"Kiss My A**, I Paid a Lot for It"

Jackie (00:00):
So that's why I was happy when she mentioned it because it's like not everyone, our bodies aren't all the same, our bodies aren't all perfect. We all start at a different area. So you have to have realistic expectations I think with surgery in general. So I thought-

Dr. Chang (00:15):
Ah, you tell 'em, you tell 'em sister. You are listening to Secret Services where we discuss the procedures nobody admits to, but everyone's curious about. I'm your host, Dr. Christopher Chang. I was up a lot this weekend from Victor's birthday party and I had those nine-year-olds running around like wild animals. It was like Jumanji in my house. It was absolutely insane. Up until 2:00 AM.

Jackie (00:42):
They probably ate everything too.

Dr. Chang (00:44):
Yeah. And one kid was bringing lemonade up to the attic. They were all hanging out. I was like, "What? We only in the kitchen. Dude, you don't need to bring lemonade." And this was at 1:30 in the morning. It was total chaos.

Jackie (00:56):
Lemonade in the attic is crazy.

Dr. Chang (00:58):
I was like, "What are you doing? It's 1:30 in the morning." Anyway, welcome back to Secret Services. I'm Dr. Chang.

Jackie (01:07):
Hi, I'm Jackie.

Dr. Chang (01:08):
We're going to talk a little bit about a 25-year-old TikTok star with eight million followers who posted a photo dump captioned Self Deprecation, a series by me and buried in slide 14 was the line the internet had been waiting for. Kiss my ass, I paid a lot for it. She didn't say what it was, but the plastic surgeons who've been fielding the calls all summer have a name for it. So stay with us.

Jackie (01:35):
All right. So a patient walks in holding their phone and it's on Alix Earle's Instagram. What's the first question you should ask before you talk about any procedure?

Dr. Chang (01:45):
I would say, who is that?

Jackie (01:47):
Please.

Dr. Chang (01:49):
Alix Earle. I mean, all the young people seem to know who she was, but I mean, of course I know who she is now. I guess she's one of the biggest influencers. She's kind of like Mr. Beast, I guess. But what did she. Well, I mean, as an influencer, she's just a hot young girl, but what did she get famous for?

Jackie (02:08):
Literally just making TikToks. I started following her because she was a college student at Miami. I mean, obviously she's gorgeous, but she actually had really bad acne, horrible skin. And so she talked about her Accutane journey, her skincare, how she would -

Dr. Chang (02:31):
She was early to the game?

Jackie (02:33):
Yeah. How she would layer her makeup so she looked amazing on Instagram, but she actually had really bad skin. So she was very relatable-ish. And then everything started coming out that her stepmom or mom was the escort in the big scandal. Was it Anthony Wiener or someone? The New York or New Jersey.

Dr. Chang (02:59):
Or Cuomo? Was it Wiener or Cuomo?

Jackie (03:00):
Was it Cuomo? I don't know.

Dr. Chang (03:02):
I don't know.

Jackie (03:03):
It's one of them.

Dr. Chang (03:03):
A politician.

Jackie (03:04):
So then you're like, okay, well, did she get famous on TikTok because of her ties?

Dr. Chang (03:09):
Her mom's an escort?

Jackie (03:10):
Yeah.

Dr. Chang (03:11):
Okay. Anyway, I didn't know this, but okay.

Jackie (03:13):
You got to watch the show. Honestly, I was a little skeptical. So I really liked her when she first got going and then she's so big now. So I was like, all right. I mean, it's not as relatable.

Dr. Chang (03:24):
I just think about it as she's. I'm late to the party. I didn't follow her from the beginning, so I have no idea why everybody who was following her and then all of a sudden she became super famous and then now I follow her or I don't even really follow her, but I just know who she is because she's a celebrity.

Jackie (03:39):
Yeah. I mean, she's huge now. She was on the field at the Super Bowl. So she has -

Dr. Chang (03:46):
For no good reason. Okay.

Jackie (03:47):
She has a breast aug. It's pretty clear. And she also talks about it. So she's not afraid to admit her plastic surgery. She gets fillers, she gets Botox. She talks about all that openly. Another interesting thing to note of her is if you look at her before and after, there's somewhere online where it's her IDs and there's the before and then there's right now. And her nose looks significantly different, but she swears she did not have a rhino. She says it's from the Accutane, which can be true, right?

Dr. Chang (04:25):
Could be true. It could be true. Also, when she started, she was in college or something. She was very young.

