Augmenting any part of the body with an implant tends to be very predictable in terms of how big you are going to get in that specific anatomical area, like your breast. When it comes to injecting fat into any part of the body, this will require a more challenging surgical technique and an understanding of the factors related to fat survival and body contouring with the fat. Fat transfer to the buttock is very technique-dependent and when I say technique-dependent, it means that not every surgeon is going to get the same results. Just because one surgeon augmented the buttocks with a good result that does not mean that the surgeon next door will do the same job. There are different things that need to be considered when injecting fat in the buttocks. First the fat needs to be injected in different levels including inside the muscle and outside the muscle. Inside the muscle is a much better plane for fatty injection because the muscle has a higher blood supply with a recipient bed that is more suitable for long-term results. On the other hand, fat injected in the buttocks does not provide you as much projection as fat injected in the superficial fascia above the skin. The reason is because the fascia around the muscle is thick and many times it does not expand to the level that we desire. So injecting the fat inside and outside the muscle is a good technique to minimize complications and provide a long-term result. In addition how you strain the fat, how you remove the fluid from the extracted fat is really important. Multiple studies have been done using different techniques. In my opinion, the less you do to the fat, the better. In other words, when I remove the fluid, my main goal is to strain the fat, meaning all the fluid from the fat will be removed and only the fat will stay. The more you decant the fat or remove all the fluid, the better will be your results. Many surgeons will harvest the fat and not remove the fluid that comes with the fat and the problem with that is initially your buttocks is going to be of a significant volume. Once the fluid is reabsorbed it creates a less than satisfactory result. In addition, the type of cannula that they use and the port of the cannula is very important. We would like to use a 2.7 to 3 mm cannula with a 2 to 3 mm port so the fat that is coming out of the cannula is in small amounts which will help the fat survive as it is being injected in the recipient bed, and you will have enough blood supply surrounding the aliquots of fat for a good result. The best technique of buttock augmentation is choosing a surgeon who understand the concept of buttock augmentation. Buttock augmentation is a procedure that is mastered with time and technique. It might take a surgeon 5 to 7 years to master and control how the buttocks is shaped and at the same time minimize complications.