake and comfortable, and you know who is in the room. |
| Cases per surgeon, per day | Fifteen to twenty. | What one surgeon can do well, with a limit on how much per session. |
| How you know who operated | You wake up and are told. | You were there. |
| Accreditation and inspections | Managed around the visit. | AAAHC-accredited, surveyed on site. Any day is inspection day. |
| Where the fat goes | As much as possible. | Under the skin only, as the task force requires, and only as much as one session can carry. |
| Follow-up care | The next patient. | Your surgeon sees you about a month later. A published concern process stands behind it. |
Goals’ own comparison. The left column describes a model, not any one clinic.
Florida, 2019 to 2023
The Law Caught Up
After a run of deaths, Florida wrote rules for fat transfer to the buttocks. The Board counted ten verified deaths in the 36 months before its 2022 rule.⁴ The news has kept counting since, most recently in October 2026.¹¹ ¹⁴ The rules read like a description of how we already worked.
2019: Fat Only Under the Skin
The Board of Medicine’s emergency rule, now Rule 64B8-9.009. Fat goes under the skin only. It must never cross into the muscle.¹ ²
2022: Ultrasound, and Three a Day
Ultrasound guidance while the cannula is placed and the fat goes in. The recording stays in your chart. No surgeon does more than three BBLs in a day.³ ⁴
2023: The Surgeon, Present and Alone
Statute 458.328. The surgeon examines you in person. No one else may remove or inject the fat. One surgeon, one patient at a time, no second case running. Offices are inspected unless they hold accreditation.⁵
A surgeon who stays in the room. A patient who is awake. Fat placed under the skin only. These were Goals’ rules before Florida wrote them down.
The clinical case
Why Our Patients Are Awake
The model we left needs a patient who is asleep for hours. Ours does not. The science on why that matters goes back decades.
No General Anesthetic
Local anesthesia means no general anesthetic and no long recovery from it. In a survey of 15,336 awake cases there were no deaths, no clots to the lungs, no transfusions, and no hospital stays.⁷ A later survey of 66,570 office cases found the same.⁸
You Walk Out the Same Day
Blood clots are the leading cause of death after liposuction. They form during long operations, when a body lies still for hours under general anesthesia.⁹ ¹⁰ An awake patient stands up and walks out of the room.
Fat Only Where It Cannot Travel
Fat embolism is what the Miami autopsies found. It happens when fat is pushed into or under the buttock muscle and reaches the lungs. The task force and Florida law both say: under the skin only.⁶ ⁵ That has been our rule from day one.
The Goals standard
What We Built Instead
Awake, Under Local Anesthesia
Most Goals body contouring is done awake, under local anesthesia. You know who is in the room because you are in it too.
One Named Surgeon
The surgeon you meet is the surgeon who operates, and the one who sees you after. You can look up the license yourself.
Fat Where the Task Force Says
Fat transfer to the buttocks goes under the skin only, never into the muscle, and only as much as one session can safely carry.⁶
AAAHC-Accredited, Every Facility
Every Goals facility is accredited by AAAHC and surveyed on site at least every three years.
Vetted, Then Proctored
License, board status, malpractice history, and hospital privileges are checked before a surgeon’s first case with us. A senior Goals surgeon stands in the room for the first ones.
A Way to Raise a Concern
If something worries you, there is a published route to tell us. A named person takes it and works it through with you.
Our statement
A Note From the Goals Team
We did not leave Miami because the patients were wrong. They wanted what every patient wants. A result they can live in. A price they can plan for. A surgeon who tells them the truth. The market had learned to deliver the first two by giving up the third.
Surgery of any kind carries risk. We say so in every consultation. Our job is to keep that risk as low as the evidence allows, and to be honest about what remains. We do this because of what comes after. A patient walks out of the room the same day. A few weeks later, they walk into a body they feel at home in. That change is why we do this work. It is not worth a single shortcut.
So, to anyone thinking about body contouring, anywhere: learn your surgeon’s name before you learn the price. Ask who will be in the room. Choose being awake over being told what happened. Pick the clinic that is glad to see the inspector. None of this requires choosing Goals. It only requires asking.
Transparency
Don’t Take Our Word for It
Every claim on this page can be checked. Here is where.
NPI Registry
The federal directory of every U.S. clinician. Name, specialty, and practice address, free to search.
State License Lookup
Every state medical board runs a free license search. New York’s is updated daily.
Board Certification
ABMS Certification Matters tells you whether a surgeon is certified by a member board.
Our Surgeon Profiles
Each Goals surgeon’s licenses and board certification, as we verified them.
Real Results
Our own patients, photographed by us, before and after.
Prepare for Your Consultation
What to bring and what to ask, so you leave with straight answers.
For patients
Six Questions Worth Asking Anywhere
Ask them at any clinic, in any city. Here is how we answer.
Who Will Operate?
At Goals: the surgeon you met, in the room from first cut to last stitch.
How Many Cases Today?
