In this area we have a nice 40 year old lady from Scottsdale, Arizona who came to my plastic surgery office requesting multiple plastic surgery procedures. I listened carefully as she explained her dissatisfaction with her buttocks. She mentioned during the consultation that she had a Brazilian butt lift performed in Beverly Hills, CA 6 years previous to meeting me. She also had liposuction in several areas. After her Brazilian butt lift and fat transfer she was not happy with the other surgeon. She wanted me to improve on what had been done. She did not like the shape of her butt. She felt the buttocks were still too flat and the upper shelve was too much. She was very dissatisfied with the unnatural shape of the lower back and buttocks. She had gained some weight since her original surgery, but she felt this did not contribute to the appearance. She sat down with me and discussed her options for revision Brazilian butt lift and liposuction. After examining her, I recommended repeat liposuction of her upper back, arms, thighs and abdomen. I also recommended fat injections to the lower buttocks and abdominal dimples. In order to obtain a more natural result for the buttocks, I recommended fat injections to the lower back and conservative liposuction of the upper butt. The procedure was carried out at a local Arizona plastic surgery center with an overnight stay. During surgery, a total of 4 liters of unwanted fat was gentle removed from her body. Into each lower buttock, 400 cc were injected. In the lower back, I placed 240 cc of fat. The abdominal dimples were filled with 100 cc of fat. Only 150 cc of fat was removed from the upper buttock to achieve a more natural result. Her photos taken 3 months after cosmetic surgery demonstrate a thinner figure with improved contours. She is pleased that the overly exaggerated shelf is gone. She mentioned at her last visit, surgery has given her a new confidence with the more natural appearance of the lower back and buttocks, while maintaining the round shape.