A 36-year old lady from Goodyear, Arizona wanted tummy tuck, liposuction and Brazilian butt lift to be performed in one setting. We call this operation a mommy makeover type 4 or a composite body contouring procedure. She came to my medical practice located in Scottsdale, Arizona for a plastic surgery consultation. She mentioned that her fat pockets over the back and hips made her look like she had a square butt and complained that her waist was not well defined. She preferred to have a better hourglass figure after body contouring. Her other goals were to improve the size and shape of her buttocks via fat transfer. She wanted her buttocks to look more round. She requested that I use the fat available in her tummy. She wanted a tummy tuck with liposuction of the back, thighs, and hips to tighten her tummy and reduce the size of her fat rolls. She then wanted me to perform the fat injections to the buttocks and saddlebags. Before surgery, she is 5 feet 3 inches and 139 pounds. She told me that she never had enough fullness in her buttock and that she was not happy with the size and shape of the buttocks and back. I recommended a mommy makeover type 4, which includes tummy tuck, liposuction and Brazilian butt lift. The operation was performed at a local Arizona plastic surgery and recovery center. During surgery, 3 liters of unwanted fat was removed via gentle liposuction on the thighs, tummy, back, and arms. This preserves the largest number of living fat cells. She then had 650 cc of fat grafting into each butt. She also had 200 cc of fat injections into the saddlebags. The total volume of fat transferred was 1650 cc. She is shown 1 year after body sculpting surgery with an excellent demonstration of the long-term results of fat grafting to the buttocks. She finds it remarkable just how round and firm her buttocks look now.