Buffalo hump, a term often used to describe an abnormal fat deposit at the back of the neck and shoulders, is a condition that can cause physical discomfort and aesthetic concerns. It affects individuals differently, sometimes leading to self-consciousness, pain, or restricted movement. We explain what a buffalo hump is, what causes it, and how it can be treated or removed.

What is a Buffalo Hump?

A buffalo hump, medically known as a dorsocervical fat pad, refers to an accumulation of excess fatty tissue between the upper back and the base of the neck. While the name conjures an image of a prominent, hump-like bulge, the size and shape of the fat pad can vary greatly among individuals. For some, it may be a small, soft lump that is barely noticeable. For others, it may be a more significant and pronounced mound that disrupts their posture and draws unwanted attention.

What Does a Buffalo Hump Look Like?

The visibility of a buffalo hump often depends on several factors, including body fat percentage, posture, and the underlying cause. In some cases, the hump may be concealed by clothing, but for those with a more significant fat deposit, it may be difficult to hide. This can lead to feelings of self-consciousness and a reluctance to wear certain types of clothing.

Causes of Buffalo Hump

Understanding what causes a buffalo hump is crucial for effective treatment. The causes can range from lifestyle factors to more complex medical conditions. Here are some of the most common contributors:

1. Obesity and Weight Gain

Excess body fat is a common cause of a buffalo hump. When people gain weight, fat is often deposited in various areas of the body, including the back of the neck. For some individuals, this can result in a noticeable hump. Weight loss may help reduce the hump, but this is not always guaranteed.

2. Long-Term Use of Steroid Medications

Chronic use of corticosteroids, such as prednisone, can cause a redistribution of fat throughout the body. This is known as “steroid-induced lipodystrophy,” and the buffalo hump is a hallmark sign. Patients taking steroids for autoimmune conditions, asthma, or chronic inflammatory diseases may be particularly prone to developing this issue.

3. Cushing’s Syndrome

Cushing’s syndrome occurs when the body is exposed to high levels of cortisol, either due to long-term steroid use or because the body itself produces too much cortisol. This hormonal imbalance leads to several physical changes, including fat accumulation in the face (“moon face”), abdomen, and back of the neck (buffalo hump). Other symptoms include easy bruising, muscle weakness, and high blood pressure.

4. Hormonal Imbalances

Hormonal disorders, such as polycystic ovary syndrome (PCOS) or thyroid imbalances, can also lead to fat deposits in unusual areas. Similarly, adrenal gland disorders, which affect cortisol levels, may contribute to the development of a buffalo hump.

5. Poor Posture

While poor posture alone does not directly cause a buffalo hump, it can worsen the appearance of existing fat deposits. Individuals who frequently slouch or work in positions that encourage a forward neck posture may notice that their hump appears more pronounced over time.

6. Medications

Besides corticosteroids, other medications, such as certain antiretroviral drugs for HIV treatment, can cause fat redistribution. This can result in fat accumulation in specific areas, including the back of the neck.

7. Genetics

Your genetic predisposition plays a role in how and where your body stores fat. If your family members have a history of buffalo humps or abnormal fat deposits, you may be more likely to develop one yourself.

Symptoms and Complications

The buffalo hump can present with a range of symptoms, varying from mild discomfort to severe pain. Here’s a look at the common signs:

• Visible Lump: A noticeable accumulation of fat at the back of the neck.

• Pain and Discomfort: The hump can cause discomfort, especially if it puts pressure on the surrounding muscles or nerves.

• Restricted Movement: In some cases, the presence of a buffalo hump can limit neck mobility, making it difficult to turn your head or lift your chin.

• Postural Issues: Individuals may develop a forward neck posture or rounded shoulders, which can exacerbate neck and upper back problems.

• Emotional Impact: For some, the buffalo hump can be a source of embarrassment, leading to lowered self-esteem and anxiety in social settings.

Potential Complications

If left untreated, a buffalo hump can lead to further complications. The most common issues include chronic pain, worsening of postural problems, and potential damage to the cervical spine. Moreover, if the hump is linked to an underlying condition, ignoring it can exacerbate the primary health issue.

Diagnosis

To diagnose a buffalo hump, a doctor will begin with a thorough medical history and physical examination. The goal is to determine the cause of the fat deposit and rule out any serious underlying conditions.

Steps in Diagnosis

1. Medical History: Your doctor will ask about your medical history, any medications you are taking, and whether you have experienced any hormonal symptoms or significant weight changes.

