Typically, a combination of sculpting of the waistline with liposuction (+/- tummy tuck and/or natural weight loss) and augmenting the buttock with implants provides the best chance for a long lasting and desirable "hour-glass" figure. However, please keep in mind that a physical exam is always first necessary before providing any final surgical recommendations.One of the most important factors in creating the perfect derriere with implants is indeed selecting the right size AND shape. Also, it is crucial that the surgeon place the implant intra-muscular, not on top of the muscle or “subfacial”. I have found the best way to assure this is to simply measure the actual dimensions of the patient’s buttock cheeks. With these anatomical measurements, I can select an implant that not only significantly augments the buttock but also supplies the correct 3-dimensional enhancement to look as real as possible...even in the most petite patients. Traditionally, teardrop oval implants have a 30+% risk of rotation and thus unnaturally change the buttock shape/appearance when doing so. However, one and a half years ago I created and patented a new "Stanton Anatomic" shaped implant that avoids this issue AND provides as much projection as similar volume (cc's) round implants - I have not had a single rotation problem in 250+ patients. Additionally Stanton Anatomic buttock implants tend to maintain a more natural buttock shape/curve even when bending over - an otherwise not uncommon problem with round implants. This is a huge benefit by the fact that ~90+% of patients have more of an oval shaped buttock cheek than round, thus creating a much more natural and harmonious buttock contour for the majority of patients. Finally, buttock implants, including Stanton Anatomics, do indeed significantly augment the hips especially by filling in much of the "hip dip". So in summary, the only way for you to know what implant works best is to consult with a board certified plastic surgeon specializing in this procedure and have him/her take your measurements before selecting an implant and proceeding with surgery. Also not a bad idea to select the surgeon who has the most experience, the best reviews, and the most pleasing before and after photos.
