We are going to talk about how the V-shape is the most surgically challenging of the different shapes. Again, let’s imagine a the diagram. A line on top of the buttocks, one at the middle, and one on the bottom. Connect these three lines, and we can see that a V-shaped is formed. In order for you to understand why the V-shaped buttock is such a difficult shape to fix, let’s say, for example, that I want to change a V-shaped into an A shape or hourglass shape; these are the two shapes that I like the most because they give the most impressive results and sexy figure. So, changing the V-shape into an A shape is an 180-degree change in proportions. We need to make the bottom part wider than the top part. Now, this seems to be an easy task. Most of you will say, “Well, that would be easy, you inject fat on the bottom and lipo the top.” The main reason that the V-shaped buttock is wide on the top is because of the width of the pelvic bone. I cannot change the width of the bone or the muscle anatomy; the only thing I can change is the fat that is on top of this. Even if you liposuction the top of the buttock, the width will still be significant. The other point is that if I try to inject fat into the lower part of the buttock to make it as wide as an A shape, in over 95% of patients, the skin in this area is very tight. This means that when you try to add fat, it does not stretch to accommodate the fat. Or, let’s say we are going to do an hourglass shape. To create the hourglass shape, I have to inject fat in the middle of the buttock. Ultimately what I want to accomplish is a smaller top of the buttock, a smaller lower buttock, and a wider center of the buttock. Again, the skin tightness does not help with this particular shape. If I start injecting fat, the skin is so tight that it tends to migrate up and down. In many cases, this can distort the buttock in such a way that the results are not what the patient expected.