is the Buffalo Hump deformity. While it occurs mostly
in patients with HIV on antiviral medications, it can
also be associated with chronic steroid use, such as in
asthma patients. Occurring in both men and women, its
predominant feature is the fat accumulation at the back
of the neck and upper back. Fat accumulation can extend
around the neck to the jawline and even around the
ears. While unsightly, it also causes functional issues
such as neck stiffness and pain and difficulty with the
fitting of clothes around the neck.
Why this fat accumulation occurs is not precisely
known, but it is a thickening of the subcutaneous fat
layer between the skin and the underlying 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 important consideration around 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 require
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 better
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 effective than an ultrasonic method.
Ultrasonic liposuction can provide significant
improvement but can not get all of the excessive 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 around 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
around the face, jawline, and ears works better than
liposuction in my experience. The facial areas and
front part of the neck are more difficult to treat with
liposuction and usually less satisfying. Unlike
liposuction, however, open excisions are associated
with postoperative fluid collections (seromas) and the
use of drains is needed. Open excision is done through
a facelift type approach, placing the scars in the most
favorable location.
Dr Barry Eppley is a board-certified premiere plastic
surgeon in in Indianapolis, Indiana at his two Ology
Spa locations at Clarian North Medical Center in Carmel
Indiana and at Clarian West Medical Center in Avon
Indiana. (http://www.eppleyplasticsurgery.com) He
writes a daily blog on plastic surgery, spa therapies,
and medical skin care at
http://www.exploreplasticsurgery.com Dr. Eppley can be
heard on his weekly radio show, Doc Chat, on WXNT
1430AM in Indianapolis on Saturday afternoons.
Article Source: http://EzineArticles.com/?
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