Awake BBL in Chicago: Why a Safer Brazilian Butt Lift Is Changing the Game
February 23, 2026
An awake BBL is a Brazilian Butt Lift performed entirely under tumescent local anesthesia — no general anesthesia, no breathing tube, no hospital stay. At BodyLuxe in Chicago, Dr. Daniel Farrugia performs the awake Gold Coast BBL™ as a safer, more affordable alternative to the traditional approach. You walk in, get sculpted, and walk out the same day.
Key takeaway: The traditional BBL was once the deadliest elective cosmetic procedure in the United States, with a mortality rate nearly 20 times higher than other aesthetic surgeries. The awake approach eliminates the risks of general anesthesia and addresses the root cause of that danger — fat embolism — through a built-in biological safety mechanism that only works when you’re conscious.
An awake BBL is a Brazilian Butt Lift performed under tumescent local anesthesia instead of general anesthesia. You remain fully conscious throughout the procedure — relaxed and comfortable, but aware — while Dr. Farrugia sculpts your midsection with awake liposuction and transfers purified fat to your buttocks for a natural, lifted result.
The tumescent technique involves injecting a dilute solution of lactated Ringer’s (similar to saline), lidocaine (a numbing agent), and epinephrine (to minimize bleeding) directly into the treatment areas. This completely numbs the fat layer between the skin and muscle, so you feel pressure and movement but no pain. Most patients describe it as surprisingly comfortable — many watch shows on our big-screen TVs, listen to music, look out at Lake Michigan from our 36th-floor suite, or chat with our team throughout the procedure.
Unlike a traditional BBL — which requires a hospital or surgical center, general anesthesia, an anesthesiologist, and often an overnight stay — the awake BBL is performed as an outpatient procedure right here at BodyLuxe on Chicago’s Gold Coast. The entire process typically takes 2 to 3 hours from start to finish.
The BBL has historically carried the highest mortality rate of any cosmetic procedure. A landmark 2017 survey by the Aesthetic Surgery Education and Research Foundation (ASERF) found that BBL had a mortality rate of approximately 1 in 3,000 — roughly 20 times higher than the average for aesthetic surgery. The cause, in nearly every case, was the same: fat embolism.
Fat embolism occurs when injected fat enters a blood vessel — typically the superior or inferior gluteal vein — and travels to the lungs, causing a pulmonary embolism that can be fatal within minutes. A 2022 autopsy review of 25 BBL deaths in South Florida confirmed that in every single case, fat had been injected into the gluteal muscle, where these large veins run. Not one death occurred when fat was placed only in the subcutaneous layer (above the muscle).
This finding led the American Society of Plastic Surgeons, along with four other international surgical societies, to issue an urgent safety advisory: fat should only be placed in the subcutaneous tissue and should never be injected into the muscle.
The question became: how do you guarantee the fat stays above the muscle? That’s where the awake technique provides an answer that general anesthesia simply cannot.
When you’re under general anesthesia, your muscles are completely paralyzed by neuromuscular blocking agents. The gluteal muscles go soft, removing the physical barrier between the subcutaneous layer (safe) and the intramuscular space (dangerous). If the cannula drifts too deep, neither the surgeon nor the unconscious patient can feel it happening.
When you’re awake, three safety mechanisms work simultaneously:
Your gluteal muscles remain active and firm under tumescent local anesthesia. The tumescent solution numbs the fat layer but not the muscle beneath it. This creates a clear physical boundary — the cannula glides easily through the numb subcutaneous fat but meets firm resistance at the muscle fascia. A 2018 study in Plastic and Reconstructive Surgery — the flagship journal of the American Society of Plastic Surgeons — concluded that fat embolism “cannot occur in the awake patient without the surgeon being acutely aware of a misguided cannula.”
If the cannula gets too close to the muscle, you feel it and can tell the surgeon immediately. This is a biological safeguard that doesn’t exist when a patient is unconscious. It’s the difference between operating with a co-pilot and flying blind.
