The areas to be injected are marked before surgery. Also, the donor sites, where fat will be harvested, are marked. The donor sites are the areas of fat excess, which almost always includes the flanks because the subtraction of fat from these areas helps to accentuate the curve of the buttocks. The other typical donor areas are the tummy and thighs.

The LipiVage^TM System, which acts to separate the fat out while it is being suctioned, makes this much easier because it is no longer necessary to centrifuge small syringes of fat, which is very time consuming and may increase the risk of infection. The fat is injected into the central part of the buttock, measuring to make sure equal amounts are injected on each side. Usually the fat is injected using the same incisions used to perform liposuction of the flanks, so there are no additional scars.

Ultrasonic assistance is still used, but only after the fat has been removed for transfer so that the ultrasound does not break up the fat cells, which must be preserved intact so that they will take in their new site. Fragmented fat cells would be quickly absorbed.