At Goals: only as many as one surgeon can do well. Ask, and we will tell you the number.
Awake or Asleep, and Why?
At Goals: awake, under local anesthesia. The person responsible is the one you can see.
Accredited by Whom?
At Goals: AAAHC, at every facility, surveyed on site at least every three years.
Where Does the Fat Go?
At Goals: under the skin only, never into the muscle, and only as much as one session can carry.
What If Something Worries Me After?
At Goals: a published concern route, a named person who takes it, and your surgeon at follow-up.
Patients from Florida
Still in Florida? Still Welcome.
We no longer operate in the state. Patients from Florida still come to us. Here is how.
Closest Goals Clinic: Atlanta
About two hours by air from Miami. AAAHC-accredited, with Goals surgeons who operate awake.
Flying In for Surgery
How we arrange your consultation, your surgery day, and your follow-up when you travel to us.
Awake Brazilian Butt Lift
Fat transfer under local anesthesia, placed under the skin, by the surgeon you met.
Related guides
Keep Reading
The BBL Death Rate, Explained
Every figure, sourced, and what changed when the fat stayed under the skin.
Liposuction Rules by State
What seven states require, Florida for comparison, and every license lookup.
How to Verify a Plastic Surgeon
Four free checks in ten minutes, with the links.
FAQ
Questions About This Statement
Yes. Goals operated in Miami and no longer practices in Florida. Our clinics are in New York, New Jersey, Pennsylvania, Maryland, Georgia, Texas, and California.
No. We name no practice. This page describes a way of working we saw and refused, and the rules Florida has since written about it.
Yes. Awake, under local anesthesia. Fat under the skin only. Done by the surgeon you met, at a volume one session can safely carry.
Florida’s law is far stricter than it was in 2019. The safest BBL anywhere has the same four marks: the surgeon you met does the whole operation, the fat stays under the skin, the volume fits one session, and the facility is accredited. Ask our six questions at any clinic, and judge the answers.
Surgery done, in whole or in part, by someone other than the surgeon you agreed to. It usually happens under general anesthesia, so you cannot know. Florida’s 2023 law now forbids handing off fat removal or injection.
Every surgeon’s license is public record. Our safety page shows how to look it up and how to confirm board certification. Every facility’s AAAHC accreditation can be confirmed with AAAHC.
No. Every operation carries risk, and your surgeon will go through yours with you at your consultation. What we promise is to keep it as low as the evidence allows, and to be honest about the rest.
Atlanta, Georgia, about two hours by air from Miami. Our Flying In guide explains how we arrange the consultation, the surgery day, and the follow-up.
Get started
Ask Us Anything
Free consultation, no obligation. Ask who your surgeon will be, how many cases are on the day’s list, and where you will be treated. You will get straight answers.
Prefer to talk now? (833) 462-5769
References
Sources
The numbered references for the figures and rules cited on this page, checked October 13, 2026.
- Florida Department of Health, Board of Medicine. Annual Regulatory Plan 2019: emergency rule 64B8ER19-1 on gluteal fat transfer, incorporated into Rule 64B8-9.009 effective September 3, 2019.
- Florida Administrative Code, Rule 64B8-9.009, Standard of Care for Office Surgery.
- Florida Administrative Code, Emergency Rule 64B8ER22-3, Standard of Care for Office Surgery (effective June 14, 2022).
- WUSF Public Media. Surgeons are challenging state restrictions on Brazilian butt lifts (June 22, 2022), reporting the Board of Medicine’s stated reasons for the 2022 emergency rule.
- Florida Statutes §458.328 (2023), Office surgeries, as amended by CS/CS/HB 1471, effective July 1, 2023.
- Multi-Society Task Force for Safety in Gluteal Fat Grafting. Urgent warning (July 2018).
- Hanke CW, Bernstein G, Bullock S. Safety of tumescent liposuction in 15,336 patients: national survey results. Dermatol Surg. 1995;21(5):459-62.
- Housman TS, et al. The safety of liposuction: results of a national survey. Dermatol Surg. 2002;28(11):971-8.
- Grazer FM, de Jong RH. Fatal outcomes from liposuction: census survey of cosmetic surgeons. Plast Reconstr Surg. 2000;105(1):436-46.
- Iverson RE, Pao VS. MOC-PS CME article: liposuction. Plast Reconstr Surg. 2008;121(4 Suppl):1-11.
- NBC 6 South Florida. Woman died of pulmonary fat embolism after plastic surgery in Miami: autopsy (2022).
- Mofid MM, et al. Report on mortality from gluteal fat grafting: recommendations from the ASERF Task Force. Aesthet Surg J. 2017;37(7):796-806.
- Rios L, Gupta V. Improvement in Brazilian butt lift (BBL) safety with the current recommendations from ASERF, ASAPS, and ISAPS. Aesthet Surg J. 2020;40(8):864-870.
- NBC6 Investigates (Viteri A, Fossi C). Family demands answers as NBC6 uncovers six patient deaths linked to Miami clinic. October 16, 2026.