Fat Above the Tailbone: Why It Forms and How It’s Treated
September 15, 2026
Fat above the tailbone is a pad of fat over the sacrum, the flat triangular bone at the base of the spine just above the buttocks. It is sometimes called sacral or lumbosacral fat. Its size is largely set by genetics, so it may not change much with diet and exercise. Options such as liposuction or non-surgical fat reduction are assessed individually.
All surgical and invasive procedures carry risks, and non-surgical procedures also carry risks. Results vary between individuals.
What is the fat above the tailbone?
It is a normal fat deposit that sits over the sacrum, between the lower back and the top of the buttock crease. Many people have it, whatever their weight or fitness.
The back has several distinct fat areas: at the base of the neck, around the shoulder blades, near the armpits, above the hips (flanks) and above the tailbone. This article covers only the tailbone area. For other areas, see treatment options for bra-line fat and what a buffalo hump is.
A fuller sacral fat pad can soften the curve where the lower back meets the buttocks, so the buttock and lower back can look like one continuous shape from the side or back.
Why doesn’t tailbone fat go away with exercise?
Exercise and diet reduce overall body fat, but they cannot target where fat is lost. The pattern of where your body stores fat is largely inherited.
Fat in the lower back can also be more fibrous (containing more connective tissue) than fat in some other areas, particularly in men and in people who have had large weight changes. This does not make it harmful, but it can affect how it responds to treatment.
If you notice a new, growing, painful or firm lump near the tailbone, see your GP. A lump in this area can have medical causes, such as a lipoma or a pilonidal cyst, that need assessment rather than cosmetic treatment.
What are the treatment options for fat above the tailbone?
The main options are liposuction of the area alone, liposuction of the area as part of a fat transfer to the buttocks, or non-surgical fat reduction. Which, if any, suits you is decided at consultation.
| Option | What it involves | Main considerations |
|---|---|---|
| Liposuction of the sacral area | Fat is removed through small incisions, for example with ultrasound-assisted (Vaser) liposuction | Surgical; anaesthetic, compression garment and recovery time; results vary with skin quality |
| Liposuction as part of a BBL | Fat from above the tailbone and nearby areas is removed and some is transferred to the buttocks | Adds the risks of fat grafting, including fat embolism; longer recovery |
| Non-surgical fat reduction (fat freezing) | A cooling applicator is placed on the skin to reduce fat cells in the treated area | Not everyone is suitable; more than one session may be needed; results are gradual and vary |
| Lifestyle changes | Diet and exercise reduce overall body fat | May change overall size; cannot target one area |
Liposuction of the tailbone area
Liposuction may reduce localised fat above the tailbone. Vaser liposuction uses ultrasound energy to loosen fat before it is removed through a thin tube (cannula). It may be performed under local anaesthetic with sedation or under general anaesthetic, depending on the treatment areas and individual assessment.
Skin needs enough elasticity to adapt once fat is removed. If skin elasticity is reduced, the area may look loose or uneven afterwards. Downtime varies between people and is discussed with your doctor. More information is on our Vaser liposuction page.
Tailbone fat and BBL contouring
The sacral area is one of the common donor sites for a fat transfer to the buttocks. Reducing fat above the tailbone can make the transition from the lower back into the buttock more defined, which is why it is often part of BBL planning. How much this changes the outline depends on anatomy. See how BBL shape options relate to your body.
If your main concern is only the tailbone area, a BBL is a bigger operation with more risk than you may need, so this is weighed at consultation.
Non-surgical fat reduction
Fat freezing (cryolipolysis) is a non-surgical option that aims to reduce fat cells in the treated area. It is not a weight-loss treatment, and results develop gradually over weeks to months. More information is on our CoolSculpting page.
Who may be suitable?
People who may be suitable for treatment of tailbone fat are generally in good health, at a stable weight, and have a localised fat deposit rather than wanting weight loss. Suitability is assessed individually in consultation.
For liposuction or a BBL in Australia, you need a GP referral, two pre-operative consultations (one with the doctor performing the surgery), and a cooling-off period of at least 7 days before surgery.
Risks and considerations
Liposuction risks include bleeding, bruising, swelling, infection, seroma (fluid collection), contour irregularities or dents, changes in skin sensation, skin discolouration, blood clots, scarring and reactions to anaesthetic. Pain, bruising and swelling are expected after surgery and vary between patients.
If liposuction is combined with a BBL, the fat grafting adds further risks. The most serious is fat embolism, where fat enters large blood vessels near the gluteal muscle and travels to the lungs or heart, which can be fatal. International plastic surgery safety task forces recommend placing fat only in the layer under the skin to reduce this risk. Fat necrosis, asymmetry and fat reabsorption can also occur.
Fat freezing risks include redness, bruising, swelling, numbness, tenderness and pain in the treated area. A rare complication called paradoxical adipose hyperplasia causes the treated fat to enlarge and harden rather than reduce, and may need surgical treatment.
Frequently asked questions
Is fat above the tailbone the same as love handles?
No. Love handles (flanks) sit at the sides of the waist above the hips. Tailbone fat sits in the centre of the lower back, just above the buttocks.
Can posture make tailbone fat look bigger?
The curve of the lower back affects how prominent the area looks. Posture does not change the amount of fat.
Is the fat taken from above the tailbone used in a BBL?
It can be. Whether it is used depends on how much is available and the overall plan.
Can tailbone fat come back after liposuction?
Fat cells removed by liposuction do not return, but remaining fat cells can grow with weight gain.
Can I treat the area if I am pregnant or planning pregnancy?
Talk to your GP and doctor first. Pregnancy changes body shape, and elective procedures are generally postponed. See pregnancy after liposuction.
Book an assessment
Whether fat above the tailbone can be treated, and how, depends on your anatomy, skin and health. Read more on our fat transfer to buttocks page, or contact our patient care team on 1300 138 797 to arrange a consultation.
All surgical and invasive procedures carry risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Results vary between individuals.
Disclaimer: This article is general information only and does not replace a medical consultation. All surgical and invasive procedures carry risks. Results vary between individuals. Suitability, risks and recovery are discussed in detail during consultation with a qualified medical practitioner. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.