Poliquin's Biosignature work talks about fat distribution in the human body as a picture of your hormonal profile. Spot reduction, from personal experience is highly possible, only not through the same mechanism we've thought of in the past. Modulating and effecting various hormones through direct or indirect means can have a specific effect on fat tissue in certain areas.
Here is just one interesting piece:
Greenway FL, Bray GA.
Department of Medicine, UCLA School of Medicine.
Beta-adrenergic stimulation and alpha 2-adrenergic inhibition increase lipolysis from fat cells. Twenty-eight obese women were placed on a calorie-restricted diet and one of five treatments was applied to one thigh three to five times per week for four weeks: (1) isoproterenol injections; (2) cream containing colforsin (forskolin), aminophylline, and yohimbine; (3) yohimbine cream; (4) colforsin cream; or (5) aminophylline cream. The opposite thigh was treated with a placebo (injection or cream). The treated thighs lost significantly more girth after treatment, both by injection and by cream. No adverse reactions were attributable to either the cream or the injections. It is concluded that local fat reduction from the thigh can be safely accomplished.
PMID: 2894247 [PubMed - indexed for MEDLINE]