2. Physical Examination: A hands-on assessment of the neck and upper back area will be done to evaluate the size and consistency of the fat deposit.

3. Blood Tests: Blood tests may be ordered to check hormone levels and assess for conditions like Cushing’s syndrome or thyroid disorders.

4. Imaging Studies: If necessary, imaging tests like X-rays, MRI, or CT scans may be used to provide a clearer picture of the lump and its relationship to surrounding tissues. These tests also help rule out spinal problems or tumours.

Endocrinology Consultation

In some cases where a hormonal imbalance is suspected, you may be referred to an endocrinologist. They can perform additional tests to pinpoint the issue and recommend appropriate treatment.

Treatment Options for Buffalo Hump

The approach to treating a buffalo hump depends on the underlying cause. Let’s explore the most common treatment options, from lifestyle modifications to surgical interventions.

1. Lifestyle Modifications

For cases linked to obesity or poor posture, simple lifestyle changes can make a difference:

• Dietary Changes: A balanced, low-calorie diet can help promote weight loss and reduce fat deposits. Focus on whole foods like fruits, vegetables, lean proteins, and healthy fats.

• Exercise: Regular exercise, including cardiovascular activities and strength training, can help shed excess weight. Targeted neck and upper back exercises may also improve posture and reduce the prominence of the hump.

• Postural Training: Practising good posture can alleviate discomfort and make the hump less noticeable. Ergonomic workspaces and exercises like yoga or Pilates may help.

While lifestyle changes may not completely eliminate a buffalo hump, they can contribute significantly to overall well-being and physical appearance.

2. Medical Management

In cases where the hump is caused by medication, such as corticosteroids, your doctor may suggest adjusting the dosage or switching to an alternative treatment. Always consult your healthcare provider before making any changes to your medication regimen.

Hormonal Treatments

If a hormonal disorder is identified, specific treatments may be recommended to address the imbalance. This may involve hormone replacement therapy or medications that reduce cortisol levels.

Pain Management

For those experiencing pain or discomfort, pain-relieving medications or physical therapy may be beneficial. Physical therapy can help strengthen the muscles around the neck and upper back, reducing strain and discomfort.

Surgical Options for Buffalo Hump Removal

When conservative treatments fail to provide relief or the hump is large and bothersome, surgical options may be considered. Here’s an overview of the most common surgical procedures:

1. Liposuction

Liposuction is a popular and effective surgical option for removing excess fat deposits, including buffalo humps. Here’s how it works:

• Consultation: The process begins with a consultation with Mr Nassab. During this visit, we will assess the fat pad, discuss your expectations, and determine if you are a good candidate for liposuction.

• Anaesthesia: The procedure can be performed under local or general anaesthesia, depending on the size of the hump and patient preference.

• Procedure: We make small incisions around the fat pad. A cannula, a thin tube, is inserted to break up and suction out the fat. The incisions are then closed, and the area is dressed.

• Recovery: Swelling and bruising are common after liposuction and typically subside within a few weeks. You may be instructed to wear a compression garment to minimise swelling and promote healing.

Pros of Liposuction

• Minimally invasive

• Short recovery period

• Immediate results

Cons of Liposuction

• Possible risks, including infection, bleeding, and scarring

• Results may vary depending on skin elasticity

2. Excision Surgery

In cases where the fat pad is dense or fibrous, excision surgery may be necessary. Sometimes we may be able to break down the fat with Vaser liposuction but sometimes excision may be required. This procedure is more invasive than liposuction but can effectively remove a large hump.

• Procedure: We make an incision and removes the fat tissue manually. This method may be used if liposuction alone is insufficient.

• Recovery: Recovery is longer than with liposuction, and patients may need to limit physical activity for several weeks.

Risks of Excision Surgery

• Infection

• Scarring

• Prolonged recovery period

Despite these risks, excision surgery can provide more dramatic and lasting results, particularly for large or fibrous humps that do not respond well to liposuction.

Non-Surgical Treatments for Buffalo Hump

For individuals who are not candidates for surgery or prefer a less invasive approach, non-surgical treatments may be an option. While these methods may not deliver the same level of results as surgical procedures, they can still be effective for some patients.

1. Cryolipolysis (Fat Freezing)

Cryolipolysis, commonly known by the brand name CoolSculpting, is a non-invasive procedure that uses cold temperatures to destroy fat cells. The fat cells are gradually eliminated by the body over the course of several weeks. Here’s what to expect:

• Procedure: An applicator is placed over the buffalo hump, delivering controlled cooling to the fat cells. The treatment typically lasts 30 to 60 minutes per session.

