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Surgical Management of Dorsocervical Fibro-Lipodystrophy (Buffalo Hump): Systematic Review and Meta-Analysis
Joseph M Escandón1, Chihiro Matsui2, Gabriel De La Cruz Ku3,4
1Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St, New York City, NY, USA. Joseph.Escandon.Medical@gmail.com.
Aesthetic Plastic Surgery
|May 4, 2026
Summary
Suction-assisted lipectomy is a safe and effective treatment for dorsocervical fibro-lipodystrophy (buffalo hump). Meticulous technique is key, though more prospective studies are needed to optimize management strategies.
Area of Science:
- Plastic Surgery
- Dermatology
- Metabolic Disorders
Background:
- Dorsocervical fibro-lipodystrophy, or buffalo hump, is a challenging deformity.
- Often linked to HIV-related lipodystrophy or idiopathic causes.
- Existing surgical techniques lack comprehensive outcome evaluation.
Purpose of the Study:
- To evaluate surgical interventions for dorsocervical fibro-lipodystrophy.
- Specifically assess suction-assisted lipectomy outcomes.
- Analyze safety, efficacy, and recurrence rates.
Main Methods:
- Systematic review and meta-analysis of 22 studies (218 patients).
- Searched PubMed and ScienceDirect for suction-assisted or excisional lipectomy outcomes.
- Used random-effects model; assessed heterogeneity and publication bias.
Main Results:
- Suction-assisted lipectomy was most common; pooled recurrence rate was 10.6% (1.4% after sensitivity analysis).
- Excisional and hybrid techniques showed 0% recurrence.
- Complications like seroma and hematoma were higher with excisional/hybrid methods.
Conclusions:
- Suction-assisted lipectomy is a safe and effective treatment for buffalo hump.
- Meticulous technique is crucial for optimal results.
- Low evidence quality necessitates prospective studies for management optimization.
