What is the BEST procedure to get rid of stubborn back fat? (photo)

I appreciate your question. Coolscultping as a non-invasive procedure gives you 2-25% reduction in 3 months. This is permanent. It may require an area to have more than 1 treatment, but this is all done while watching tv or working from your computer in our office. PAH is very rare, less than 1%. There aren't any risk factors to look for, but is simply treated with liposuction. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery. Best of luck! Dr Schwartz

Hello and Thank you for your photo and question,CoolSculpting is a great, FDA-approved treatment for fat reduction. Based on your question and photo, I think that you are an excellent candidate for Coolsculpting. Patients in our office have seen an average fat reduction of 20-25% with each treatment. Depending on the patient's body composition and outcome goals, it may take more than one treatment to achieve optimal results. It takes 3 months to see the final results. The results are long-lasting as long as you maintain a stable healthy lifestyle. I recommend you schedule a consultation with a certified plastic surgeon for information on coolsculpting.

It is obviously difficult to answer this without examining the area you wish to have addressed.  Based on the picture you provided it appears that your back has a more "deflated" appearance with excess skin than truly large fat deposits. As such direct excision of this "bra roll" may give you the best outcome.  Of course you would be trading a better back contour for a scar. This may not be acceptable to you, however, a plastic surgeon would do his/her best to disguise the scar in the bra line. 
Not everyone is a good candidate for this treatment so please see a Board Certified or Board Eligible Plastic Surgeon to evaluate if you may benefit. Good luck!
This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional.  You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition. 

An examination of you would be helpful to give you advice about treating your back fat.  It is possible that you do not have a significant amount of fat in your back and it could be excess skin that is more of the issue.  If this was the case, that would explain why you did not see improvement with liposuction or CoolSculpting.  If there is some fat there, then another non-invasive option would be SculpSure.  

Hello and thank your for your question,Based on the photos you have provided your seem to have more skin laxity in your back and bra roll than fat. This would explain why you didn't see a result with Coolsculpting or Liposuction. I would recommend consulting with a Board Certified Plastic Surgeon to set up a consult and discuss your options. Good luck!

Qbk921310,
It's difficult to answer your question without the benefit of being able to exam the area. The pictures suggests that you may be experiencing more skin laxity than fat bulges. The consideration of skin laxity is further supported by the fact that you have already undergone both gold standards for invasive and non-invasive fat reduction without a response. I recommend a surgical consultation to identify your diagnosis and to discuss your possible options.
Be Well
Dr Scott Gerrish - CoolSculpting University East Coast Medical Director

First and foremost, it would be beneficial to consult with your physician about what should be done. CoolSculpting  is at the pinnacle of non-invasive fat-loss procedures, but it isn't for everyone. Also, your diet and exercise routine, though commendable, could possibly use guidance or some variations. I would consult with a nutritionist and a trainer for more information in that regard. 

There are many options to remove fat noninvasively. Coolsculpting is the gold standard for removing fat without surgery, and does so by cooling fat to a temperature which is fatal to fat cells. CS needs to have pinchable fat to latch onto with its suction handpieces. Another popular option is Sculpsure - which uses a laser to heat the fat to a point in which it is destroyed. Sculpsure is laid on the skin and can be used on any area of the body. There are ultrasonic devices such as Ultrashape which uses high frequency ultrasound to heat up the fat to a point it is killed. There is also radiofrequency, such as Trusculpt, which heats up the fat to a point that it is killed as well. There are pluses and minuses to each. Liposuction is going to be the most aggressive and give you the best results. Treating the skin (to tighten) and the fat at the same time is probably a good option for you as well. The new Bodytite might be an option you explore. It uses RF to heat the fat and skin with part of the device below the skin surface and part of it above. There are many options for this problem. Hopefully I didn't confuse you even more.