A reader sent me this photo and inquired whether Kim Kardashian may have had work done to her buttocks. Tough call. While her bottom does appear to jut out unnaturally, this may, in fact, be hereditary. I have seen some patients with similar figures who have not had any work done.
Buttocks are usually augmented using either solid silicone implants or via fat grafting (the Brazilian Butt Lift). I have never performed a buttock augmentation using implants, but have made the bottom bigger with fat grafting. This seems to work pretty well. My favorite way to enhance the buttocks, however, is to liposuction the hips and thighs around it. This essentially makes everything around it smaller, and can indirectly make the bottom look bigger and rounder compared to the rest of the body. It doesn't take as much time, has few complications, and allows the patient to sit down immediately. After surgery there is no need to say, "Bottoms up..."