What is a "buffalo hump" and how is it removed?

If you're living with a buffalo hump – a buildup of fat at the base of the back of your neck – you're not alone. Many people experience this condition, which can result from various factors such as genetics, poor posture, obesity or medical conditions. Fortunately, plastic surgery offers a solution that can significantly improve your quality of life.

We talked to ASPS Member Surgeons Michael Hakimi, MD, FACS, and Sara Dickie, MD, about the benefits of buffalo hump (dorso cervical fat pad) removal, the importance of choosing a board-certified plastic surgeon for the procedure and the recovery process.

Understanding buffalo hump removal

Buffalo hump removal typically involves liposuction to remove the excess fat. If you've felt your hump, you might notice the fat is extra hard compared to fat on other parts of your body. However, a plastic surgeon can remove even the toughest fat with the proper techniques and tools.

"Out of all the areas with liposuction, the fat in this buffalo hump area is very fibrous and hard," said Dr. Hakimi. "Usually, you can liquify or break up the fat before, so it's easier to extract."

Safety first

Choosing the right surgeon is crucial for a safe and successful procedure. Dr. Hakimi emphasizes the importance of expertise and board certification.

"I think board certification is the bare minimum they should look for because that means they've done it in their training, they have a good knowledge of anatomy, and at least they know how to stay safe," said Dr. Hakimi. "And safety has to always be the first priority for all of us."

The procedure

One of the comforting aspects of buffalo hump removal is the minimal risk involved, particularly concerning vital structures like the spine.

"The spinal cord is very deep to the fat that needs to be removed and is not at risk of injury during buffalo hump surgery," said Dr. Dickie. "It is also protected by the bony spine, which is also quite deep to the level of fat removal."

Dr. Hakimi adds that a plastic surgeon with liposuction experience can perform the procedure even if they are not buffalo hump removal specialists.

"If it's done by someone who knows how to do liposuction, you don't even have to be an expert," said Dr. Hakimi. "If you have knowledge of anatomy, everything is over the muscle. So, unless somebody is very cavalier in this area, there is not much you can harm."

Anesthesia options

There are options to ensure you are comfortable during a buffalo hump removal procedure. You can opt for general or even mild sedation, known as "twilight" anesthesia, if your surgeon offers it.

"Awake anesthesia is an option for patients undergoing liposuction or direct excision depending on the extent of the surgery and the surgeon's confidence in being able to provide adequate pain management," said Dr. Dickie.

Awake anesthesia can make the experience more manageable for patients who may have concerns about general anesthesia or who might not be candidates for general anesthesia due to a high BMI or other medical concerns.

Recovery: What to expect

Recovery from buffalo hump removal is generally straightforward. Patients can expect swelling and discomfort in the treated area, which typically subsides within a few weeks. Most people can return to work within a day or two.

Still, following your plastic surgeon's postoperative care instructions, including wearing a compression garment, is essential to ensure optimal healing and results.

The emotional and physical benefits

The benefits of buffalo hump removal extend beyond the physical. Many patients experience a significant boost in self-esteem, according to Dr. Hakimi.

"It's rewarding because you see how many years they've been holding it in," said Dr. Hakimi. "Either they didn't know that they could fix it, or they didn't know where to go to fix it."

He said many women he operates on no longer wear their hair down to hide the hump and send him selfies of themselves happily wearing their hair up.

Getting the outcome you deserve

When considering buffalo hump removal, it's essential to choose a board-certified plastic surgeon who is an ASPS member. These certifications mean they'll prioritize safety, and you'll have peace of mind throughout your surgical journey.

If you're considering buffalo hump removal, consult with a qualified plastic surgeon to discuss your options and develop a plan tailored to your needs. With the proper care, you can look forward to a smoother, more comfortable neckline and improved quality of life.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.