The epinephrine in the tumescent solution constricts blood vessels in the treatment area, including the gluteal veins. Constricted veins are smaller targets and carry less blood flow, which further reduces the risk of fat entering the vascular system. This also means significantly less bleeding — the inventor of tumescent anesthesia, Dr. Jeffrey Klein, demonstrated that the technique reduces blood loss from up to 42% of removed fat to less than 1–2%.
A 2020 follow-up survey in the Aesthetic Surgery Journal showed that after surgeons adopted subcutaneous-only technique — the technique inherent to awake BBL — the mortality rate fell approximately 4-fold, from 1 in 3,448 to 1 in 14,952. In a separate study of over 12,000 consecutive BBL cases where 98% of surgeons injected subcutaneously only, there were zero fatalities. And in a study of 9,002 patients who underwent tumescent liposuction over 17 years, there were zero deaths and a major complication rate of essentially zero.
The awake BBL at BodyLuxe follows a precise, three-stage process using our FormSculpt® technique.
Dr. Farrugia carefully injects the tumescent solution into the donor areas (typically the abdomen, flanks, and/or back). Within minutes, these areas become completely numb. You’ll feel a brief pinch from the initial injection, then some vibration as the numbing solution is infiltrated into the treatment areas.
Using small, specialized cannulas, Dr. Farrugia performs awake liposuction to remove unwanted fat while sculpting the donor areas for a contoured, balanced look. BodyLuxe uses minimally invasive liposuction equipment by Euromi, a Belgian medical device company, which allows for precise fat removal through tiny incisions. The harvested fat is then processed and purified, keeping only the healthiest fat cells for transfer.
The purified fat is carefully injected into the buttocks in small amounts at multiple depths and angles to create a natural, rounded shape. Dr. Farrugia places the fat exclusively in the subcutaneous layer — above the muscle — using a controlled technique that accurately measures and limits injection pressure in real time. This maximizes fat survival and ensures safe, even distribution. Because you’re awake, you can provide direct feedback throughout — something that’s impossible when a patient is unconscious.
| Feature | Awake BBL (BodyLuxe) | Traditional BBL |
|---|---|---|
| Anesthesia | Tumescent local | General anesthesia |
| Fat embolism safeguard | Muscle tension barrier + patient feedback + vasoconstriction | No muscle barrier (paralyzed); no patient feedback |
| Setting | Luxury private suite | Hospital or surgery center |
| Procedure time | 2–3 hours | 3–5 hours |
| Return to light activity | 3–5 days | 7–14 days |
| Real-time feedback | Yes — you communicate throughout | No — you’re unconscious |
| Cost (Chicago) | $10,500–$12,500 | $12,000–$18,000+ |
| Overnight stay | No — go home same day | Often required |
| Post-op pain management | OTC medication; 24-hour tumescent analgesia | Often requires prescription opioids |
| Blood loss | Less than 1–2% of aspirate | Up to 42% without tumescent |
Key takeaway: The awake BBL offers a fundamentally safer approach by keeping you conscious — which activates the muscle tension barrier, enables real-time patient feedback, and eliminates all general anesthesia complications. It also costs significantly less and has a faster recovery.
The BBL fat transfer at BodyLuxe typically costs $3,000 on top of the price of sculpting the donor areas (e.g., the abdomen and love handles). That means your total cost depends on how much liposuction you need. For most patients getting a BBL with Lipo 360, the all-in cost ranges from $10,500 to $12,500.
The savings compared to traditional BBL come from eliminating three separate line items that hospitals and surgery centers charge: anesthesiologist fees ($1,500–$3,500), facility/operating room fees ($1,000–$3,000), and the costs associated with general anesthesia itself. According to the American Society of Plastic Surgeons, understanding what’s included in your BBL cost is essential for comparing options.
