When I perform the hourglass buttock augmentation, which is much better than the Brazilian buttock augmentation shape precedes projection. Shape is always better than projection. You can have a big behind, but if you look square, you are not going to look very sexy and pretty. You need to understand what is the hip and what is the buttocks. Many patients get confused that anybody can get both anatomical areas at the same time. For starters, if we look at this before and after pictures from the back, the patient has an hourglass shape and looks very pretty. Most people will say, “Well she got hips.” She has a very curvy figure, but from the back view, you can not tell the hip area. You can look hourglass from the back view and still look square from the front view. Let me explain this. If you look at the anatomy of the buttocks and notice that the buttock has a central part and lateral parts, central means in the midline, lateral means on the sides. So the side is where I inject fat to give an hourglass shape or an A-shape. If we look on the front view, we are going to have the hip area, and the hips start at the hip bone, which is very easily identified by physical examination. The hip blends with the thigh. People get confused on what is the thigh and the hip. Some of these women that “look curvy” if you look closely, they do not have the hourglass shape, but they have this small bulging on the side, which provide them some shape but not necessarily what is considered an hourglass shape. If you look at patients with a very curvy figure from the front view, the hips blends from the hip bone at the top, all the way passing the junction of the groin crease with the thigh, and distally with the leg. In those patients who have a significant thigh, it blends nicely with the hips and hourglass shape. You need to understand that the buttocks and the hips are two different anatomical areas, in other words fat is needed for buttock projection on the central part and the shape on the lateral side or on the side and also if you want hips that is actually on the front view, which is different than the back view. In other words, if you want to have hips and buttocks, you need to have more fat and not everybody can get these. So when you come to your plastic surgeon, be prepared to answer these questions: Do you want to have hips, do you want to have hips and butt, or only butt? If you do not have enough fat, you are going to need to compromise, because fat that goes in the hips does not go in the buttock. Unfortunately not everybody is a candidate for this, since you have to do liposuction in multiple areas to get the fat injected in the buttock and the hip. So if you do not have enough fat, then you are going to need to decide which option is better suited for you. Understanding the anatomical location of the hip and buttock is important when you come to your plastic surgeon to your consultation to determine if in fact you are going to have hips, buttocks, and what kind of shape you want. Many times, you are going to need to compromise because only your anatomy and the amount of fat, among other things, will determine what is possible with the procedure.
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