Four years ago I began my cosmetic fellowship with Dr. Michael Salzhauer in Miami, Florida. Coming from the west I had not had much exposure to buttock augmentation with fat transfer. Where I did my training, traditionally women were trying to make their buttocks look smaller – not larger! At first I was hesitant about what kind of improvement it could make. Much to my surprise it became one of my favorite operations that I currently perform. Buttock augmentation with fat transfer can totally transform a woman’s body. And, it is not only for women who want to increase their size it is also for women who want to change the shape of the buttocks. Overall, it takes a commonly seen square shape and sculpts it into a very feminine hourglass figure. The buttocks gain lift and projection. The process involves having liposuction from various areas of the body. Much of this part of it depends on how much fat a woman has on her body and also how much of a size change she wants to her buttocks. The fat is then processed and placed back into the buttocks. All of this is done with just a few tiny incisions. The patient then wears a compressive garment for a few weeks to assist with contoured healing. Much to my excitement, since moving to the Austin area, I have seen more and more patients who are interested in this procedure. The preconceived idea that buttock transfer is only for patients who want to gain size is giving way to the understanding that it is more about transforming the shape of a patient’s body.