Ultrasound Guided Brazilian Butt Lift: the new standard for safe BBL surgeries in Florida

Ultrasound Guided BBLs are the new Florida safety standard

Dr. Earle has safely performed more Ultrasound Guided BBLs than any surgeon in the United States (U.S.).

The Brazilian Butt Lift (BBL) procedure harvests fat from a patient’s body, including the lower back, hips, thighs, abdomen and flanks with liposuction. The fat is then purified and injected into the buttocks to reshape, increase volume and create a fuller figured bottom. At Pure, since 2019 our standard is to use ultrasound technology to perform safe Ultrasound Guided Brazilian Butt Lifts. We will only perform BBLs using this safety technology, which is now the standard in the state of Florida. We are pioneers in this technique in the United States (U.S.) and have performed more Ultrasound Guided BBLs safely than any other surgery practice in the country. We have ZERO deaths at Pure Plastic Surgery.

What is the difference between a traditional BBL and an Ultrasound Guided BBL?

While performing traditional BBL surgery, surgeons inject the fat into the gluteal region blindly, without being able to clearly see where fat is being placed. However, during an Ultrasound Guided BBL, the ultrasound creates a clear view with real-time images of the gluteal anatomy. This allows us to avoid injecting fat into muscle, blood vessels and other structures. Fat injected into these areas can potentially lead to pulmonary fat embolism, which occurs when fat blocks circulation by getting into the bloodstream. A pulmonary fat embolism is the greatest risk to a patient during BBL surgery followed by infections. Both can lead to major complications or death. While there are risks to every surgical procedure, the use of ultrasound technology makes the BBL safer and decreases the chances for issues to arise.

What are the benefits of an ultrasound guided BBL?

The most important benefit of an Ultrasound Guided BBL is safety. The ultrasound technology provides a safer way to perform the BBL procedure. Some consider the BBL to be the most dangerous cosmetic surgical procedure. We know from experience that with ultrasound technology and top-level safety measures, the BBL doesn’t have to be unsafe. Without the ultrasound, there is a greater risk that the surgeon can go too deep into the patient’s muscle and disrupt large blood vessels. Any disruption to the vessels increases the chance of pulmonary fat embolism. Another benefit to using ultrasound technology is that it helps to transfer the fat into optimum areas improving patient results.

What kind of training is required to perform an Ultrasound Guided BBL?

It is important to choose a Board-Certified Plastic Surgeon to perform your Ultrasound Guided BBL surgery who has proven results, a stellar safety record and experience using the latest ultrasound technology. For surgeons to safely perform Ultrasound Guided BBLs, they should take a course on how to use the ultrasound technology effectively. After completion of the course, a surgeon will have the information needed to maintain the equipment up to safety standards and use it correctly during surgery. It typically takes an experienced surgeon 20-30 safely completed BBL cases to become comfortable using the new ultrasound technology; and after 50 cases without incident, a surgeon would be considered an expert. If a surgeon is following the Florida guidelines, which limit each doctor to perform three (3) BBLs per day, then it could take one (1) to four (4) weeks to become completely comfortable using the ultrasound equipment during surgery.

Where is the fat supposed to be injected during a BBL?

Fat is supposed to be injected in the subcutaneous fat layer between the skin and muscle during BBL surgery. It is against the Florida state law and medical board safety standards to inject fat into the muscle. At the beginning of the procedure, we make a small incision where fat is to be extracted. We then use an instrument called a cannula to remove fat from the body under sterile conditions. At the time of fat transfer, the ultrasound probe is used to create an image of the region on a screen so the fat can be transferred safely through a cannula into the subcutaneous fat layer, also called the safe space. The surgeon maps out these safe spaces based on the patient’s anatomy and the buttocks shape that will provide the desired results.

Do Ultrasound Guided BBLs take more time than traditional BBLs?

Ultrasound Guided BBLs are safer than traditional BBLs and can be performed in the same amount of time. The time it takes to perform a BBL procedure varies based on the patient’s BMI along with the amount of fat extracted from the body and injected back into the buttocks. Typically, a BBL procedure takes between 1.5 to three (3) hours, with two (2) hours as the average time. Any BBL surgery that lasts longer than three (3) hours increases the risk to the patient. The less time a patient is in surgery and under anesthesia is a positive for the patient and the overall surgery.

Does an Ultrasound Guided BBL shorten healing time?

Healing after an Ultrasound Guided BBL is the same as healing after a traditional BBL: the day after surgery a patient can get up, walk around and clean drains. For six (6) weeks after surgery, patients are required to sleep on their stomachs to avoid disturbing fat cells and altering the shape of the new buttocks. The goal during this period is for optimal fat retention and healing. Patients should avoid putting any pressure on the gluteal region. This can be done by sitting on a special pillow and avoiding strenuous activity or heavy lifting during this time. After six (6) weeks all regular activities may resume.

Besides Ultrasound Guided BBLs, what other safety measures are in place at Pure Plastic Surgery?

Patient safety is our priority along with providing beautiful results that help patients reach their goals. In addition to ultrasound technology, here are a few other safety measures we have in place:

  • Pure operating room (OR) – Our OR at Pure Plastic Surgery is equipped with advanced state-of-the-art technology. It is maintained to the highest safety standards, and it is accredited by the Joint Commission – the highest level of accreditation possible for an office-based surgery clinic. Our OR and staff provide the safest conditions for plastic surgery, including our pre-operative department, which ensures anesthesia is safely administered to all patients.
  • Safety checklist – We require all patients to complete a Pure Safety Checklist prior to surgery, including an examination, blood work and approval from a primary care physician.
  • Post-surgery check-ins – All patients are scheduled for required post-surgery check-in appointments. These appointments help to ensure all safety and sanitary guidelines are followed post-surgery. Most infections occur after surgery and can be avoided with proper care. This safety measure helps improve healing and results.  
  • “Hump Day” education series– Every Wednesday we educate patients on various topics and procedures through our social media channels. We focus on safety, results and answer frequently asked questions (FAQs). Join us every Hump Day!

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You can also reach our Miami office directly by calling 305-900-5310. Pure Plastic Surgery serves patients in Kendall, Coral Gables, and throughout the Miami metro, as well as patients across the United States and internationally.




“I could not have picked a better doctor. Dr. Earle is a perfectionist and settles for nothing less than perfection. I am incredibly happy with my results.”* - Rosie

“Absolutely amazing! The entire journey has been great. The staff and customer care are exceptional! Best service I have ever received.”* - Destiny

“From start to finish they were nothing short of amazing! Amazing doctor and team! Great results and wouldn't trust another. I felt absolutely comfortable from the minute I met them and knew I was in good hands”* - Natasha


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