For comparison, AirSculpt’s Power BBL in Chicago averages approximately $13,109 according to RealSelf community data — for a procedure performed by a rotating roster of independent contractor surgeons at a corporate chain clinic.
| BBL Pricing | BodyLuxe (Awake) | Chicago Average (Traditional) | AirSculpt (Chicago) |
|---|---|---|---|
| Lipo 360 | Starts at $7,995 | $10,000–$18,000 | ~$11,000+ |
| BBL + Lipo 360 | $10,500–$12,500 | $12,000–$18,000+ | ~$13,109 avg |
| Anesthesia fee | Included (local) | $1,500–$3,500 additional | Included (local) |
| Facility fee | Included | $1,000–$3,000 additional | Included |
| Surgeon | Dr. Farrugia — consult through follow-up | Varies | Rotating contractors |
BodyLuxe offers financing through CareCredit and Cherry Financing, with monthly payment plans starting as low as $150/month and up to 24 months of zero-interest financing for qualifying patients. Contact us for a personalized quote.
The ideal awake BBL candidate is someone in good overall health who has enough donor fat for transfer and realistic expectations about the outcome. Because the procedure uses local anesthesia, it’s also an excellent option for patients who are nervous about going under or have medical conditions that make general anesthesia riskier.
Good candidates:
May not be suitable:
During your consultation, Dr. Farrugia evaluates your anatomy, discusses your goals, and determines the best approach. BodyLuxe offers complimentary in-person and virtual consultations.
One of the biggest advantages of the awake BBL is a faster recovery. Because there’s no general anesthesia to recover from and the tumescent technique causes less tissue trauma and virtually no blood loss, most patients feel significantly better within the first few days. The tumescent solution also provides up to 24 hours of post-procedural pain relief, so most patients manage discomfort with over-the-counter medication — no opioids needed.
You walk out of BodyLuxe the same day. Expect soreness, swelling, and some fluid drainage from the liposuction sites (this is normal and actually speeds healing by flushing out inflammatory byproducts). You’ll be in a compression garment. Have someone drive you home and stay with you overnight. No sitting or lying directly on your buttocks.
Swelling and bruising peak. Manage discomfort with ibuprofen or acetaminophen. Short walks around the house every few hours help circulation and reduce blood clot risk. Continue sleeping on your stomach or side.
Swelling begins to decrease. Most patients feel well enough for light daily activities. You can shower briefly (removing the compression garment). Many patients return to desk work within 5–7 days using a BBL pillow. Continue avoiding direct sitting when possible.
Bruising fades and swelling continues to decrease. You’ll start to see the shape of your new contours. Most patients are back to normal daily routines. Lymphatic drainage massage may be recommended to speed recovery.
Most swelling has resolved. The transferred fat has largely settled into its permanent position. See real patient transformations in our before and after gallery. You can sit normally again and gradually resume exercise.
Your final shape is visible. Research shows that approximately 60–70% of transferred fat cells survive long-term — a figure confirmed by a prospective ultrasound study that measured 66% mean retention. The body naturally reabsorbs the rest over the first few months, which is why results look slightly larger initially before settling into their final shape. The surviving fat cells are permanent and behave like any other fat in your body — maintained with a stable weight and healthy lifestyle.
There’s a meaningful difference between getting a BBL at a concierge, surgeon-owned practice and getting one at a corporate liposuction chain.
At BodyLuxe, Dr. Farrugia performs every procedure personally — no assistants doing the sculpting, no trainees, no hand-offs. He is certified by the American Board of Surgery and is a Fellow of the American College of Surgeons (FACS), with decades of surgical experience and training at institutions including Mayo Clinic, University of Florida, and University of Pittsburgh. He sees every patient at consultation, performs the procedure himself, and follows up personally.
Corporate chains like AirSculpt, SonoBello, and Mia Aesthetics operate on a different model. They hire surgeons as independent contractors — rotating providers who may not be the person you consulted with (if you even consulted with a surgeon at all, rather than a salesperson). At AirSculpt, patients typically meet with a sales consultant, not the surgeon, before their procedure. The 2022 autopsy review of BBL deaths in South Florida found that 92% occurred at high-volume budget clinics — the kind of assembly-line operations where speed and volume are prioritized over individualized care.
BodyLuxe is the opposite of that model. Located on the 36th floor of the John Hancock Center on Chicago’s Magnificent Mile, the facility is designed around comfort and privacy — not throughput. You’ll have a private treatment suite, a personalized consultation that respects your time, and a team that treats you like a guest. Dr. Farrugia uses BodyLuxe’s FormSculpt® technique, which combines precise tumescent liposuction with strategic fat transfer to create natural-looking, proportional results.
The Gold Coast BBL™ is our signature procedure for patients who want a safer, more refined approach to buttock enhancement — with a surgeon who knows your name, your goals, and your anatomy from the first consultation through your final follow-up.
The awake BBL is significantly safer than a traditional BBL under general anesthesia. The ASERF Task Force identified intramuscular fat injection as the cause of virtually all BBL deaths — and the awake technique directly prevents this through the muscle tension barrier, real-time patient feedback, and vasoconstriction from the tumescent solution. In a 2018 clinical study, 47 awake BBL procedures were performed with zero deaths and zero complications. No procedure is risk-free, but the awake approach eliminates entire categories of danger that exist under general anesthesia.
Most patients describe the sensation as pressure or tugging, not pain. The tumescent anesthesia thoroughly numbs the fat layer in all treatment areas. You’ll feel a brief pinch when the numbing solution is first injected, but after that, the procedure itself is comfortable. Many of our patients say the experience was much easier than they expected. If you’re anxious, we can provide oral sedation to help you relax.
The procedure typically takes 2 to 3 hours from the first injection to the final stitch. This is shorter than a traditional BBL under general anesthesia (3–5 hours), partly because there’s no time spent on anesthesia induction and emergence, and partly because the tumescent technique makes fat harvesting more efficient.
The surgical technique is fundamentally the same: liposuction to harvest fat, processing to purify it, and injection to sculpt the buttocks. The difference is the type of anesthesia. In a traditional BBL, you’re completely unconscious under general anesthesia with paralyzed muscles. In an awake BBL, you’re conscious under tumescent local anesthesia with active muscles — which provides the safety mechanisms described throughout this guide. For most patients seeking a natural enhancement, the awake approach delivers comparable results with reduced risk and faster recovery.
The amount varies based on your anatomy and how much donor fat is available. Typically, we transfer enough fat to create a noticeable, natural-looking enhancement. The awake approach is ideal for moderate augmentation — patients seeking a proportional improvement rather than an extreme change.
The fat cells that survive the transfer are permanent. Research shows approximately 60–70% of transferred fat survives long-term, with most reabsorption occurring in the first 3–4 months. The surviving cells behave like any other fat in your body — they’ll grow or shrink with weight changes. Maintaining a stable weight is the best way to preserve your results. Many patients enjoy their BBL results for years and decades.
You should avoid sitting directly on your buttocks for the first 2–3 weeks. This gives the transferred fat cells the best chance to establish blood supply and survive — direct pressure during this critical window can compress the fragile new blood vessels forming around the fat, causing cells to die. When you need to sit, use a BBL pillow that shifts pressure to your thighs. By week 4, most patients can sit normally. We provide detailed aftercare instructions at your appointment.
The BBL fat transfer is $3,000 on top of the liposuction pricing for the donor areas. For most patients getting a BBL with Lipo 360, the all-in cost ranges from $10,500 to $12,500 — significantly less than the $12,000–$18,000+ typical for traditional BBL in Chicago. We offer financing through CareCredit and Cherry Financing with up to 24 months at 0% interest.
The Gold Coast BBL™ is BodyLuxe’s signature awake BBL procedure, named after Chicago’s Gold Coast neighborhood where our facility is located. It combines Dr. Farrugia’s FormSculpt® liposuction technique with precise subcutaneous fat transfer — all performed under tumescent local anesthesia in a luxury private suite.
Tumescent anesthesia is a technique where a dilute solution of lidocaine, epinephrine, and saline is infused directly into the fat layer being treated. It completely numbs the area, constricts blood vessels (reducing bleeding to nearly zero), and hydro-dissects the fat for easier removal. Developed by dermatologic surgeon Dr. Jeffrey Klein in 1987, it has been used safely in over 9,000 consecutive patients with zero fatalities. Learn more in our guide to local anesthesia for cosmetic procedures.