Jackie (04:30):
Right.

Dr. Chang (04:31):
I mean, your face does change a little bit as you get older, particularly if you're just a kid in college, you're 18 years old or 19 years old to your mid - 20s. Yeah, sure.

Jackie (04:41):
And I want to say she did at least two rounds of the Accutane. So I mean, I believe that.

Dr. Chang (04:49):
Your whole face can change.

Jackie (04:50):
Yeah. I buy it.

Dr. Chang (04:51):
Your face can change. A little bit of the baby fat goes down. She definitely is doing some cosmetic stuff and obviously everything. She's following the Kardashian model where everything she's made up 100% of the time, has beautiful pictures and beautiful setups. So I think a lot of that also has to do with the surrounding environment of how you curate your image.

Jackie (05:10):
I mean, she's obviously so pretty. Well, before we get more in depth with her, we have an anonymous question. "I got a BBL three years ago and I've never told anyone at work. Every summer I have to fake being sick to skip my company's beach retreat. Alix Earle just casually confirmed hers on Instagram and I've been sitting here wondering if it would actually be easier to just say something. Is there a right way to do this?" So I guess technically she didn't confirm it. She just posted that, "Kiss my ass, I paid a lot for it." But speculation, we all think that it's true. Yeah.

Dr. Chang (05:47):
We'll talk about Alix Earle a little bit, I guess.

Jackie (05:49):
Okay. If you had a BBL three years ago and you never told anyone, I don't know. I mean, one, do you think people aren't noticing already?

Dr. Chang (05:59):
We get this question for breast augs all the time. People who are like, "Well, I want to get breast implants, but I don't want anybody at work to know or I want to be conservative." People think automatically when you get breast implants that everybody's going to be able to tell and they're going to out you. But a lot of it is, more of it actually is how will you wear it. There's plenty of women with C and D cup and plus bra sizes that are just more modest in what they wear, and it doesn't seem like the breasts are their whole image. And there's women that wear very low cut, showy, exposing, tight clothing where it is much more noticeable. So it just depends, I think, on how you dress up. The same thing with the butt. If you wear something very tight, like yoga pants or something that's very clingy, you'll probably see a lot more volume. And if you wear things that are a little bit more conservative, I don't think anybody's going to be looking. I don't know. I got to have a picture of this. I don't know.

Jackie (07:01):
I know, right? Because I'm thinking, okay, well, they may have already noticed.

Dr. Chang (07:06):
Yeah. And nobody's talking about it anymore, frankly. If they're like, why was.

Jackie (07:11):
I feel like the only way it would be if it was an insane BBL. But if it was that bad, they probably would've noticed already.

Dr. Chang (07:19):
Yeah. Well, there's some people that get giant BBLs. There are some really big butts.

Jackie (07:24):
But like a shelf butt, I feel like you would be able to tell at work.

Dr. Chang (07:29):
Yeah. I think this patient is really making a bigger deal out of it. They're more nervous and nobody else is worried.

Jackie (07:35):
Yeah. You always think everyone's going to notice every little thing about you and they don't.

Dr. Chang (07:39):
Yeah, they're more worried about themselves.

Jackie (07:41):
Everyone has their own thing to be self-conscious about, especially at a company beach retreat. I feel like everyone's probably a little uneasy about showing everything off. But like you said, it's all in how you wear it. She could wear a little sarong or something to cover it up. Yeah. I wouldn't hide because I got a BBL. Is that the whole point in my head?

Dr. Chang (08:00):
Yeah. Hopefully it looks better than. If she had not had the BBL, she probably would've be self-conscious about her butt and not want a bathing suit anyway.

Jackie (08:07):
If you pay for a BBL, shouldn't you want to look good in your bathing suit?

Dr. Chang (08:11):
Yeah. I mean, unless she doesn't like her results. But still, I think that it would be difficult, I think, to get something enhanced and then be nervous to show that you had it enhanced because that's the whole point. You want to show it.

Jackie (08:23):
Well, and then I would say there's a generational split on cosmetic surgery secrecy.

Dr. Chang (08:29):
Oh, there's definitely a generational split, right?

Jackie (08:31):
I feel like younger people, they don't care. They want to document their whole journey.

Dr. Chang (08:36):
It's a badge of honor sometimes. People are like, "Oh, well, I can afford this, or this is trendy, or I did just what the Kardashians did, or what the Alix Earles of the world did." It's almost like a bragging rights or a luxury piece of jewelry or luxury handbag or something. It's sort of like,

Jackie (08:51):
Yeah,

Dr. Chang (08:53):
I splurged for this and I love it.

