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How to Get Rid of a Buffalo Hump, excess fat behind the neck

Before and after photographs 3 months after neck liposuction for a buffalo hump.

Modern life makes many spend hours looking down and staring at a screen, either on our phones, work computers, or slouched on the sofa watching television. With this predisposition for poor posture and other factors, more patients are developing excess fat behind the neck, otherwise known as buffalo hump or widow’s hump.

What is a Buffalo Hump?

Buffalo hump is a term used to describe extra fat pad behind your neck and between your shoulder blades. Plastic surgeons refer to this fat as the dorsocervical fat pad. This excess fat can give an “old lady” appearance. The extra volume behind the neck itself is a cosmetic concern for many, but may be a possible sign of underlying an medical condition.

What causes a Buffalo Hump?

A hump behind the neck can be due to multiple factors, which may include:

  • genetics
  • poor posture – years of slouching may predispose one to accumulate fat in the posterior neck
  • excess cortisol hormone – Cushing’s syndrome, which may occur from a variety of causes such as long-term steroid use
  • osteoporosis
  • weight gain
  • lipodystrophy from HIV medications
  • fat redistribution after body liposuction

What is plastic surgery treatment for Buffalo Hump?

Before seeing a plastic surgeon, patients should see their primary care physician or PCP to evaluate possible medical causes of a buffalo hump. A simple physical examination will determine the presence of a buffalo hump, but a series of tests may be required for further evaluation.

In addition, a balanced diet and routine exercise should be a part of everyone’s lifestyle. However, an appropriate diet and exercise program alone is often insufficient for patients with a buffalo hump from neck fat. Cosmetic surgery is often required to reduce this excess fat volume.

Once the hump has been determined to be caused by excess fat and you’ve tried to correct your posture and to improve your lifestyle, then cosmetic surgery can be considered. Other potential benefits of buffalo hump plastic surgery that have been reported include increased range of neck and shoulder motion, improved posture, and decreased neck strain.

Liposuction

Liposuction is the primary method to improve the appearance of the neck from excess fat. This procedure reduces fat and stimulates skin tightening over time. Buffalo hump liposuction can be performed in the office via local anesthesia. In some patients, the fat may be quite fibrous or dense and thus require an incision through overlying skin and soft tissues for surgical reduction.

Patients after liposuction more often describe mild discomfort that resolves with over-the-counter pain medication alone, and prescription pain medication is typically not required after the first couple days. Patients are generally able to return to work within a week after neck liposuction surgery. Strenous activity, such as exercise, should be avoided for at least two weeks after neck liposuction.

Patients may notice an immediate reduction of neck fat, but results continue to develop over several weeks to months as skin tightens after buffalo hump liposuction. The majority of swelling resolves within a few days or so after surgery, however, the final contour improvement may take several months to become apparent.

Kybella®

Kybella is the newest method to reduce neck fat. It has been FDA approved to reduce fat under the chin to improve a double chin (i.e. submental fullness). However, plastic surgeons have used Kybella in other areas such as the posterior neck to reduce excess fat for those who don’t want liposuction. Read more about this nonsurgical fat reduction in our blog post Kybella vs. neck liposuction.

Patients have been happy with buffalo hump treatment with cosmetic surgery. Keep in mind, however, that fat can reaccumulate, especially with weight gain, and a procedure may need to be repeated.

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    Houtan Chaboki, M.D.