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Factors that Influence a BBL and Ogee Lipo (Part 1)

Zones of Adherence, Internal and External Fat and Asymmetry 

Dozens of things influence a BBL and Ogee Lipo. From vectors and pelvic shape to asymmetries, every patient has personal traits that will affect their overall look. These differences impact results and are why each patient who gets a BBL ends up looking unique.

Part one of the three part blog, Factors that Influence a BBL and Ogee Lipo, will cover zones of adherence, internal and external fat and asymmetry.

Zones of Adherence

Thanks to what we refer to as zones of adherence, instead of our skin hanging about our bodies, it adheres to our muscles in particular areas that help to allow us to bend and move freely. These zones also affect how we look after surgeries are performed, and they are located throughout the body.

After receiving liposuction, you may see extra skin that hangs over in these areas - this is normal and expected. 

As the body recovers after surgery, the fat and skin readjust and suck back to your body, re-draping your muscles. Still, it’s important to mention that you will always have a bit of extra skin in these areas no matter what surgery we perform.

Some skin rolling in these areas is a normal part of our body’s composition – it’s thanks to zones of adherence, we can bend, move or even stand erect, and our skin stays connected to our bodies.

Internal and External Fat

Internal and external fat are fundamental to understand before a BBL because the type of fat determines whether a patient needs to lose weight before a procedure.

If you poke your stomach, external fat is the cushy kind that lives below your skin. 

While no one wants fat, external fat is the most common, making up about 90% of a person’s overall body fat, and it is often the hardest to lose. 

However, the person with more external fat is a more likely candidate for lipo and a BBL because subcutaneous fat cells are the only kind that can be removed and readded during the procedure. 

Visceral or internal fat lives just under the abdominal wall. Though it isn’t usually the kind that is predominant to the eye, internal fat is the nasty, disease-causing kind. Chronic conditions like cardiovascular disease, cancer, asthma, dementia are just a few health risks associated with excessive internal fat. 

If you have high internal fat, you will likely be encouraged to lose weight before your procedure. This type of fat has to be lost through diet and exercise because it lives in and around your organs and can’t be removed. 


We are all asymmetric. Normal asymmetry is often invisible to the eye before surgery, so it’s essential to see and discuss them preoperatively.

Asymmetries will still be there to some degree after your procedure. Things like the shape of the spine, muscles, ribs and pelvis cannot be altered during surgery, so it’s important to understand where you have asymmetries and how we will address them ahead of your procedure.

A significant degree of asymmetry, something like scoliosis, is easier to see before surgery because it’s at a higher degree.

Understanding what makes your body unique is vital before deciding on or proceeding with surgery.

Stay tuned for part two of Factors that Influence a BBL and Ogee Lipo. Topics covered will be the winning combination, fat transfer and point of maximal projection and tissue distensibility.