The anatomical difference between saddlebags and hip dips
The most frequent cause of dissatisfaction in gluteal surgery is often not the technique, but the diagnosis.
Many patients come in requesting liposuction to remove saddlebags. However, the True cartridge belts are less common of what is believed.
In many cases, what appears to be a lateral bulge is actually an optical illusion. hip dips or trochanteric hollows.
Related: Understand the global approach of BBL and how to plan your waistline with 360° liposuction.
The case: they looked like cartridge belts, but they weren't.
In the intraoperative video, the patient showed lateral irregularities that at first glance could be mistaken for saddlebags. This is a very common situation seen in the clinic.
But upon closer examination of the anatomy, the conclusion was different.
What appeared to be excess side fat wasn't actually saddlebags under the gluteal fold. It was a visual effect produced by... Hip dips marked on both sides.
In simple terms: There was no excess volume where there seemed to be. There was a lack of volume where there was a gap.
Pencil cases and hip dips: a quick comparison
| Problem | What is it really? | What not to do | What usually works |
|---|---|---|---|
| Genuine pencil case (real saddle bag) |
Fat accumulation below the gluteal fold, with a protrusion towards the thigh. | Aggressive or unplanned liposuction, because it can cause collapse and irregular transitions. | Liposuction very dosed and strategic, respecting support and continuity. |
| Hip dips (trochanteric fossa) |
Lateral depression related to bone structure and tissue distribution. It is not excess fat. | Remove fat where there appears to be a lump, because it can worsen the hollow. | strategy additives: fat grafting in the hollow to restore lateral continuity. |
On mobile: swipe the table to the side to see all columns.
What are real pencil cases?
The saddlebags are a specific anatomical feature. They are accumulations of fat. under of the gluteal fold that protrudes towards the thigh, like a small overhang.
less frequent than many people believe.
When present, they can be treated with liposuction, but with great caution. If too much is removed, support is lost and the skin can collapse or become uneven.
What are hip dips and why are they so misleading?
The hip dipsTrochanteric depressions, also called lateral indentations, are lateral clefts between the pelvis and the femur.
They are not an accumulation of fat. They are a point where the anatomy creates a natural or more pronounced depression.
This creates an optical illusion: the eye interprets that there is a bump above the hollow, even though that area is completely normal or even lacks volume.
That confusion is the root of many planning errors in BBL and body contouring.
Why confusing them can worsen the outcome
In secondary surgery reviews, a pattern is repeated: patients who had liposuction in the lateral area because it was thought that there was a saddlebag, when in reality there were hip dips.
- An unnecessary void is created. in an area that should not have been emptied.
- The surrounding fat can be redistributed irregular shape and produce secondary lumps.
- The skin can collapse, leaving depressions, undulations or asymmetries.
- The subsequent correction is usually more complex than the original problem.
Golden Rule: Never routinely remove volume from an area that doesn't actually have excess.
Strategy in this case: don't touch what looked like a pencil case
In this patient, the suspected area was left intactNo liposuction was done there.
The focus shifted to the real problem: hip dips.
Using EVL or EVLF technique, that is, vibration-assisted grafting, fat was transferred to the trochanteric fossa to restore lateral continuity and eliminate the optical effect of a bulge.
The result was a smoother, more harmonious and more stable silhouette, without risking collapses or unnecessary irregularities.
How to interpret intraoperative images
Intraoperative images are taken at the end of surgery, when there is still swelling and the volume may appear exaggerated.
Afterwards, the edema subsides and part of the graft is reabsorbed in a predictable manner.
Therefore, in the operating room, a slight overcorrection is usually sought to compensate for the expected loss during recovery.
The correct diagnosis is what changes the outcome
The success of a BBL It depends less on how much fat is moved and more on where the volume is preserved y where it is added.
Labeling hip dips as saddlebags leads to destructive decisions. Identifying them correctly allows for a more logical, safer, and more effective strategy.
Royal pencil case or hip dip?
During the consultation, it's determined whether the lateral bulge is actually excess fat or the visual effect of an anatomical hollow. This difference completely changes the treatment plan: selective liposuction or fat grafting in the correct location.
FAQ
How do I know if I have saddlebags or hip dips?
The real cartridge pouches usually protrude from below the gluteal fold towards the thigh.
Hip dips are a lateral indentation that creates visual contrast. During a clinical examination, they are confirmed through palpation and analysis of the anatomy while standing.
Why can liposuction worsen hip dips?
Because it removes support in an area that does not have an actual excess of fat.
This can exacerbate depression, create irregularities, and promote skin breakdown.
Are hip dips always corrected with fat grafting?
This is the most common strategy when there is sufficient donor fat and the goal is to improve lateral continuity.
The amount, placement, and design of the graft depend on your anatomy and the quality of the tissues.
Is the intraoperative result the final result?
No.
In the operating room, there is swelling and the volume appears more pronounced. Afterward, the swelling subsides and part of the graft is reabsorbed; therefore, the procedure is planned with a predictable margin of loss.
Can a mistake be corrected if I've already had lateral liposuction?
Often yes, but it's usually more complex than doing it right from the start.
That is why preoperative diagnosis is so important in gluteal surgery and body contouring.
Do you want a personalized assessment?
Every patient is different. At Cirumed Clinic Marbella, Dr. Aslani's team will study your case individually to explain which options are safe, realistic, and suitable for your anatomy.
You can send us your goals and some photos via video consultation. We'll guide you through the procedure, recovery, and the most suitable plan for you.
