Before surgery, it is extremely important to have a physical examination to determine the type of buttocks you have. There are different types of buttocks, and one of the most challenging ones to correct with any buttock enhancement procedure is the V-shaped buttock. What is a V-shaped buttock? The patient with a V-shaped buttock has a very small width at the lowest part of the butt compared to the top of the buttock. In essence, it creates a V. These patients have the following characteristics: They tend to be top-heavy They tend to be significantly overweight The buttock is very small The skin is very tight, not only in the central part of the buttock, but on the sides It is important to understand the V-shaped buttock. Patients with V-shaped buttocks are, in my experience, not the best candidates for a buttock enhancement procedure. Yes, you can have the fat transfer to the buttock, but the problem is that these anatomical factors are going to negatively impact the final results. To change a buttock from a V-shape to an A-shape—to make the lower part of the buttock wider than the top—is virtually impossible. This is because: The skin is extremely tight The skin on the sides of the buttocks has a limit on how much it can stretch when fat is injected, meaning that reversing the proportions you see on this patient is going to be a surgical challenge If you have this type of buttocks, you can still have the surgery, but you are not going to get the results you want. In my practice, I tend not to do this procedure on V-shaped buttocks, because even with my experience, it is impossible to get a result that the patient is going to be happy with. Yes, there is going to be an improvement, but in the mind of the patient it might not meet their expectations.