Jackie (08:54):
Yeah. Or like, "I just graduated college and my new boobs are my gift." And it is funny because I started watching the Alex Earle show. It's on Netflix and it just came out. So I think that's why it's a really hot topic right now. But it is crazy because you're watching the show and you're like, "I remember when she was a nobody." And you feel like, "Well, why shouldn't I try to be an influencer? Look at her life now."

Dr. Chang (09:22):
Because you grew up with her. It's real time. You follow her realtime.

Jackie (09:25):
Right. All these people online see all these other influencers sharing stuff and they're like, "Well, I could get these things done and share it and then maybe I could become rich and famous."

Dr. Chang (09:35):
Yeah, come have your plastic surgery. You can see as a Congressional Plastic Surgery, then you become an influencer. Go ahead.

Jackie (09:40):
I can see why it's enticing to younger people. Okay, this could be a career path. So I think it's just a totally different mindset. Also, I think younger people were on our phones a lot more, we're posting more, you see more of your face, so you're just like, "Screw it. If I want to fix something, I'll fix it."

Dr. Chang (10:00):
On the plus side, I think it's really refreshing that people are owning stuff that I think generation before we would be a lot more conservative or scared to share.

Jackie (10:12):
Definitely.

Dr. Chang (10:13):
And people are like, "Yeah, I did this and I feel great and you should do it too." I think there's something refreshing about that.

Jackie (10:19):
Yes.

Dr. Chang (10:21):
Having people be enthusiastic about what they're doing. Because before, I mean, people doing it and they're nervous or they're hiding it, that kind of sucks, right?You're investing money and time and you're insecure.

Jackie (10:33):
And now there's more of a community. It's easy to find other people that have had things done to talk to instead of everyone just secretly keeping it to themselves. So you feel like, "Well, none of my friends have ever gotten plastic surgery, so I don't know if I feel comfortable for them to pick me up or something after I have something done." Which we do see a lot sometimes, especially in older patients sometimes. They'll have a friend pick them up or even a family member and they're like, "Do not tell them what I had done." And that's always a difficult conversation.

Dr. Chang (11:04):
It's super weird. Sometimes patients will come in and it'll be somebody that their spouse. Right.

Jackie (11:11):
And they have no idea.

Dr. Chang (11:11):
Or their long-term boyfriend or girlfriend or whatever that they've been with for decades and they're like, "Don't tell them I did this." Well, what are we going to say?

Jackie (11:20):
Right. It's hard like, "Yep, she had a procedure."

Dr. Chang (11:24):
Yeah, it's like, "Here's your post-op Instructions."

Jackie (11:27):
Don't ask why she's wrapped up like that.

Dr. Chang (11:29):
Yeah. Just ignore the things under the clothes and call us if you have concerns.

Jackie (11:34):
Right. All right, so back to Alix Earle. She posted, it was the day before her Netflix show debuted. So of course this got everyone talking. The slide that read, Kiss my Ass, I paid a lot for it, widely read as her confirmation of what fans had been calling out for months. There's this photo of her. She's in a red bathing suit, great shot of her butt. It was posted a few months ago and everyone was like, "Her butt looks great, but you can tell that this wasn't from working out. She had to have had Alloclae." And so it's been speculated online for a few months now. And then this post, everyone's like, "She did it. This is it." So all these people are speculating that she got Alloclae, an injectable allograft adipose matrix made from purified human donor tissue used for non-surgical gluteal contouring, a middle option between filler and a full surgical BBL. So tell us what you know about Alloclae.

Dr. Chang (12:35):
Well, I had a great experience getting to know the leadership at Tiger Aesthetics, which is the parent company behind Alloclae, And actually spent some time in Texas, in San Antonio, Texas down at their scientific facility where they procure the tissue and process it for basically making the Alloclae product. So it's really quite an interesting process, very scientifically progressive and interesting. The concept is that we use donor tissue for a lot of things, for ligament repairs, for valves in the heart, for skin grafts, for burns, or even for breast cancer reconstruction.

(13:17):
We use human tissue for a lot of different things. And so in that world of using human tissue, people are always saying, "Well, what can we do with the fat?" Because there's a lot of. We're using skin, we're using bones, we're using ligaments, they're using eyes, hearts and stuff like that. So these are patients that have agreed to organ donation, but they're deceased and they're sort of like, "When I leave my body, I would like to leave my body for future use for medical use." So what they do is they obviously have a rigorous screening process to make sure the donor is healthy and no diseases and that kind of stuff.

