Fat above my butt on lower back. Do I need surgery to remove it? (Photo)

From the photo, this appears to be an exercise resistant area of fatty tissue. It does not look like it would be difficult to remove with a localized liposuction procedure. Local tumescent anesthetic could be used without the need for general anesthesia. The other option would be to consider a non-invasive fat removing device such as CoolSculpting, or Liposonix. If you decide on trying one of the devices, I still HIGHLY recommend that you see a surgeon who offers BOTH surgical, and non-surgical options. You want to have an expert to evaluate you, and to help you decide the best plan of treatment.

From your photo, it looks like you are in good shape. So, this must be an area of stubborn fat that can be seen even in very fit women.Your options include exercise, liposuction or coolsculpting. If you are at your ideal body weight then liposuction or coolsculpting (nonsurgical fat freezing) may be an option.  If you still could lose a few pounds to get to your ideal body weight, then exercise might be a healthier option.Good Luck!

Thank you for your question and sharing your photo. From what I see in the photo this can be fixed with Liposuction in office without general anesthesia. I would still recommend consulting in person with a board certified plastic surgeon for a more thorough evauluation. Best of luck!Dhaval M. Patel Double Board Certified Plastic Surgeon Hoffman Estates Barrington Oakbrook Chicago Orland Park 

If your BMI is normal the flank area in particular is difficult to fix with just diet and exercise alone.  Liposuction would be the best option for this area.

Thank you gigimcfalls for your question.  Liposuction typically works well in this area to help reduce the fat and smooth out the area.  It may be able to be done under local anesthetic or even a light anesthesia, depending on if there are any other area's you were considering.  Consult your provider to make sure you are a proper candidate for the procedure and to answer any additional questions.  

You appear to be in good shape.  You don't NEED anything done, but if you WANT something done, some mini-liposuction in my experience works well, usually with local anesthesia in the office in my opinion.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search. 

This particular area is non-responsive to dieting and exercise.  Recommend that you consult with a board certified plastic surgeon who is experienced in liposuction.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

First thank you for your question. I have seen and treated this area many times. The best options is liposuction to this area. But the doctor will get the best results with using the microaire device as it allows a much more aggressive removal of the fat in this area. Also the surgeon must put some type of compression to this area after the surgery otherwise it will still look full after the surgery. Best of luck. Have a great day.

gigimcfalls.   It appears from the photograph that you have a well circumscribed area of fat in that region. If it bothers you liposuction is an excellent option, as it may be difficult to rid yourself of fat in that region with diet and exercise. Be certain to consult with a board-certified plastic surgeon in your area. Best of luck.

Dear gigimcfalls,based on your photo, it looks like you are a great candidate for a liposuction. This small area can be removed under local anesthesia. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery