The present invention relates to a system and method for support and off-loading. The system includes an inner bladder filled with a flowable composition. An outer bladder filled with a flowable composition is positioned adjacent to the inner bladder. The composition of the inner bladder has greater flow characteristics than the composition of the outer bladder. The inner bladder micro-contours to the received body part and the outer bladder macro-contours to the inner bladder after the inner bladder is micro-contoured to the received body part. Alternatively, the system provides a pair of ultra low pressure plenums and a positioner. The patient body size and size and corresponding surface area of the positioner control the amount of gas which is displaced evenly against the walls of the ultra low pressure plenums.