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BME/Extreme, or Surgical is the heavy body modification branch of BME, founded in 1996 on the one year anniversary of Jack Yount's death. It contains genital piercings and tattoos, implants of all sorts, surgical modifications (including subincisions, tongue splitting, and more), non-surgical modifications (vacuum pumping, saline injection, nipple stretching, and so on), as well as nullification (eunuchs, female genital cutting, etc).
A BME/Extreme membership also includes access to BME/HARD, as well as to the extended mainstream piercing, tattooing, and scarification photo galleries on BME.
Users can purchase memberships which helps pay for the site's bandwidth. Free memberships are available to people who contribute photos and stories.