The round buttock shaped is easy to fix if you decide that you desire the hourglass shape. To achieve this, liposuction is performed on the top and the middle third of the buttock to decrease the horizontal dimensions. When fat is injected into the buttocks for projection, this also decreases the horizontal dimension by stretching the skin in a posterior direction, essentially borrowing skin from the horizontal nature of the round buttock into a more posterior-projected direction. This is why I like to first inject fat for projection and to round the buttock, keeping the fat injection to the most central aspect of the buttock and avoiding any fat in the lateral part of the buttock. This is very different than the A-shaped buttock, where I inject fat for projection, but also in the lower third of the buttock to recreate the shape. The round buttock demonstrates why the shape of the buttock is important. Depending on the shape and skin tone, the surgeon determines where the fat is going to be injected as well as how to change the dimensions of the buttock vertically and horizontally. Understanding all the buttock shapes is essential to get the results that you want. Only a surgeon with significant experience in buttock enhancement procedures will be able to provide those results.