• Results: Results are gradual and may require multiple sessions. While some patients experience a significant reduction in the hump, results vary depending on the individual.

Pros of Cryolipolysis

• Non-invasive

• Minimal downtime

• Gradual, natural-looking results

Cons of Cryolipolysis

• Requires multiple sessions

• Results may be less dramatic compared to surgery

• Potential side effects include temporary numbness and redness

2. Fat Dissolving Injections

Kybella, an FDA-approved treatment for submental fat (double chin), is sometimes used off-label to treat small buffalo humps. Kybella injections contain deoxycholic acid, a substance that breaks down and absorbs fat cells. Kybella is not widely available in the UK but Aqualyx is often used as a similar product. These have limited results on larger areas.

• Procedure: The treatment involves a series of injections directly into the fat pad. Multiple sessions may be necessary to achieve the desired results.

• Recovery: Swelling and bruising are common side effects, but these typically subside within a few days.

Pros of Fat Dissolving Injections

• Minimally invasive

• Can be performed in an office setting

Cons of Fat Dissolving Injections

• Requires multiple treatments

• Swelling and discomfort are common post-treatment

• Results may not be as effective for larger humps

3. Radiofrequency and Ultrasound Therapies

These non-surgical treatments use energy to break down fat cells and tighten the skin. Procedures like Ultherapy and Thermage are examples of such therapies. While these methods may not deliver the same level of fat reduction as liposuction, they can improve skin tone and contour.

• Procedure: Energy is delivered to the fat and skin layers, causing fat cell destruction and collagen stimulation.

• Results: Gradual improvement in the appearance of the hump, usually after multiple sessions.

Pros of Radiofrequency and Ultrasound

• Non-invasive

• No downtime

Cons of Radiofrequency and Ultrasound

• Results are subtle and may require ongoing treatments

• Not effective for large fat deposits

Recovery and Aftercare

The recovery process varies depending on the chosen treatment. Surgical options like liposuction or excision surgery require more downtime and post-procedure care compared to non-surgical methods.

Aftercare Tips for Surgical Procedures

1. Follow-Up Appointments: Attend all scheduled follow-up visits to ensure proper healing and to address any concerns.

2. Pain Management: Use prescribed medications to manage pain and inflammation. Over-the-counter pain relievers may also be recommended.

3. Compression Garments: Wearing a compression garment can help reduce swelling and support the treated area.

4. Activity Restrictions: Avoid strenuous activities and heavy lifting for several weeks. Light walking is encouraged to promote circulation and prevent blood clots.

5. Scar Care: Your surgeon may recommend scar treatment options, such as silicone sheets or topical creams, to minimise the appearance of scars.

How Much Does Buffalo Hump Removal Cost in the UK?

The cost of buffalo hump removal depends on several factors, including the type of procedure, the complexity of the case, and the surgeon’s expertise. Here’s a general breakdown:

• Liposuction: From £4500. The final price may depend on the amount of fat to be removed and whether general anaesthesia or hospital admission are required.

• Excision Surgery: From £6500. This is typically more expensive due to the invasive nature of the procedure.

Insurance Coverage

In some cases, buffalo hump removal may be covered by insurance if it is deemed medically necessary, such as when it causes pain or mobility issues. However, cosmetic treatments are generally not covered. Check with your insurance provider for more information.

Why Choose Mr. Reza Nassab for Buffalo Hump Removal?

Mr. Reza Nassab is a highly respected plastic surgeon known for his expertise in body contouring and fat removal. His patient-focused approach ensures each treatment plan is bespoke and designed to achieve natural-looking, long-lasting results. With a wealth of experience in performing liposuction and complex fat pad excisions, Mr. Nassab provides compassionate care and meticulous attention to detail.

Conclusion

A buffalo hump can be both a cosmetic and functional concern, but with the right treatment plan, it is possible to improve your quality of life and confidence. Whether you opt for lifestyle changes, non-surgical treatments, or surgical removal, consulting with a specialist such as Mr Nassab is the first step towards effective management.

If you’re considering buffalo hump removal, book a consultation with Mr. Reza Nassab to explore your options and get a bespoke treatment plan tailored to your needs. At our clinic, we prioritise your comfort, safety, and satisfaction, helping you achieve the best possible outcome.