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A Zone-Specific, Minimally Invasive Approach with a Rotary Cutting System for Moderate-to-Severe Fibrotic Buffalo
Renpeng Zhou1, Boyan Li1, Angang Ding2
1Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China.
Aesthetic Plastic Surgery
|April 27, 2026
Summary
A new zone-specific surgical technique using a rotary cutting system effectively treats fibrotic buffalo hump, improving aesthetics and mobility with minimal complications.
Area of Science:
- Plastic Surgery
- Minimally Invasive Surgery
- Aesthetic Medicine
Background:
- Management of moderate-to-severe fibrotic buffalo hump is challenging.
- Current treatments include suboptimal minimally invasive techniques and invasive open procedures.
- A novel zone-specific surgical strategy using a rotary cutting system was developed.
Purpose of the Study:
- To evaluate the efficacy and safety of a novel zone-specific surgical strategy for fibrotic buffalo hump.
- To assess aesthetic outcomes and functional improvement.
- To compare outcomes with existing treatment options.
Main Methods:
- Retrospective cohort study of 56 patients with fibrotic buffalo hump.
- Zone-specific strategy: rotary cutting system for avascular central zone (Zone I), blunt dissection and liposuction for vascular-rich peripheral zone (Zone II).
- Outcomes assessed via observer-rated aesthetic scale and patient-reported Neck Extension Mobility Score (NEMS).
Main Results:
- Mean follow-up of 8 months.
- 92.9% of patients achieved "Good" or "Excellent" aesthetic outcomes.
- Significant functional improvement: moderate-to-severe mobility restrictions decreased from 69.6% to 5.4% (NEMS 3-4).
- Minor complications: transient numbness (25.0%), seroma (3.6%), no hematoma or infection.
Conclusions:
- Zone-specific rotary cutting system application is a safe and effective advanced minimally invasive option for fibrotic buffalo hump.
- This technique bridges the gap between minimally invasive and open surgical procedures.
- Offers improved aesthetic and functional outcomes for challenging cases.
