One option to augment the buttocks is to use buttock implants. Buttock implants have some limitations when it comes to recreating the hourglass shape. If you look at this diagram, the buttock implant is inserted in the central aspect of the buttock to provide projection and only projection. The problem is that patients who require any sort of buttock augmentation procedure have different asymmetries in different parts of the buttocks, and the implants will not correct asymmetries apart from making your buttocks bigger. They will not provide you with an hourglass shape. Another problem with buttock implants is that even if you place the implant inside the muscle, the edges can be visible, particularly in patients who are very thin. For this reason, I combine buttock augmentation with implant and fat transfer. When I perform a buttock augmentation with fat transfer, I perform liposuction of the abdomen, flanks, and sides; then the patient is placed in the prone position or on the chest and liposuction is performed on the upper and lower back and the waistline. I will then create two incisions, one in each buttock, and the buttock implants will be placed inside the muscle. Closure will be performed, and then once I know for sure that the implants are in the right position, I will perform a fat transfer around the implants, including the top, the sides, and the lower part, to provide not only a more natural look and feel, but also an hourglass shape. Combining fat transfer with a buttock implant is absolutely necessary regardless of the type of buttock implant that you use. Buttock implants will not provide the shape that you want unless different surgical techniques are combined to re-create your shape.