I perform hundreds of buttock augmentations with implants a year; this is a very challenging surgery, but if it is performed properly and with the right protocol, the patient’s satisfaction is very high. One of the main problems we have in the United States is that the silicone buttock implants we use are very different than the silicone breast implants. Breast implants are filled with highly cohesive silicone that gives them a very soft feel, while a buttock implant is made of a solid silicone and tends to feel a little bit more firm.As you can see, I am holding a silicone implant in my right hand that is soft. When I squeeze the implant, notice that the implant has memory, provides softness to the breast, and feels like a breast. On the left side, I am holding a round buttock implant, and as you can see when I squeeze it, it tends to be firmer. In the United States, these are the only implants approved for buttock augmentation. In other countries, they have implants that are softer and provide a buttock that feels more natural. The buttock implants that we have in the United States will feel like you have been exercising; it feels firm. This is one of the reasons that whenever I insert a buttock implant, I inject fat around the implant to provide a better shape, hide the implant edge, and provide the patient with a better result and a more natural feel.