Background: No reports can be found in medical literature describing the anatomic details that make the buttocks beautiful, nor the defects in this region that can help the surgeon decide whether gluteal prostheses are necessary or not, and, if so, which type, design, and volume of prostheses should be used, in which plane they should be placed, and so forth. Methods: The authors studied 1,320 photographs of nude women and measured 132 female patients ages 16 to 62 years. They found that four characteristics determine attractive buttocks. They also found the balanced anatomic dimension of the maximal gluteal projection. Results: On the basis of the information obtained, the defects of the gluteal region were classified into five types, resulting in surgical recommendations intended to achieve buttocks as close as possible to the standard of beauty, with the right volume and projection. Conclusions: The authors concluded that surgery for correction of the buttocks involves more than projection and volume. The surgeon must be familiar with the "signs" of beauty so an attempt can be made to recreate them. Most importantly, the surgeon should achieve buttocks with projection and volume. However, these must be in a balanced proportion with the rest of the body.