This out-of-country 26 years old female presented to Dr. Agha for a buttock augmentation surgery and correction of banana roll excess. On examination, the patient had minimal buttock tissue with virtually no fat on her. Dr. Agha planned to use a buttock implant to be placed within the buttock muscle (intra-muscular). Given the fact that the implant results in augmentation of the upper butt, Dr. Agha also planned to liposuction her lower back and to transfer all the available fat into her lower buttock. At the same time, the patient also had a posterior thigh lift with correction of the thigh laxity and banana roll excess. Post-operative pictures were taken at about 1 month before the patient returned home.