BBLs are the wave right now. But because there are so many risks and complications surrounding procedure, many people are afraid to get it. Fortunately, the South Beach Butt Lift is a new BBL procedure that’s taking Miami by storm. And not only is safer, it’s more natural-looking, too.

What is a BBL?

A Brazilian Butt Lift, a.k.a. “BBL,” is a surgical procedure that removes fat from unwanted areas of the body and injects it into the buttocks. The result is the more firm and shapely derriere you see all over social media.

The BBL trend BLEW UP on social media and IRL. And as a result, it’s become one of the most requested procedures of all time. According to the American Society for Aesthetic Plastic Surgery, BBL surgeries increased by nearly 100 percent from 2015 to 2019. And if our social media timelines are any indication, there are no plans of slowing down.

Who is Dr. Earle?

Dr. Alexander S. Earle is a double board-certified plastic surgeon based in Miami, Florida. He and his team at Pure Plastic Surgery have a TON of experience performing BBLs on patients of all backgrounds. Dr. Earle performs up to 15 BBL procedures every week. And with over 2,000 ultrasound-guided BBLs performed, it’s safe to say Dr. Earle is a master at what he does.

And if you’re worried about surgical complications (or worse), he and his team are committed to providing safe, quality surgical procedures. So much so that Dr. Earle has never experienced a patient death — an impressive feat considering that BBLs have the highest mortality rate of all cosmetic procedures.

But if you’re still not convinced, Dr. Earle is introducing a brand new technique to make BBLs even safer for his clients. Enter the “South Beach Butt Lift.”

What is the South Beach Butt Lift?

BBL surgery is one of the most requested surgeries today. But sometimes, they can be unsafe and even life-threatening. However, thanks to Dr. Earle, his new South Beach Butt Lift technique greatly reduces the risk of complication and death. Not to mention, it’s designed to suit your body’s unique frame for a more natural, aesthetically-pleasing look.

And lucky for us, Dr. Earle stopped by to chat about it all in this exclusive 21Ninety interview. Check it out:

Brittni Williams: BBLs are HUGE. They’re all over social media, and now, they’re pretty accessible to the average person.

Dr. Earle, could you explain exactly what a BBL surgery is and why so many people want one?

Dr. Earle: Yeah, sure. So BBL stands for Brazilian Butt Lift. And the reason you’re seeing that is because it’s believed that the first BBLs were actually done in Brazil by a famous surgeon called Dr. Pitanguy.

But what it is, is a combination of liposuction and fat transfer. So you’re essentially removing fat from the areas you don’t want, and then adding it to areas that you do want. So you can think of it as a fat transplant, if you will.

And so typically you want to remove excess fat from the waist area, the abdomen, and the back to enhance the buttock and hip region.

BW: Who would you say is an ideal candidate for a BBL surgery?

Dr. Earle: Well, first of all, this is a completely elective surgery so you have to be absolutely healthy and in good shape. Before anyone undergoes this procedure, we check all their labs, and make sure that they’re medically cleared.

But having said that, ideal candidates are typically women who are in a relatively healthy BMI range, meaning that you can’t be too overweight, and you can’t be too thin for the procedure. For example, the BMI range that I use in my practice is a BMI of 21 to a BMI of 30, which is the top of the range there.

BW: We’ve also been hearing news about complications and even deaths related to the surgery. Can you tell us just how risky BBL surgery actually is?

Dr. Earle: You’re absolutely correct. If the surgery is not done properly, you can injure a large vessel in the buttock region. And then if fat gets into that vessel, it can travel to the lungs and clog up the lungs, and the patient can die. And that is called a pulmonary fat embolism.

Back in 2017, the mortality rate for this procedure was excessively high — one in 3,000. And so what happened at that time was that surgeons started making sure that they placed the fat in the safe space, which is the space between the muscle and the skin. And starting in 2017, that was what all — especially board certified surgeons — started to do. And so then there was a follow up study in 2019 and the mortality rate had gone way down to about one and approximately 15,000, which is pretty much equivalent to a tummy tuck and other aesthetic procedures.

So a lot of the data on the articles that are coming out currently is a little bit dated. It’s back from the data in 2017, which is no longer the case. But if you’re placing that fat in the appropriate location, then it can be done very, very safely.

But here’s the thing, when you’re doing the fat transfer traditionally, it’s essentially a blind procedure. So you’re putting the fat with this long instrument called a cannula, and you can’t obviously really see exactly where that instrument is.

And so what I’ve been doing since 2019, is I use ultrasound imaging technology, where I can actually now turn a blind procedure to one where I can see. I know where the cannula is, I know for sure that it’s in that safe space, and therefore really, truly, truly minimizing the risk of any fat embolism. And since 2019, I’ve done about 2,000 BBLs. And, of course, never had an issue like that, because I’ve been using the ultrasound since then.

BW: So there are risks and complications. But fortunately, anyone who is looking to have the surgery can rest easier now with your new procedure. Dr. Earle has come up with a new technique called the South Beach Butt Lift. Can you tell us a little bit about it and why you created it?

Dr. Earle: Yeah, yeah. The “South Beach Butt Lift” or “SoBe BL” was inspired by a lot of the beautiful woman we have here in South Florida. And I noticed that the trends were starting to change. So with the original BBLs, a lot of patients and surgeons were going for very, very dramatic, almost exaggerated looks where you can definitely tell that someone had surgery. And the trend is actually now starting to go in a different direction where you don’t necessarily want it to be so obvious.