(13:52):
And then they process and procure the fat and they essentially filter it down and then de-cellularize it and sterilize it so that basically what they have are these matrices or ghost cells essentially of fat that do not have the DNA material.

Jackie (14:11):
Ghost cells.

Dr. Chang (14:12):
Well, they call them ghost cells because they don't really have -

Jackie (14:15):
From the deceased. I know, but it's just.

Dr. Chang (14:18):
It doesn't have the ability to sort of be a foreign cell in your body. It has foreign parts. Just like if I give you a skin graft, say you burn, we get skin graft from a cadaver, it will have some of the connective tissue. So anyway, but it's very cool. The idea is then to get it processed and stabilized so that they can re-inject it later on and interact with the host, the patient who's receiving it. And that will create both volume of fat and then also allow for integration of your own adipose cells in there. It is very cutting edge technology, so it's pretty new. It hasn't been around for decades, but they're quickly becoming very, very popular.

Jackie (14:58):
And do you think that the popularity is growing because it's not so much for high fat volume BBLs, right? You're not going to use a ton.

Dr. Chang (15:10):
Well, I think part of it is we're comparing it to what we would do traditionally by getting fat out of the stomach or thighs and then injecting it into the buttocks. So those can be high volume procedures for two reasons. One, you have a limited opportunity because you're there and you're already liposuctioning the rest of the body and you're just trying to get as much as you can to make the liposuction part look as good as possible. And two, you're grafting a lot of fat to the buttocks because a lot of that will get reabsorbed. In the transfer process, there's a huge reabsorption problem. So you have this one opportunity, you're in the OR, you're going to maximize the opportunity. And so that's why there's a lot of large volume autologous fat transfer. In this situation, because you could just add little by little by little, you can have the luxury of time and not feel that pressure to throw it all in there at once. So that is one of the advantages of Alloclae.

Jackie (16:08):
Well, I think people are speculating that that's the route Alix Earle went down because she is so thin. So they're like, "She couldn't have possibly used her own fat."

Dr. Chang (16:20):
Well, that's true. That's the other advantage is that patients that are thin, they don't have a lot of fat to take from. So you want to make your butt big, but you keep your tummy small and your tummy's already small, where are we going to get it from? So that's where this is a very exciting breakthrough and possibly very, very huge market for the company. So I think it's a very good idea. That being said, some of the story I don't totally believe because I'm not sure if Alix Earle's the world famous influencer that she actually paid for her ass. I'm sure they gave it to her or something.

Jackie (16:52):
Well, right. And also, she has never actually named the product. Right. Which part of me. I mean, you get a little insight when you watch her show of just how heavily scrutinized every little thing is when you're an influencer. And I can't help but wonder, do you think she's a little worried about backlash from using Alloclae? Because I've seen a lot of people in the comments of other influencers, other people talking about it, other people who have used it, the ethics behind it, like this is a dead person's fat who didn't 100% consent. Do you think -

Dr. Chang (17:28):
Well, they probably consented to donation.

Jackie (17:31):
Correct.

Dr. Chang (17:32):
But then nobody, when you do that, you give up essentially. You can't screen who gets it. So if I passed away and I said, "Okay, you can use my skin to help burn victims," but don't use it for anybody who wants breast surgery just for burn.

Jackie (17:50):
You don't get to.

Dr. Chang (17:50):
Goes to a tissue bank. They process it and they use it for whatever they need to use it for. But I think that she probably had. I don't know. I think she's teasing, teasing.

Jackie (18:01):
I know. I do feel like she'll eventually tell us everything. I do. Yeah.

Dr. Chang (18:04):
She's supposed to be an open book, right? Yeah. That's her appeal.

Jackie (18:08):
Right. Well, that's why I was anti her show, because I'm like, "Well, if you're an influencer, we see everything every day from your life. So what are you going to show me on the show?"

Dr. Chang (18:17):
Just like you said before, she actually talks about everything. She was talking about her boobs having breast implants, right?

Jackie (18:21):
Yes. So she was talking about -

Dr. Chang (18:24):
She's sitting in the car talking to her friend, Right?

Jackie (18:27):
Yeah, she was talking to her friend and she was talking about how her nipples are not both facing forward. She says one is forward and one is looking left.

