Enlargement of the dorsocervical fat pad leads to the so-called “buffalo hump” deformity.  This localized fatty deposit is prominent at the upper back and neck region.  A buffalo hump may be associated with obesity, however other medical causes should be ruled out.  Enlargement of the dorsocervical fat pad may be found in patients with adrenal disease or linked with certain medications (including steroids and HIV treatment).  Patients often present seeking contour improvement if this localized fat deposit is unresponsive to diet and exercise. In certain cases, the fat may be quite fibrous and require an incision through overlying skin and soft tissues.  The most common procedure however to address this fatty deposit is buffalo hump liposuction performed through small access incisions.

What is buffalo hump liposuction?

Buffalo hump liposuction is a surgical procedure most commonly performed under general anesthetic in an operating room setting.  Fluid is first infiltrated through two small incisions, each 3-4mm in length.  This fluid breaks down some of the fat cells and also helps to achieve pain control post-operatively and reduce blood loss.  A cannula is then inserted which suctions out the localized fatty deposit.  Two incisions are most commonly used to allow removal from different angles.  Contour improvement is confirmed during surgery by direct examination as well as palpation of tissue thickness to confirm uniform reduction.  The amount of aspirated fat is also measured during the procedure.  Small stitches are often placed to close the access incisions, which generally heal with minimal scarring.  A compressive dressing is placed following surgery and most commonly removed within a week of surgery.

What is anticipated recovery after buffalo hump liposuction?

Patients are discharged home a few hours following surgery once ambulating well and pain well-controlled.  Prescription pain medication is generally required for a few days post-operatively and then transitioned to Tylenol plain or extra-strength as needed.  Patients are generally able to return to office-based work within a week of surgery.  It is important to refrain from exercise, strenuous activity, and heavy lifting for one month following surgery to lower the risk of healing complications (in particular bleeding, increased swelling, and fluid collections).

When are results apparent following buffalo hump liposuction?

It often takes several weeks to months for swelling to resolve following buffalo hump liposuction.  The majority of swelling resolves within a few weeks of surgery, however final contour improvement may take up to 6-12 months to become apparent.  Once the excess fatty deposit has been suctioned, the overlying skin must then tighten and contract.  Scar maturation takes one year following surgery.

Am I a good candidate for buffalo hump liposuction?

This question depends on several factors which will be discussed in consultation.  Patients presenting with a well-localized fatty deposit at the upper back and neck region are generally appropriate candidates.  It is recommended to lower your body mass index to less than 30, ideally as close to 25 as possible, before surgery to lower risk of complications.  A detailed medical assessment will be performed during consultation to understand your past medical history.  Some medical conditions may require optimization before elective surgery is performed in an out-of-hospital facility.  Smoking cessation is also important for at least one month pre- and post-operatively to lower the risk of infection and other healing complications.  Dr. Power will carefully consider your aesthetic concerns and expectations to determine whether buffalo hump liposuction may be the right  procedure for you.

Please contact us if you are interested in discussing buffalo hump liposuction in more detail!

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