The buffalo hump neck deformity refers to a collection of fatty collections on the back of the neck. The size of the fat collection can vary greatly from small lipomas to very large hump-shaped fatty tumors. They can appear gradually with no apparent reason or can occur because of well known causes such as HIV lipodystrophy as the most recognized etiology of large buffalo hump deformities.
Appearing on the back of the head, they present as masses that stick out as the name implies. Because of their location they often create discomfort and restriction of neck extension. Their location on the back of the neck determines what type of treatment would be used to treat them.
Buffalo humps can occur at two different tissue locations. One anatomic location is partial intramuscular. These present as well formed and encapsulated lipomas. They can only be completely removed by an open excision. Their encapsulated form allows for complete removal from their partial intramuscular location.
Buffalo humps can also occur at the subcutaneous level. The native posterior neck subcutaneous fat becomes enlarged. The dysmorphic fat is not necessarily encapsulated like the traditional lipoma. It is more diffuse in nature and is often larger than the encapsulated lipoma. This form of buffalo hump can be treated by liposuction. Its subcutaneous location allows for it to be more easily and effectively removed. While open excision can be performed liposuction is usually the procedure of choice. Because of its more fibrous consistency, energy-driven forms liposuction are preferred.
Dr. Barry Eppley
Indianapolis, Indiana