Buffalo Hump Deformity - Plastic surgical operation rehabilitation

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One of the manifestations of the lipodystrophy syndrome is the Buffalo Hump deformity. While it occurs mostly in patients with Hiv on antiviral medications, it can also be connected with continuing steroid use, such as in asthma patients. Occurring in both men and women, its sublime feature is the fat accumulation at the back of the neck and upper back. Fat accumulation can extend nearby the neck to the jawline and even nearby the ears. While unsightly, it also causes functional issues such as neck stiffness and pain and strangeness with the fitting of clothes nearby the neck.

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Why this fat accumulation occurs is not indeed known, but it is a thickening of the subcutaneous fat layer in the middle of the skin and the basal muscle or bone. This fat is unique in that it is very fibrous in quality, meaning it is a mixture of fat and scar tissue that makes it more difficult to remove than many other fat sites in the body.

Liposuction is the preferred method in many cases for removal of the buffalo hump as the scarring is minimal which is an prominent observation nearby the neck and face. Liposuction avoids the need for a long incision on the neck and upper back, has a lower risk of postoperative fluid collections, and does not need the use of drains. This fat is surprisingly gritty and tough to remove and traditional liposuction methods can be quite disappointing. Or at the least, requires a lot of work to get much out. For these reasons, ultrasonic liposuction is my preferred technique. This does best than traditional cannula methods in this type of fat. I have not yet used laser liposuction methods but I would expect them to be effective, but am unsure if they would be more sufficient than an ultrasonic method.

Ultrasonic liposuction can provide indispensable improvement but can not get all of the immoderate fatty tissue. Expect improvement but not a complete cure of the problem. No long-term studies have ever been done that can substantiate how permanent the results from liposuction reduction of the buffalo hump are.

Fat nearby the front part of neck up into the face can be part of the buffalo hump or can also occur in Madelung's disease. Open excisions of fatty tissue nearby the face, jawline, and ears works best than liposuction in my experience. The facial areas and front part of the neck are more difficult to treat with liposuction and commonly less satisfying. Unlike liposuction, however, open excisions are connected with postoperative fluid collections (seromas) and the use of drains is needed. Open excision is done straight through a facelift type approach, placing the scars in the most suitable location.

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