Considering butt implants. Is my wish pic possible? What size do you recommend? (Photo)

In short, a combination of sculpting your waistline with liposuction and augmenting your buttock with implants provides the best chance for a long lasting "hour-glass" figure. Please read on for more surgical details:

 Regarding buttock augmentation, let me start off by saying that I currently see at least 2 - 3 patients per week, from around the world, that failed "brazilian buttock lift" (i.e. the fat melted away after 10 - 12 months) and are now seeking a more reliable and permanent option (i.e. buttock implants). 

One of the most important factors in creating the perfect derriere with implants is indeed selecting the right size AND shape. 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 year 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 200+ patients. The benefit of this is the fact that ~80% of women patients have more of an oval shaped buttock cheek than round, thus creating a much more natural and harmonious buttock contour. Thus, 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. 

The largest stock buttock implant currently available in the USA is a 750cc round implant. For the implant brand i prefer and my Stanton Anatomic Oval implants, the largest is 600cc. Indeed custom implants can be ordered larger, not only at a premium price but at a premium risk for most patients'. Unlike breast implants which are placed under the very expandable tissue of the breast and half of the pectoral major muscle, buttock implants should only be placed under or at least within the largest strongest muscle of the body, the gluteus maximus muscle, which is not nearly as expandable or forgiving. Thus most patients simply do not have a large enough native buttock muscle to fit an implant much over 500 ccs', without leading to significant complication such as wound breakdown/opening &/or implant exposure...necessitating removal. If a patient wants larger implants, 9-12 months after the initial implants have settled in to place and the muscle relaxed/stretched, then a second operation can be performed to replace them with larger ones (similar to the process of going bigger with breast implants).   

While buttock implants will help, it is doubtful they can achieve your wish pic. That is simply asking them to do too much. Such implants would have to be placed above the muscle and they would have to be 600cc or bigger.

Buttock implants can certainly be done if you do not have fat donor sites to enhance your buttocks.  Best of luck.