Dermatologists experiment with non-invasive technology for back fat resistant to diet and exercise. - Hamilton, Douglas (
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Dermatologists experiment with non-invasive technology for back fat resistant to diet and exercise.

High intensity ultrasound being investigated for the treatment of women’s back fat, bra fat

For many women, back fat that bulges along the bra lines is an embarrassing reminder that even a healthy diet and regular exercise can only go so far when it comes to one’s genetic predisposition to fat pockets. While tumescent liposuction has long been the gold standard for eliminating bothersome fat on many areas of the body, including the back, many patients do not want to undergo an invasive surgical procedure. 

Now, dermatologists are testing a non-invasive technology known as high intensity focused ultrasound (HIFU) – currently approved by the Food and Drug Administration (FDA) for abdominal fat – to target and safely eliminate excess back/bra fat.

Information provided by Cheryl Karcher, MD, FAAD, a board-certified dermatologist and assistant clinical professor of dermatology at New York University (NYU) Medical Center in New York, NY.

Similar to how it is used to break up kidney stones, ultrasound technology is now being harnessed as an innovative approach to breaking up fat. By delivering focused, high-intensity sound waves at precise depths within the fat, HIFU heats and destroys the fat cells. The fat cells are then absorbed by the body and eliminated slowly eight to twelve weeks following the procedure. 

Dr. Karcher explained that HIFU has been shown to reach deeper fat and only requires one treatment session to produce measurable results. When HIFU has been used on abdominal fat, most patients have experienced a waistline reduction of more than 1 inch in circumference. Although not approved by the FDA for the treatment of back fat, Dr. Karcher is finding similar results during her study of HIFU.

Subcutaneous fat in the back and bra area tends to be very fibrous and dense, making it very resistant to diet and exercise. Patients with unsightly “back rolls” that form around the bra area may be good candidates for HIFU.  Dr. Karcher cautioned that the procedure is not for everyone and candidates must meet the following criteria:

  • Able to “pinch an inch” (2.5 cm of fat) in the treatment area
  • Have a body mass index (BMI) less than 30 with isolated fat (procedure is not intended for obese patients)
  • Have no large scars or wounds in treatment area
  • Have good skin tightness in the area to be treated
  • Have no redundant skin folds

In an ongoing study at Dr. Karcher’s practice, she has treated more than a dozen women who met the criteria for HIFU on back fat. While men can be treated, Dr. Karcher only has treated women and noted that men typically do not have fat in this particular area of the back. Dr. Karcher noted the following early findings:

  • Two different frequencies are being studied – a lower energy that takes slightly more time to treat (one hour), and a higher energy that takes less time (45 minutes).
  • The average circumference loss of fat has been 1.08 inches in the back/bra area.
  • At this time, there have not been any significant safety concerns with this procedure.
  • Pain medication can be administered before treatment to counter mild pain post-procedure.
  • Some patients experience mild bruising following treatment.
  • Best results were seen after eight to 12 weeks.
  • Patients are advised to maintain a healthy weight and to exercise, as future weight gain could result in new back fat.

“Our early results using HIFU to treat back and bra fat have been positive and well received by our patients, especially since this non-invasive technology doesn’t pose the risks associated with surgery,” said Dr. Karcher. “I think as we fine tune the technology, this off-label procedure can become widely used by dermatologists to combat this stubborn fat that affects countless women – many of whom may not even be overweight. In the meantime, if you have concerns about back fat, see your dermatologist for solutions that work with your lifestyle.”

Courtesy of The American Academy of Dermatology.  See the article on

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