Absolutely. BodyLuxe regularly treats patients who drive in from across the Midwest or fly in from across the United States and beyond through our fly-in program. Because the awake BBL doesn’t require a hospital stay and has a faster recovery, it’s particularly well-suited for out-of-town patients. We arrange virtual consultations before your trip and coordinate your visit so you’re comfortable before heading home. Follow us on Instagram @dr.snatched to see patient transformations and behind-the-scenes content.
Both procedures are performed under local anesthesia, but the similarities largely end there. AirSculpt is a corporate chain that uses independent contractor surgeons — you may not meet your surgeon before the procedure, and the person who consulted you is often a salesperson, not a physician. At BodyLuxe, Dr. Farrugia personally handles every consultation, every procedure, and every follow-up. AirSculpt also charges a premium ($13,000+ average in Chicago) for proprietary branding around what is mechanically standard tumescent liposuction with an added laser component. Read our detailed AirSculpt vs. awake liposuction comparison for a full breakdown.
Schedule a complimentary consultation with Dr. Farrugia to discuss your goals, assess your anatomy, and find out if the awake Gold Coast BBL™ is right for you. In-person and virtual consultations available.
Call (312) 999-5505 or book online
Medical Disclaimer: This article is for educational purposes only and does not constitute medical advice. Individual results vary. Brazilian Butt Lift surgery involves risks including infection, asymmetry, fat reabsorption, fluid accumulation, and in rare cases, fat embolism. A personal consultation with Dr. Farrugia is required to determine if you are a candidate for an awake BBL. BodyLuxe is located in Chicago, IL on the Magnificent Mile at 875 N Michigan Avenue in the John Hancock Center.
Back to teaching Zumba in less than 2 weeks 🙌
Awake body contouring designed to fit real life.
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Thank you for sharing your experience, Marisol.
“La mejor experiencia que he tenido de verdad que fue un excelente trabajo y mi recuperación en menos de dos semanas yo ya estaba dando clases de zumba me encantó la silueta que me quedó Gracias doctor Daniel J Farrugia MD PhD”
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Awake, comfortable, and watching Elf 🎄
This is what awake FormSculpt® body contouring looks like at BodyLuxe.
Wishing you a cozy and confident holiday season ✨
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After a long week of changing lives, Dr. Farrugia is officially clocking out 💻✨Laptop closed, vibes on — ready for the holiday week ahead — who else is?🎄🕺
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When your patient sends a twerking video because she’s that excited about her new BBL and tiny waist… we know we did our job. 😌 🍑
Minimal downtime (usually just 4–5 days) and completely awake during the procedure — and she’s already showing off that curvy, sculpted booty.🔥
We absolutely love getting these fun updates from our patients. Keep them coming.✨
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Ready to sculpt on the Magnificent Mile? BodyLuxe specializes in awake, minimally invasive liposuction and natural fat transfer—performed under local anesthesia at our Chicago clinic in the John Hancock Center.
👉 Request your consultation: https://bodyluxe.com
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📍 Location: BodyLuxe, John Hancock Center, Chicago, IL
Why BodyLuxe:
Awake procedures under local anesthesia (no general anesthesia)
Minimally invasive approach designed for precision and comfort
Natural‑looking contouring and fat transfer options
Downtown convenience on the Magnificent Mile
Procedures we offer:
Liposuction: abdomen, waist, flanks, thighs, arms, chin
Fat Transfer: breasts, buttocks (BBL), hands
Skin Tightening with Renuvion (J-Plasma)
What to expect:
Private 1:1 consultation with the surgeon to confirm candidacy and goals
Personalized treatment plan reviewed by our clinical team
Clear aftercare guidance and support
Go to https://bodyluxe.com to request your complimentary consultation.
Disclaimers:
This video is for informational purposes only and is not medical advice. Consultation is required to determine candidacy. All procedures carry risks; we’ll review these with you in detail. Individual results vary. Footage may feature a model; not a patient.
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Snatched for Summer — Jawline Edition ✨
Sculpt a sleek, defined jawline with FormSculpt™ Chin Liposuction + Renuvion® skin tightening — performed awake under local anesthesia at BodyLuxe.
Summer 2025 Special: up to $4,000 OFF select procedures.
