Hi, Thanks for your question and pictures. "Banana rolls" area is a skin fold and this skin became tight when the body is bending. This is like the lower abdomen skin fold when the body is in sitting position. Most people have skin fold (banana rolls ) in this area in standing position. This area is one of the most challenge area to treat. There are 2 options : remove the fat ( if applicable) or tight the skin surrounding it. In my opinion excess fat removal in this area can make you buttocks drop. Aggressive liposuction should be avoided in this area. In some cases actually the surgeon would need to add some fat graft also on the buttock. Each case is different and so the treatment can vary patient to patient. In our clinic we offer a bespoke assessment and treatment plan with combination of Vaser (with very mild lipo or not liposuction) /Bodytite with Morpheus 8 (3 sessions 4 to 6 weeks apart) or Renuvion and or non surgical device such as Radiofrequency/ Ultrasound with other aesthetic medical treatments including Profhilo, collagen-stimulating dermal fillers ( e.g. Radiesse, Sculptra etc. ) These combined procedures will allow to increase the probability of skin tightening and so reduce more the risk of "saggy" skin. Aftercare recommendations including healthy diet and regular exercise can also help. In some very challenged cases, where the saggy/excess skin not improve after at least 6 months/1 year with the above treatment plan then it is possible to consider more invasive options such as surgical treatment to remove the excess of loose skin. However in my opinion I would always start with less invasive treatments and move to more invasive treatments if required. I would recommend to make an appointment with an expert body contouring surgeon for a medical/surgical assessment in order to make a bespoke treatment plan. Hope this helps, Best Wishes, Dr Giuseppe Fiore