Currently, there are two different types of buttock implants on the market, the anatomical shape and a round shape. The round shape essentially is what the description is, a round buttock implant with maximal projection on the middle of the implant. Then there is the anatomical shape implant, where there is less fullness on the top and more fullness at the bottom of the implant. If I look at the anatomy of the buttocks, I do not understand why anatomical implants even exist, since most buttocks require significant projection in the central part. Anatomical implants are not going to do this. Buttocks do not have a teardrop shape except if you are getting old and your butt is saggy. One problem with the anatomical buttocks implant is creating a pocket that fits precisely, because if the implants either flip sideways or up and down then you are going to notice a significant change in your buttock shape. This is in contrast of round implants, where round implant rotates and the shape will be the same because the round implants are symmetric. One possible indication of an anatomical shape implant will be a patient that has some sort of deficiency in the trochanteric area or any other part of the buttocks prior to surgery. If during your physical exam, it is determined that the inferior part of the buttocks is less prominent than the top of the buttocks, then anatomical shape implants make sense because they would not provide significant fullness on the top while increasing the fullness at the bottom part of the buttock. In addition if there is deficiency in any of the four quadrants of the buttocks, then an anatomical shape implant will be better to create symmetry in the buttocks. During your consultation, we will determine which implant is better for you. In my opinion, it is better to combine a buttock implant with fat transfer regardless, because most patient have asymmetries that the implant itself will not correct. Combining fat transfer with a around implant not only would provide you projection, but also hourglass shape that you need.