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✅ Target submental (under‑chin) fat for definition
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✅ Awake procedure • Tiny entry points • Minimal downtime*
✅ Performed by Dr. Daniel J. Farrugia in our Chicago clinic on Michigan Avenue
Other Summer favorites: FormSculpt™ fat removal • BBL • Fat transfer to breasts • Skin‑tightening enhancements.
Book your FREE consultation:
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📞 (312) 999‑5505
📍 John Hancock Center on the Magnificent Mile, Chicago
Financing: 0% for 24 months for eligible clients.
Deadline: Offers valid for procedures performed by September 30, 2025.
—
Medical & offer notes: Results and recovery vary. Not a weight‑loss treatment. Candidacy, areas, and pricing determined at consultation. Financing on approved credit. Renuvion® treats appropriate skin laxity; individual outcomes differ.
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Who said surgeons can`t have fun?👨⚕️ In the OR, I`m all about precision. On the dance floor? Let`s just say I`m unapologetically me.🕺Sculpting bodies by day, dancing souls by night.🎵 #snatched #drsnatched #bodyluxe #minimallyinvasive #fatremoval #fattransfer #bbl #bodysculpting #breastfatttransfer #skintightening #awakefatremoval
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Snatched for the New Year – Looking and Feeling Unstoppable!
Start your journey to confidence with our exclusive New Year promotion! For a limited time, enjoy up to $4,000 OFF on select procedures at BodyLuxe. Whether it’s a snatched waist, sculpted jawline, BBL, fat transfer to the breast or skin-tightening enhancements, let us help you achieve your dream look in 2025.
Spots are limited, so don’t wait! Go to BodyLuxe.com to schedule your FREE consultation. We are conveniently located in the iconic Hancock Tower on the Magnificent Mile in Chicago. 🏙️
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🔹 Brazilian Butt Lift (BBL)
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Book your complimentary consultation today to lock in these jaw-dropping savings.
📞 Call us at (312) 999-5505
🌐 Consultation booking links in bio.
⏳ Don’t miss out—offers are valid for procedures performed before February 15, 2025.
Model used for illustrative purposes only. Not an actual patient.
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Snatched for the New Year – Looking and Feeling Unstoppable!
Start your journey to confidence with our exclusive New Year promotion! For a limited time, enjoy up to $4,000 OFF on select procedures at BodyLuxe. Whether it’s a snatched waist, sculpted jawline, BBL, fat transfer to the breast or skin-tightening enhancements, let us help you achieve your dream look in 2025.
Spots are limited, so don’t wait! Go to BodyLuxe.com to schedule your FREE consultation. We are conveniently located in the iconic Hancock Tower on the Magnificent Mile in Chicago. 🏙️
🔥 Exclusive Snatched for the New Year Offers:
🔹 FormSculpt™ Fat Removal
🔹 Brazilian Butt Lift (BBL)
🔹 Fat Transfer to Breasts
🔹 Snatched Jawline
For eligible clients, pay over 2 years with ZERO interest.
Transform your look and step into 2025 feeling your absolute best. 💃
📅 Time-limited Deal!
Book your complimentary consultation today to lock in these jaw-dropping savings.
Model used for illustrative purposes only. Not an actual patient.
📞 Call us at (312) 999-5505
🌐 Consultation booking links in bio.
⏳ Don’t miss out—offers are valid for procedures performed before February 15, 2025.
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✨ Chicago Fashion Week, Here We Come! ✨
We’re stepping off the surgical floor and onto the runway! 🏙️💃 Join Dr. Farrugia and the BodyLuxe team as we bring a touch of aesthetic excellence to this year’s Chicago Fashion Week! 💫 From creating snatched jawlines to sculpted silhouettes, we know that true style starts with confidence. 💁♀️💖
Get ready to see Dr. F’s fashion debut, where art meets fashion, and beauty meets confidence. 🎨👗 It’s going to be a showstopper you won’t want to miss! 😎✨
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This is your season to refine, sculpt, and elevate your confidence.
This limited-time offer ends March 31, and appointments are filling quickly.
Tap below to reserve your consultation and let BodyLuxe sculpt your summer look.
