Liposuction is an effective surgical solution for reducing the noticeable accumulation of fat known as a “buffalo hump.” This cosmetic procedure specifically targets the excess fatty tissue that forms at the base of the neck and the upper back. The removal of this localized fat deposit, medically termed the dorsocervical fat pad, aims to restore a smoother, more natural contour to the neck and shoulder area.
What is the Dorsocervical Fat Pad?
The dorsocervical fat pad is a localized fat accumulation situated at the junction of the neck and the upper thoracic spine, creating a visible, rounded mound. This collection of fat develops due to various underlying medical or pharmacological factors, making it distinct from general weight gain. The fat within the hump is often fibrous and firm, which is why it frequently fails to respond to diet and exercise alone.
A common medical cause is Cushing’s syndrome, where excessive cortisol leads to fat redistribution. Long-term use of glucocorticoid medications, such as prednisone or hydrocortisone, can also trigger this localized fat growth as a side effect. Furthermore, certain antiretroviral therapies used to treat HIV/AIDS can cause lipodystrophy, resulting in fat accumulation in this specific region.
The dorsocervical fat pad can also be linked to rare genetic disorders or conditions like Madelung disease, often associated with heavy alcohol intake. While obesity can contribute to fat deposition, the fat pad’s development often points to a hormonal or medication-related cause that requires medical evaluation. Understanding the specific origin is important for treatment planning and managing the risk of recurrence.
The Liposuction Procedure
The goal of liposuction for a buffalo hump is the precise removal of the dense, localized fatty tissue to achieve a smooth contour. The procedure typically begins with anesthesia, which may be local with sedation or general anesthesia for larger humps. The surgeon often uses a tumescent technique, infiltrating a sterile solution containing a local anesthetic and a blood vessel constrictor into the fat pad.
This fluid helps to numb the area, minimize blood loss, and make the fat easier to remove. Next, small incisions are made near the hump, through which a thin, hollow tube called a cannula is inserted.
For this particularly fibrous area, advanced techniques like power-assisted liposuction (PAL) or VASER (ultrasound-assisted) liposuction are often employed. VASER uses ultrasonic energy to selectively melt and liquefy the fat before it is suctioned out, which minimizes trauma to surrounding tissues. The liquefied fat is then aspirated through the cannula, and the surgeon continuously palpates the area to ensure uniform reduction and a smooth transition.
Post-Procedure Healing and Results
Following the procedure, patients can expect immediate contour changes, although the final result will be obscured by post-operative swelling and bruising. Most patients can return to non-strenuous, office-based work within one to two days. Managing the swelling is a primary focus during the initial recovery period.
A compression garment must be worn consistently over the treated area for several weeks. This helps to reduce swelling, promote skin contraction, and support the new body contour. Discomfort is generally manageable with over-the-counter or prescription pain medication for the first few days. Patients are typically advised to avoid strenuous activity, heavy lifting, and intense exercise for two to four weeks to prevent complications.
While significant swelling subsides within the first few weeks, the area will continue to refine and settle over time. The final aesthetic outcome, where the full contour improvement is visible, may take anywhere from three to six months as residual swelling resolves and the skin tightens. The removed fat cells are permanently gone, but maintaining a stable weight and addressing the underlying cause is necessary to prevent fat accumulation.
Candidate Evaluation and Medical Screening
A comprehensive evaluation is the required first step to determine if liposuction is the appropriate treatment for the dorsocervical fat pad. The surgeon must first confirm that the hump is composed of excess fat and not an underlying structural issue, such as a spinal curvature, which liposuction cannot correct. Candidates should be in generally good health with no uncontrolled medical conditions that could complicate surgery or slow healing.
A thorough medical history review is performed, with particular attention paid to the potential cause of the fat pad, such as specific medications or underlying endocrine disorders. If the hump is a side effect of medication, the patient must consult their prescribing physician to see if the dosage can be safely adjusted or the medication changed, as this reduces the risk of recurrence. The quality and elasticity of the skin are also assessed, as good elasticity is a factor in how well the skin contracts over the reduced volume, influencing the smoothness of the final result.