So there’s actually three differences between your standard BBL and the South Beach BBL. Number one is the look. So with the South Beach BBL or the SoBe BL, we’re essentially working with a patient’s foundation and creating what I like to call “an enhanced natural shape”. And you may ask ‘natural to whom?’ It’s natural to that very patient-specific frame. So each one is a little bit unique. But the goal is that you make sure that all the contours are smooth, and that all the transitions are smooth, and so that it looks like it belongs to the patient, like you didn’t just kind of stick something on there.

The second thing is actually in — and this is where you have to work on it [because] it makes it a little bit more challenging — but I use now much less incisions. So traditionally, you would typically use about five incisions in the back, and decrease that to two. And they’re placed in very, very hidden locations, such that, again, if you’re wearing even a small swimsuit, those are not visible at all.

And then third is the use of the ultrasound. And now this part is not so much about the look, but it’s more about the safety for the patient. So I use the ultrasound imaging to guide me through the fat transfer portion of the procedure to make sure that I’m in a safe space. And of course, we’re keeping our patients safe, so they can go back home to their families. But overall, when you have a SoBe BL, you can be out on the beach. And the goal is to have people guessing, you know, ‘Did she have a something done? Did she not?’ you know, you could never tell.

BW:  That’s interesting. It kind of sounds like a skinny BBL, which is also a popular trend on social media right now. Would you say that results from your new technique are similar to a skinny BBL?

Dr. Earle: I think in general, yes. Because typically, for the South Beach BBL, you also have to be a little bit on the lower [end] in terms of the BMI scale. So usually those patients are somewhere between a BMI of 21 and 25. And not so much the patient with, say, a 30 BMI.

But certainly the way that we hide the incisions is different. And then also, I think the overall look. And for the South Beach Butt Lift, it’s almost like an upside-down heart shape, which is a shape that really goes [well with] many, many patients frames and also a very, very long lasting shape, meaning that over the years as women age, the shape tends to hold up.

BW: So if a patient did want a larger bottom, does the new procedure allow for that?

Dr. Earle: It would allow it to a certain degree, but not to a degree where it doesn’t look like it basically belongs to her underlying frame and foundation. So within that you can do things to one degree or another, depending on what the patient desires. But you don’t want to do it to the point where it just looks like you just kind of stuck something on there. And like it doesn’t belong basically.

BW: This is great news. How long did it take you to develop this new procedure? And how long have you been using it?

Dr. Earle: So yeah, it’s been kind of a gradual kind of process. I’ve been doing BBLs since 2017. I started implementing the ultrasound aspect of it in September of 2019. And I think shortly thereafter, I’ve been tailoring it to what eventually has become now the South Beach Butt Lift. And then, I would say I’ve probably been doing it in this style pretty solidly for the last two years or so.

BW: Okay. You did briefly mention risks. Are there any risks that patients should be aware of with the new South Beach Butt Lift versus a traditional BBL?

Dr. Earle: So the other risks are similar with both procedures. So any procedure, elective or not, will carry some sort of risk. Unfortunately, in medicine, nothing can be 0% or 100%. So of course, you know, there’s always your potential risk for infection, potential risk for blood clots if the patient’s not moving around and ambulating after surgery the way that they should, and then the risk for scarring. So these are all kind of baseline risks that can occur with any surgery. And of course, it could occur with this as well.

But we do everything that we can to minimize our risk. So of course, number one is we make sure that the patient is qualified. We check their labs, we check their heart, we make sure that they get a clearance letter from their primary care doctor. And in terms of potential infectious risks, once they’re here, they receive IV antibiotics during the surgery and oral antibiotics for a week after. And so we do several things to try to minimize these risks as much as possible.

BW: Awesome. Has the new technique impacted aftercare and downtime? And if so, what can patients expect following the procedure?

Dr. Earle: So that’s a good question because it may require a little bit more aftercare, a little bit more of a commitment from the patient. So with this technique, there are two things which are incredibly important, which the patient must be aware of.

Number one is their compression. So we do have special garments that the patients use, and they have to wear that garment. For the first six weeks, they wear that night and day, and then for an additional six weeks, 12 hours a day. And then the other commitment is to massage, so there’s a special post-lipo lymphatic massage. And the patients need to do about 20 of these massages after surgery to make sure that they decrease any risk of scarring, that their skin retracts smoothly, and to optimize their results.

BW: Great. On to my last question: the procedure is called the South Beach Butt Lift. Is it available to patients outside of Florida?

Dr. Earle: Yeah, of course. So actually, a lot of my patients come from out of state. So we receive patients from multiple states — very commonly New York, Chicago, New Jersey — so a lot of the east coast but also California and Texas. And we receive patients from also outside of the US — Canada and the UK are also very popular. So yeah, we can certainly perform and tailor this procedure to patients that are not from Florida.

BW: Awesome, great information. Once again, Doctor, thank you for joining us and providing your incredible insight on this topic. I really enjoyed this discussion. And I’m sure our readers will too.

Dr. Earle: Thank you so much. My pleasure.

You can find Dr. Alexander S. Earle and his team at Pure Plastic Surgery in Miami, Florida. Set up a consultation to see him if you’re considering a BBL, or any other reconstructive and aesthetic surgery for that matter.

For more articles and interviews on topics like this, follow 21Ninety on all of our social platforms, including Instagram, Twitter and Tiktok.