Dr. Chang (18:36):
Or in her armpit. She goes like this with her fingers.

Jackie (18:38):
And then she's like, "That's why one of my nipples is always out in photos." So I thought that was an interesting thing for her to talk about. So even though you may look at Alex Earl and Envy, her boobs, you don't always know what they fully look like. So I thought that was interesting that she shared that. And then her sister made a joke that her and her ex-boyfriend would literally make jokes about her nipples to each other.

Dr. Chang (19:02):
Well, it brings up a couple things. One, she's seemingly in good spirits about having a less than perfect body. She's sort of like, "Yeah, they're not exactly perfect symmetry and I can have fun." I assume seems like she's still happy with her body and to show some cleavage here and there.

Jackie (19:23):
I mean, yeah, they look great in her clothing.

Dr. Chang (19:27):
I think that it's important for other people who are less secure than she is to understand not everybody's perfect. And it's kind of like how you flaunt it, how you wear it, your confidence and how you enter the room. And I think that part of that is that. And so I think that a lot of it depends on. It may not be bad surgery. It may be how she healed. It may be where she started.

Jackie (19:47):
Right. I was thinking that too. So that's why I was happy when she mentioned it because it's like not everyone. Our bodies aren't all the same. Our bodies aren't all perfect. We all start at a different area. So you have to have realistic expectations, I think, with surgery in general.

Dr. Chang (20:04):
Ah, you tell them, sister. So I thought that that was really good. Even Alix Earle, who everyone would say. I mean, freaking. She was dating Tom Brady. She's gorgeous, but she can even admit like -

Jackie (20:14):
She was dating Tom Brady? She just said hi to him at some Hamptons party or something like that.

Dr. Chang (20:19):
No, no, no. They were dating or hooking up.

(20:22):
What?

Jackie (20:23):
Please watch the show. No. Please watch the show.

Dr. Chang (20:26):
I thought it was awkward. He just said hi to her at some party.

Jackie (20:29):
That's what we all thought.

Dr. Chang (20:30):
And then everybody made a big deal about it.

Jackie (20:31):
No, no, no. There were more. There were more times.

Dr. Chang (20:34):
Oh, Tom. Come on, bro. Not that.

Jackie (20:37):
Well, I'm like, Alix, Tom is, I was listening to Tom all yesterday with the Redskins game, Commander's game.

Dr. Chang (20:46):
Yeah. He looked good. I liked his little suit. It was like a tan suit or something, like a gray suit.

Jackie (20:52):
Yeah, I was just laughing.

Dr. Chang (20:53):
It's like the Obama thing.

Jackie (20:54):
I was curious and I just kept thinking about him and Alix Earle. But yeah, I mean, she's always been an open book. Like I said, she always talked about her struggles with acne. So I think she's. I had low expectations going into the show, but I do feel like she's a pretty good role model. She has a good head on her shoulders. She seems very realistic about everything. So I thought that would be -

Dr. Chang (21:18):
I'll have to plug in. I'll have to get into the show. I'll have to try it a little bit.

Jackie (21:22):
I'll be interested. I mean, I think they'll definitely get a season two, and maybe season two, she'll actually name it Alloclae. I did Alloclae in my butt.

Dr. Chang (21:34):
All right.

Jackie (21:34):
Maybe we'll see it.

Dr. Chang (21:35):
We'll wee. But if you want to learn a little bit more about Alloclae or anything else in terms of - Yep.

Jackie (21:41):
We have it here if you're interested in a little Alix Earle BBL.

Dr. Chang (21:45):
Yeah. I still don't think she did it. I think she's just screwing with all of you guys. But if you are interested in it, we do have those products and we would be happy to do a consultation. Anyway, if you have any other questions about that or comments about Alix Earle, please leave them in the section below. Subscribe and like and listen to more for everything else, plastic surgery and cosmetic related.

Jackie (22:07):
All right. We have some patients. We got to go.

Dr. Chang (22:09):
All right.

Jackie (22:09):
All right. Bye.

Dr. Chang (22:12):
Thanks for listening to Secret Services, the podcast where we see everything and say nothing except right here. I'm Dr. Christopher Chang, double board certified plastic surgeon located in Tysons, Virginia. Follow us on TikTok @congressionalpsurgery or on Instagram @congressionalplasticsurgery. To send us a classified message or to hear more episodes, go to secretservicespodcast.com. Links to everything we talked about on today's show are available in the show notes. Oops. Patient's here. We got to go.