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Q: Dr. Eppley, I am interested in Liposuction of the Dorsocervical fat accumulation. I am curious if you do this procedure and what ball park of cost would this procedure be in. Please advise as I need your help.
A: Liposuction is an excellent option and often preferred treatment for neck fat. I believe when you refer to the dorsocervical fat accumulation, you seek the classic ‘Buffalo Hump’ reduction. This is a procedure that I have done numerous times (most commonly in the HIV patient although not always) and I have found that the use of laser liposuction (Smartlipo) can give a very effective reduction without the need for an open operation with a long incision. This is a procedure that takes less than an hour to do, often under sedation or general anesthesia. (it is helpful to have the patient have a good anesthetic depth so the liposuction procedure can be aggressive) Buffalo humps consist of a very fibrous type of fat (often looking more white than yellow) as opposed to a softer and more buttery type of fat more commonly seen in many areas of the body including the anterior neck. This is why laser liposuction or power-assisted liposuction (PAL) is used as it is more effective at breaking up this more dense fat that is held together by fibrous tissue bands. Buffalo humps can be very effectively reduced by this liposuction approach. In my experience, patients have not reported a recurrence of this posterior neck fat accumulation. The ballpark cost would be in the $4,000 to $4,500 range.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I want to have my buffalo hump liposuction along with my neck done at the same time. As I have gotten older the buffalo hump and bad posture have made my spine curve a bit. The hump is really visible when I straighten my back and when you feel it you can feel tissue but you can also feel my bone. My concern is does this put me at a risk for injury to my spine? is it possible to hit my bone while performing the liposuction and paralyze or injury my spinal cord in any way?
A: The buffalo hump is a collection of fat that appears above the fascial covering of the muscle. It is a subcutaneous collection that is far away from the deeply located spinal cord which is under the muscle. Also remember that the spinal cord is encased by protective bony vertebrae besides being deep to the muscle. Therefore, there is no chance of vertebral or spinal cord injury with liposuction surgery to the buffalo hump fatty deformity. The type of fat that is in the buffalo hump is also a more firm or fibrofatty tissue that can be more difficult to extract than softer fat like that in the stomach. For this reason, the use of advanced technology, like Smartlipo, may be more effective in the loosening or melting of the fat prior to suction extraction.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am a 50 year old woman and am fairly thin being 5’3″ and weigh 117lbs. I have had what I think is fat on the back of my neck for as long as I can remember. It looks like a buffalo hump and it runs in my family. I have exercised all my life and continue to this very day. I have always been concerned about my posture so this buffalo hump is quite disturbing. I HATE IT! I have had liposuction on my stomach and thighs but no doctor seems to want to address my neck problem. I have had xrays and I do have a greater curve in my upper back than most people. Looking at me from the front my posture is impressive, but when I turn to the side it looks thick like there is a flap of thick fibrous fat. I can grab and feel it. I am self-conscious about wearing my hair up. Now blouses do not fit properly and often I have to alter clothes for them to fit. Please, I hope that you can help me.
A: Buffalo humps on the back of neck are almost always collections of fat. Why you have it there in an otherwise thin person who is very active is unknown. Seeing that your relatives have it indicates that it is genetic in origin and not from one’s lifestyle. An attempt at liposuction would certainly seem to be worthwhile. The fat in the buffalo hump is different than that in other body areas being more fibrous and not pure fat. This is why an open excision is the most effective approach but the midline scar may not be worth it. I would recommend laser liposuction (Smartlipo) as a better liposuction technique in fibrofatty areas.
Dr. Barry Eppley
Indianapolis, Indiana