What are the options for removal of the banana roll/double butt crease? (Photos)

Thanks for your photos and questions. This is a fairly common problem. The "Banna Roll" is the result of skin laxity of this area. This is accentuated by a loss of fat. Most commonly this is seen after Liposuction of this area.
Unfortunatley the only way to correct  this is excision of the skin laxity and elevation of the upper posterior thigh skin with the incision placed in the lower buttock crease.Since your photos show lack of fullness of the lower lateral buttocks, fat injection of this area will help contour of the butocks and help hide the incision of this area.

Before planting surgical intervention and proper diagnosis needs to be made first.
This may sound very intuitive but is unfortunately not always the case with aesthetic medicine.
Banana role does not represent an excess amount of fat in the wrong place.
Because of this liposuction it typically fails as a treatment option for the banana roll.
The reason for the formation of the banana roll is a skin crease or skinfold.
The skin on the buttocks and back of the thigh that's a lot of connective tissue giving the skin the structural integrity needed to hold someone's weight while sitting.
When leaning forward the skin in this area is pulled taught and there is no fold.
Yes we stand up The skin on the back of the thigh is pushed up against the buttocks causing the fold or skin crease to form.
Exciting a large segment of skin would most likely eliminate the banana roll but is an unacceptable procedure because of highly visible scars.
At times adding volume such as a Brazilian butt lift were fat is grafted into the upper back of the thigh can at times improve the banana roll.
My practice is devoted exclusively to liposuction and fat transfer procedures.
I performed well over 3000 liposuction procedures and I can tell you with a fair amount of certainty good liposuction fails in correcting banana rolls.
Anyone who claims they can improve this with liposuction should be able to show you consistent before and after pictures with patients in the exact same body position.
At least for me attempting to treat the banana roll is often a failure unless someone is willing to undergo a volume enhancement procedure such as a BBL.
The banana roll it's by far more common than most people think.
You have a very attractive body you should be proud of.
I would not let this get in the way of wearing clothing that you like.
Best,
Mats Hagstrom M.D.