Options to get rid of this tiny little pocket of fat as an almost 40 year old woman? (Photo)

An exam is needed for a specific recommendation but there are a few options. If it is localized fat then some liposuction may be all you need. If there is skin laxity as well you could consider Morpheus8. This nonsurgical treatment combines RF technology with microneedling to improve overall skin tone and texture. Three sessions are recommended for optimal results.

Thanks for your question. There is an anatomical fat pad in that location which is not related to being "overweight". When it is large, targeted outpatient liposuction is the easiest and most effective "one and done" approach. When it is small as yours is it makes more sense to destroy the unwanted fat cells with heat. This can be accomplished with radiofrequency microneedling using a device which has the ability to set the depth of the microneedles to reach the fat cell layer (not all devices can do this). Morpheus8 is particularly versatile in this regard- we can set the microneedle depth from 0.5mm to 8mm (that's the '8' in Morpheus8) and set the energy high enough to selectively destroy fat there while simultaneously tightening the skin. The downtime is quite minimal- local redness and mild swelling. It would likely take 2 or 3 sessions but the result is predictable and as "permanent" as anything gets.
There is an injectable called Kybella which can also be used but the downtime with it is much higher, the results are less predictable and it's very expensive. RF microneedling does a much better job.
Coolsculpting is sometimes used in that region but I expect yours is not large enough for that and every client I've ever come across who did submental CoolSculpting was not impressed with the result they got, and most say they saw "no change".
Other heat-based treatments are used that do not involve microneedling (Laser-SculpSure, Radiofrequency-TruSculpt, for examples)- these can have some effect BUT the heat that can be delivered to the fat is limited by the fact that the heat has to pass through the skin layers first and you cannot risk burning the skin. With the RF Microneedling the heat is delivered only at the tips of the needles and thus you can deliver very high heat without risking a skin burn- that makes it more effective and more predictable in its results. Best of luck!

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon