Dissector-Assisted Liposuction for Dorsocervical Fibrolipodystrophy (Buffalo Hump): Results from 57 Patients

BACKGROUND: Buffalo hump is fibrolipodystrophy in the posterior part of neck. Although established surgical treatments, such as lipectomy and liposuction, are available, they each have notable limitations. Lipectomy often leads to significant scarring, trauma, and prolonged recovery. Traditional liposuction encounters challenges such as high suction resistance and potential complications. The objective of this study is to introduce a novel technique-dissector-assisted liposuction-as a potential solution to address these limitations. METHODS: A case series study was conducted. The fibrous tissue was first dissected using a specialized dissector to reduce the resistance in the subcutaneous and deep fascia layers. The fibers within the buffalo hump were also carefully dissected. Once the resistance in the buffalo hump area was significantly reduced, a 3.5-mm harvesting cannula with a cutting edge was used to perform liposuction. A 5-point Likert scale was used to assess outcomes preoperatively and 6 months postoperatively. RESULTS: A total of 57 patients underwent dissector-assisted liposuction for buffalo hump treatment without complications. The average volume of the buffalo hump was 328.72 mL. Immediate improvements in appearance were observed in all patients. Six months after surgery, with the exception of scarring (which showed a median Likert scale value of 0 in both the preoperative and postoperative periods), the Likert scale value for the other 4 parameters showed a significant increase ( P < 0.05). CONCLUSIONS: Dissector-assisted liposuction offers several advantages, including the predissecting of fibrous tissue, reduction of fibrous tissue volume, and decreased resistance during liposuction, making it a promising approach for treating buffalo hump.